What if your Botox "doesn't work"?

You had Botox few times already and know what to expect, you see the same provider over the years, and suddenly just when you need it the most your results are not as good as before.
Botox, although usually predictable, is not an exact science. I personally had couple of cases of variations on the same patient that I've injected more than 5 times, same dose, placement and same Allergan-certified product. The answer is always the same: notify your injector, come in for a follow up so results are properly documented, get your touch up or free treatment provided by Allergan.
Anatomy is almost the same in everyone, almost: men have much heavier bigger muscles and tend to need much more product than women, some people have longer or shorter corrugators (muscles that create "number 11s") which can alter the position of the brows after the treatment.
Metabolism plays a great role in longevity of the product: few patients of mine who are bodybuilders go through the product in few weeks. I've also had a case of a young woman who had Botox done by me several times coming in just a month complaining it was gone. It turned out she was going through a tremendous amount of stress recently and started going to the gym every day, which increased her metabolism significantly. She still had a complimentary treatment and was extremely happy, but we've learned why it happened.
I always advise my patients to take Zinc picolinate (50 mg daily for 5 days prior to the injection of Botox) to prolong the results. Zinc plays a key role in metabolism of Botox, it makes the product attach to the nerve faster and hold on to it longer. You can find it at Whole Foods stores or on Amazon.
Word of caution: it is a good idea to check out your provider's reputation and make sure they only use certified product through Allergan, the maker of authentic Botox. Only then you can be sure your product came from the United States and only then you can count on complimentary treatment in case if your product didn't work.
Lastly: communication is key! Always talk to your provider about your concerns, always come back for the follow up if you are not completely happy, the only way you can count on compensation is by showing your face.

Complications

I'm one of those very lucky people who love their job. I love people in and out: socially and anatomically. I enjoyed every surgical case I participated in: suturing blood vessels under the microscope for muscle flap, breast reconstructions and reductions, tummy tucks, working with intricate tendon systems of the hand and perfect architecture of the bones.

As a student during my surgical rotation at Faulkner Hospital I was lucky to scub in on thyroidectomy case with legendary Doctor Atul Gawande. He wrote a very well known book "Complications" that is a part of curriculum in medical schools. The essense of the book is figuring out how do mistakes happen in medicine and how to prevent them. He described a small hospital that only dealt with appendectomy and quoted their complication rate was many times smaller than the rest of the hospitals. The moral of the story was that very narrow specialization and focus of the practice allows medical provider to almost automate the procedure thus lowering the risk.
At the beginning of building of my practice I offered many services: cellulite treatment, hair transplantation, eyelid tightening, earlobe repairs and many more. Until I sat down to analyze what I'm doing and wrote a business plan. It turned out that I was offering procedures that a) I don't enjoy doing b) not an expert in particular field. I had to be honest with myself and it turned out that I loved working with faces and more of an expert and enthusiast about proportions, esthetics, and anti-aging of the face. And that most people are seing me namely for that.
Thinking of Gawande's example I truly believe narrow focus of the practice allows performing all procedures very efficiently with highest rate of satisfaction and lowest rate of complications.