There have been clinical studies where tolderance have developed, due to clinical use of botulinum toxin type A. What was found that the higher and the more frequent dose, the greater the risk of developing antibodies to the product. However, more studies need to be performed to assess the immune responses and to detect the underlying cause, as in this particular study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872090/#!po=3.12500, all 5 cases developed antibodies after their initial treatment of recommended ‘standard’ dosing from the pharmaceutical companies, and has second treatment failure. In some cases, the patient was switched from using onabotulinumtoxinA to abobotulinumtoxinA and there was a slight response, but on the third treatment, there was no response.
In summary, the studies show that immune responses can occur even with low, infrequent doses of anti-wrinkle injections, and there needs to be more studies to conclude the true prevelance of resistance to anti-wrinkle injections.
At Cityskin, our motto is “fresh, not fake”, so we would prefer to inject less, give natural results and add more at the next treatment, generally 3-4 months after the initial treatment, as recommended by the pharmaceutical companies for repeat injections. This would lower any potential risk of developing antibodies to anti-wrinkle injections.