Myobloc for Botox Resistance in Newport Beach
If Botox has completely stopped working — not faded faster, not worked less well, but stopped working entirely — you may have developed true Botox resistance. There is a solution.
True Botox resistance is rare, but it is real. It occurs when the immune system develops antibodies against botulinum toxin type A — the active ingredient in Botox, Dysport, and Xeomin. For patients in this situation, switching brands makes no difference because all three use the same toxin type.
Myobloc is different. It is the only FDA-approved botulinum toxin type B available in the United States. Because it uses an entirely different toxin type, it works in patients for whom type A treatments have become completely ineffective.
At Plump Medical Spa in Newport Beach, Dr. Amir Mortazavi, MD offers Myobloc specifically for patients with confirmed type A resistance — not as a general Botox alternative, but as a targeted solution for a specific clinical situation.
This page is for one specific patient: someone who has tried Botox — and at least one other type A neurotoxin — and seen zero results. If your Botox is simply wearing off faster than it used to, that is a different issue and a different conversation.
I developed Botox resistance myself. I have personally experienced what it feels like to stop responding to a treatment that used to work — and I use Myobloc myself. When I tell a patient this approach works, it is not something I read in a study. It is something I live.
— Dr. Amir Mortazavi, MD · Founder, Plump Medical SpaWhat is true Botox resistance?
Botox resistance develops when the body produces neutralizing antibodies against botulinum toxin type A. These antibodies bind to the toxin before it can act on the nerve-muscle junction, rendering it ineffective.
It is important to distinguish true resistance from other reasons Botox may underperform:
No response whatsoever after injection — even with adequate dosing by an experienced injector. Has typically tried Botox, Dysport, or Xeomin with zero effect across multiple attempts.
Results that wear off faster than they used to, weaker effect than expected, or inconsistent outcomes. These are usually dosing, technique, or product storage issues — not immune resistance.
Dr. Mortazavi evaluates each patient carefully before recommending Myobloc. The distinction matters because the treatment, dosing, and expectations are entirely different.
How Myobloc is different from Botox
All commonly used neurotoxins in the United States — Botox, Dysport, Xeomin, Jeuveau — are botulinum toxin type A. If you have developed antibodies against type A, none of these will work regardless of brand, dose, or injector skill.
Botulinum toxin type A. All four share the same mechanism. Patients with type A resistance will not respond to any of them.
Botulinum toxin type B. Entirely different mechanism of action. Not affected by type A antibodies. The only FDA-approved type B toxin available in the US.
Myobloc has a faster onset than type A toxins and a somewhat different injection feel — both of which Dr. Mortazavi will discuss in detail at your consultation.
What to expect
Consultation
Dr. Mortazavi will review your full neurotoxin history — which products you have tried, at what doses, with what results. True resistance is confirmed by a pattern of complete non-response across multiple type A treatments, not just one disappointing experience. This evaluation is essential before proceeding.
Treatment
Myobloc is injected directly into the target muscles, the same way Botox is administered. The onset is typically faster than type A toxins — many patients notice results within 24 to 48 hours. Topical numbing is available for comfort.
Duration
Duration with Myobloc varies by patient and treatment area. It is generally discussed individually at consultation based on your history and goals. As with any neurotoxin, results are temporary and maintenance treatments are required.
Follow-up
A follow-up assessment allows Dr. Mortazavi to evaluate the response and adjust dosing for future treatments if needed. Finding the right dose for a new-to-Myobloc patient is a calibration process, and he approaches it with the same precision as initial treatment.
Dr. Mortazavi is one of a small number of aesthetic physicians in Southern California offering Myobloc specifically for resistance cases. He has personal experience with Botox resistance and uses Myobloc himself — which means his understanding of this treatment goes beyond clinical training. All consultations and injections are performed personally by Dr. Mortazavi. No nurses or assistants.
Frequently asked questions
How do I know if I have true Botox resistance?
True resistance means zero response — no movement reduction at all — after injection with a type A neurotoxin at an appropriate dose by an experienced injector. If you have tried Botox and at least one other type A brand (Dysport or Xeomin) with no effect whatsoever, you may have true resistance. Faster wear-off or weaker-than-expected results are generally not resistance.
Does Myobloc work differently from Botox?
Yes. Botox and all other commonly used neurotoxins in the US are botulinum toxin type A. Myobloc is botulinum toxin type B. It works through a different mechanism at the nerve-muscle junction, which is why it remains effective for patients whose immune systems have neutralized type A toxins.
Will Myobloc feel different than Botox?
Myobloc has a lower pH than type A toxins, which can cause a brief stinging sensation at the injection site. Most patients find it very manageable, especially with topical numbing. The onset is typically faster — often noticeable within 24 to 48 hours — which many patients appreciate after years of delayed or absent results.
Can I develop resistance to Myobloc too?
Theoretically yes, though type B resistance is considered less common. This is one reason Dr. Mortazavi approaches Myobloc treatment carefully — using the appropriate dose rather than over-treating — to minimize the risk of antibody development over time.
Is Myobloc FDA-approved?
Yes. Myobloc (rimabotulinumtoxinB) is FDA-approved. Its primary approval is for cervical dystonia, and its use for cosmetic resistance cases represents physician-directed off-label use — which is common and legally appropriate in aesthetic medicine, particularly in situations where approved treatments have failed.
Do you treat patients who come from other practices?
Yes. Many of Dr. Mortazavi’s Myobloc patients have spent years trying different injectors and brands with no results. A consultation at Plump begins with a thorough review of your full treatment history to confirm whether Myobloc is the right path forward.
Why does Plump offer this when most med spas don’t?
Most aesthetic practices focus on the majority of patients who respond normally to type A toxins. Myobloc requires familiarity with a different dosing approach, a different product profile, and a patient population with complex histories. Dr. Mortazavi offers it because he has personal experience with resistance — and because patients who genuinely cannot be helped by Botox deserve an option.
Schedule a consultation
If Botox has stopped working entirely, a consultation with Dr. Mortazavi is the right first step. Myobloc is available at Plump Medical Spa in Newport Beach, serving patients throughout Orange County and Southern California.
4667 MacArthur Blvd, Suite 310 — Newport Beach, CA 92660
(949) 568-7544 — info@plumpmedicalspa.com
Tuesday – Saturday, 10am – 6pm — By Appointment Only