Question (from a person treated in NY): I got 60 units of Dysport in my forehead 11s and a unit or 2 in the brow to lift it.. Nothing happened. It's been 7 days. What went wrong??? Dysport dosen’t work on me? Bad batch of Dysport?
Dr A’s Answer: I am not certain exactly what muscle(s) you had treated with Dysport. 60 units that was properly placed in the glabella (corrugator supercilii muscle, the muscle that causes the 11s) is usually a sufficient dose. However, if that 60 units also included a forehead treatment (frontalis muscle, the muscle that causes horizontal lines), then it was only about half of what was needed (or less). So, dosage could be the problem.
Another possibility is that you weren't properly informed about what to expect. Dysport and Botox only stop the muscle that caused the wrinkle (11s). It does not repair the skin if it is already damaged. For your whole life, you have been "pounding" on that skin every time you furrow your brow. That repeated furrowing of the brow over time breaks the skin down, much like if you bend anything over and over in the same spot. The skin can repair itself to some extent, so over time deep creases will get a bit better if you stop furrowing the brow using Dysport/Botox. For most of my new patients who already have developed creases, a single treatment of Restylane is used to fix the crease and the Dysport/Botox is used to keep it that way. That combination is very powerful and can eliminate even the deepest of creases.
Now if you still have full ability to furrow your brow, then the Dysport didn't work. Either it was not placed properly in the muscle, not enough was used, or you are immune. Some people require more than others, but actual immunity is extremely rare. In the vast majority of cases, the problem is failure to place the Dysport into the muscle properly . . . the target was missed. Dysport typically takes 1 to 3 days to have a substantial result and by 7 days it is almost always fully functioning. In contrast, Botox is 3-5 days before any affect is seen and 1 to 2 weeks for 100%.