We’ve spent our whole lives being inundated with information about how to speed up our metabolism—thanks, diet culture!—but when it comes to injectables, a fast metabolism can feel like the enemy. Bodies have different rates of processing neurotoxins and hyaluronic acid fillers, and some unlucky people find that their injection results last a shorter period of time than the typical three to four months for the former and the five months to two years for the latter (depending on the formula). These patients are sometimes referred to as hypermetabolizers, and if you’re one, you may be feeling frustrated with the life span of what’s in your syringe.
Ahead, doctors explain why some people run through Botox, Juvéderm, or other injectables more quickly than others and what, if anything, can be done to slow down the metabolic breakdown process.
Why do some people metabolize neurotoxins and dermal fillers faster than others?
An individual’s muscle mass and level of exercise are generally assumed to play a part in how long the effects of injectables stick around, but we don’t yet have hard answers as to how exactly metabolism factors in. Dr. Heidi Waldorf, a board-certified dermatologist in Nanuet, New York, explains, “Anecdotally, we’ve all seen active patients, particularly lean runners, who don’t seem to ‘hold’ fillers as well. We tend to say they must metabolize it faster, but truly we don’t know.” Dr. David Shafer, a board-certified plastic surgeon in New York City, points out, “There are just as many cases of people who have a fast metabolism and fillers that last a long time.”
Most experts can agree that the life span of your filler or neurotoxin depends on a complex individual processing of the formula that may or may not be directly related to how quickly you burn through your lunch. So what else could be at play? The type, depth, and amount of formula used plus the area it’s placed in, since very mobile areas, like the lips and the glabellar lines, get more blood flow.
Additionally, Dr. Brock Ridenour, a board-certified facial plastic surgeon in St. Louis, says to take a look at sources of stress in your life, including “psychological stress, lack of sleep, smoking, obesity, excessive alcohol, physical inactivity, and ultraviolet radiation.” These things all tax the body, and they may be impacting your injectables.
Could a patient be overestimating the speed at which their injectables wear off?
Possibly—it’s not uncommon for patients to have unrealistic expectations for the staying power of their injectables. Dr. Waldorf often sees what she calls “perception drift,” meaning, “[patient] perception of what they looked like before has shifted, so they don’t really remember [their baseline].” Weight changes, particularly when overall fat in the body is reduced, can also have an impact on the look of fillers. To get a better sense of how quickly you’re really going through your neurotoxin or filler—and whether you’re becoming blind to its effects—take photos or videos of facial movement before your appointment and then on a weekly basis after.
Dr. Shafer says it’s important to remember that results always wear off gradually, not instantly—no one’s day-14 Botox results are the same as their day-60 results. Even with a filler that has a two-year duration, like Juvéderm Voluma, a patient may still need to have maintenance booster treatments every year in order to keep up the results over time. “I like the analogy of filling your tank with gas. Don’t wait until you are running on empty for a refill,” he says.
Can certain neurotoxins or fillers metabolize faster than others?
For fillers, the answer is yes, but it typically comes down to a difference in formulation rather than a direct comparison of similar products by different brands. Non hyaluronic acid–based fillers, including Bellafill, Sculptra, and Renuva, will last longer; however, these tend to be used for more significant volume loss and aren’t reversible, unlike HA-based injectables.
More often, the advice for the more dynamic areas—think: lips, nasolabial folds, and cheeks—typically treated with HA fillers is to switch to another formula with a longer-lasting bonding type. “The particle size and cross-linking of the HA molecules, affects how long the filler lasts, says Dr. Dara Liotta, a board-certified facial plastic surgeon in New York City. “The larger the particle and the more cross-linking, the longer the product lasts, because the longer it takes your natural hyaluronidase [the enzyme in our blood that breaks down HA] to break down the injected filler.”
Restalyne Silk, for example, lasts around six months; Juvéderm Ultra XC and Ultra Plus XC can stick around up to 12 months; and Juvéderm Vollure, Volbella XC, and Voluma can last between one to two years.
When it comes to the neurotoxins—that’d be Botox, Xeomin, Dysport, and Jeuveau—you might see slightly longer-lasting results with one versus the others, but generally, the difference is small. You can get a longer-lasting effect with more product, if the amount injected in previous appointments had been on the conservative side. However, Dr. Jason Emer, a board-certified dermatologist based in West Hollywood, California, warns, “You will sacrifice being frozen for a while, for it to last longer.”
Related: How to Make Your Lip Filler Results Last Longer
Will not exercising help filler and neurotoxin last longer?
Doctors typically recommend that patients refrain from intense exercise for three days following injectables in order to give them time to settle in and work their magic, but after that, the resounding consensus is to resume exercising as usual. “There is no evidence to suggest excessive exercise contributes to the dissolution of filler,” insists Dr. Ridenour, and doctors caution that it’s not worth losing out on the health benefits, even if it does. “In general, I think [you] should just relax, exercise, and let your Botox and fillers work for you—don’t work for your injectables. There’s always another syringe,” says Dr. Liotta.
Can zinc help counteract the effects for a hypermetabolizer?
The jury is out, but you can probably skip the supplement. Though one 2012 study showed that zinc increased the duration of the effects of neurotoxin by almost 30%, the doctors we spoke with haven’t seen great benefits to taking it. Dr. Emer says that, years ago, people were raving about a supplement called Zytaze that was claimed to help prolong the effect of toxin, but the buzz quickly dropped off and the product is not well-marketed, which means patients likely haven’t seen big effects.
However, he points out, “zinc is great for sleep, muscular healing and fatigue, immune and metabolic function, and wound healing.” So if you want to try it and get clearance from your doctor, it could be providing you with other benefits, at the very least.
Bottom line: Can you slow your metabolism of injectables?
You might be able to “hold on to” your neurotoxin or filler a tad longer with healthy choices like getting enough sleep, putting on sunscreen, and lowering stress, but it’s not worth bumping down your workouts or reordering your life. You’re better off trying a longer-lasting product (if that’s an option), considering a more permanent surgical solution, or simply making peace with more frequent maintenance appointments.
