Do Facial Muscles Weaken from Botox Use?

Because you can no longer use the facial muscles while the Botox lasts, doesn't this mean that over the duration of using this product, that your muscles will weaken? Like any muscle in the body, the more you use it the stronger and more toned it becomes. Why would this not be true for the face also?

Doctor Answers 9

Yes, facial muscles weaken after consistent Botox use

Thank you for your question. Yes, facial muscles do weaken over time after having Botox injected regularly. This is a positive thing, because it means that eventually you won't have to receive Botox injections so often, because relaxed muscles don't cause as many wrinkles. For safe, optimal results, Botox is best injected by a certified plastic surgeon or dermatologist.

Toronto Facial Plastic Surgeon
4.8 out of 5 stars 147 reviews

Facial Muscles Are Slow To Atrophy With Botox

Botox in the muscles of facial animation, frowning, squinting, etc. are very slow to atrophy. I was the hope at the time that Botox was released that just several injections would weaken the muscles enough that follow-up treatments would drop off dramatically. This has not proven to be the case for the muscles of facial expression.There is some disuse atrophy, but the effects happen slowly, and it takes a while to change the amount or frequency of treatment.

Botox affects the ability of the nerves to release the transmitter that triggers the muscle motion. In the facial muscles of expression, the receptors are quick to regrow.

Edward Szachowicz, MD, PhD
Minneapolis Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Facial Muscles do Weaken with Repeated Botox Use

There does appear to be some weakening of muscles treated with Botox after repeated injections.  This probably is due to "disuse atrophy".  The result of this is that the Botox injections will last a bit longer and can be reinjected after longer periods of time.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Facial muscle and Botox

Absolutely, the facial muscles will weaken if it is repeatedly paralyzed with Botox.  Therefore, you will find that return visits for Botox may extend longer and longer in time.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Facial Muscles Weaken With Repeated Botox Injections

It is helpful to have weakened muscles in the areas of facial wrinkles in the upper one third of the face. This means that with time you need the Botox less frequently and save money.

This is an advantage and not a downfall of Botox.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 107 reviews

Muscles weaken with Botox

You are correct - with repeated and consistent use of Botox, the facial muscles which are being treated will weaken. This can be a good thing and lead to some patients going several months if not a year or more between treatments.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Facial muscles weaken after Botox

Yes, they do. Prolonged period of muscle rest are accompanied by muscle wasting (disuse atrophy) (Recall the feeling how your arm felt after being freed from 4 weeks in a cast or watching Astronauts attempting to walk after a few weeks in space?).

Since the muscle we target with Botox are used to snarl, frown, pull the brows down etc - permanently weakening these muscles is actually beneficial.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Botox and Long Term Effects on Facial Muscles

Hey UK,

Botox does weaken muscles. In the upper 1/3 of the face it is used to weaken the muscles that create aging wrinkles. Constant use of Botox for about 2 years results in atrophy of these muscles which results in a smoother, more youthful forehead. Take a look at patients who have had the unfortunate experience of having a facial nerve paralysis either from Bell's palsy, trauma, or surgery. They do not have wrinkles on the affected side. When used properly, Botox is safe and effective over time, and there are no long term adverse effects.

Good luck and be well, regards to the Queen.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Botox is safe because you don't need strong facial muscles.


The only purpose of facial muscles (unlike all other muscles) is to show emotion. To do that, they drag the skin around and create wrinkles. So you don't want to look "frozen" (from too much Botox or improperly injected Botox).

But a little weakness in these muscles is a good thing (fewer wrinkles). That's why Botox is safe.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.