Are Botox Results Permanent After Long-term Use?

I read somewhere that Botox results become semi-permanent after perhaps 8-12 treatments. Is this true? If so, would it only be true for certain areas or for any area treated with Botox? I'm getting Botox for down-turned corners. Thank you!

Doctor Answers 21

BOTOX results are usually not permanent

Botox causes weakness of muscles which are causing wrinkles or in your case, downward turning of the corners of the mouth. Over repeated treatments, the muscles will atrophy, provided there is not a long period between the time the effect of Botox wears off and your next injection.

I tell my patients you can think of Botox as a chemical cast on the muscles. Just like when you wear a cast on your leg or arm, the muscles get weak and smaller over time. But when the cast comes off, you can build your muscles back to the same shape they were in before. What you can expect over repeated injections is that the dosing might lessen, and potentially the length between treatments might get longer. In some cases, longer might be 9 months or more, but usually not permanent.

Panama City Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

Not permanent

Botox typically lasts for about 3-4 months but with regular appointments you can experience prolonged results so that you no longer have to have appointments scheduled as often as before. This is true for anywhere you have treated. 

Permanent results after Botox?

This really depends on the patient and the concern targeted. It is true that repeated treatments can prolong results, but they may not be permanent and last just a few months longer.

Botox results are not permanent

Botox results are only temporary, and typically last 3-4 months for most people.  For those who get injected at regular intervals over time, however, the results can sometimes last a little bit longer, since the muscles have been immobilized for a long period and can atrophy.  That said, once Botox use is discontinued, they will slowly return to how they were initially, prior to treatment.

Steven Svehlak, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 21 reviews

Botox results are not permanent

I am not aware of any scientific reports that find that Botox effects are permanent.  With repeated use the muscles that Botox targets may atrophy, but with discontinuation of Botox treatment they should gradually return to normal.

Botox and long term effect

Botox can have a thoeretical  longer term effect over time for several reasons. I havent seen any studies concerning this but there are patients who get botox for blepharospasm (spasm of the eyelid muscles) that get a lower dose over the years. The reasons are the following:

1. As muscles become paralyzed they become atrophied or weaker. Thus you may need less botox to paralyze the muscle and even off the botox the muscle may not be as strong as they were before botox

2. Muscle memory - You may learn to not use the muscles injected with botox over time if they are constantly paralyzed. 

The botox returns function because the nerve end plates regenerate. It is an irreversible medicine in that the botox binds nerve receptors permanently. Function returns because new nerve receptors grow it. This is regardless of physical activity. 

Wikipedia describes how botox works. 

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Botox results not usually permanent with long term use.

Botox usually works for 3 to 4 months.  This depends on the dose, as well as the patient.  If the patient is hyper-metabolic, (i.e. in the gym twice a day) it may last a shorter period of time.  Likewise if a patient is very animated with the muscles of facial expression, this can also decrease the length of effectiveness.

Some will say that with continued use, the muscle will atrophy and one may use less Botox, or come in less frequently.  As of this writing, there are no good medical studies to show this.  Therefore we cannot say that Botox is permanent.

Jeffrey Roth, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 12 reviews

Botox results are never permanent

After repeated injections of  Botox, muscles can have disuse atrophy making them weaker. That will reduce the frequency of Botox injections but unlikely to be permanent.

In a way it is a blessing because any severe side effects or complications related to Botox will always be temporary.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 33 reviews

Permanant Botox Effect

Botox is a paralytic and thus stops the motion of muscles. The more the muscles go without moving the more they will atrophy or get smaller. Although they will never full go away continues Botox injection will make them very small. Therefore, less Botox is needed to keep the muscle from moving and the longer the effect will last. Stopping the Botox will allow the muscle function to return. It will eventually return to its pre-Botox state.

Repeated use of Botox may weaken but not eliminate muscles

To my knowledge, there are no widely accepted reports of this phenomenon. The muscles may weaken after repeated use but can return to normal after cessation of use.