How long does it take for Botox to smooth out Frown lines?

Question

I received 20 units of Botox today for two frown lines- the provider told me that Botox simply prevents you from being able to frown therefore preventing wrinkle progression. But she stated I would not see any difference in the existing creases after the first treatment. She stated it may take up to 6 treatments before the lines are gone. My lines are pretty faint as I'm only 30. I've never heard this before and I was pretty depressed. Is this accurate?

Nelson Lee Novick, MD · Answer

I have been using Botox for aesthetic reasons since 1991. During that time I believe I have seen the entire range of response times to treatment. For most people this is typically between one to seven days following treatment, and much less commonly in my experience up to two or three weeks to see full effect. On a couple of occasions in the past twenty-five years, I have encountered patients who responded within hours of treatment, but as I said this is quite rare. Botox, as well as its competitor muscle relaxers, Dysport and Xeomin, all work to soften dynamic muscular movement, i.e. the movement of the muscles of facial expression, which in turn can help to prevent or slow the progression in the development of static wrinkles. These agents do not affect static wrinkles, i.e. wrinkles and creases in the skin that remain when the muscles are at rest. So, if lines persist at rest following Botox treatment, these are the creases left after years of emoting 1000+ times per day, every day, for years, and these, if so desired, may be additionally addressed with the use of fillers. Repeated Botox treatments, performed in a series of about four to six treatment sessions spaced at a fixed four month intervals, have been associated with achieving far more prolonged results, considerably longer than the usual four to six months, but they do not deal with wrinkles at rest that have already formed. Those, as I have mentioned, are best treated with the use of injectable fillers.

Kian Karimi, MD, FACS · Answer

Thank you for your question. Botox takes approximately 1-2 weeks to full take effect on the treated muscles. It is impossible to say exactly how many Botox treatments will be warranted in order to smooth out the frown lines you are noticing. With that said, for many patients with deeper wrinkles, 1 Botox treatment may not be enough to provide visible improvement. In these cases, I usually supplement the Botox treatment with the addition of hyaluronic acid fillers, which can temporarily fill deeper creases until cumulative Botox treatments soften the lines over time. I recommend discussing these concerns with your injector and he/she may be able to offer other suggestions to address the lines you are worried about. Best of luck.

Rod J. Rohrich, MD · Answer

Botox works by temporarily weakening the muscles. Botox will take approximately 7-10 days before seeing the full effect. This effect lasts about 3-4  months. This should be done in the hands of a Board Certified Plastic Surgeon or Dermatologist with expertise in the use of neuromodulators such as Botox, Dysport, or Xeomin.

Martin Jugenburg, MD · Answer

Thank you for your question. It is true that Botox will prevent the action which creates lines. It can take a couple of Botox treatments to assess the maximum results of frown line reduction. 6 treatments seems like too many... Perhaps wait 2 or 3 treatments and if the lines still persists consider filler. Best,

Jason Emer, MD · Answer

Botox takes 1-2 weeks to see the effects. I suggest you see an expert for treatment.  Best, Dr. Emer.

Andrea Marando, MD · Answer

Thank you for your question. the "onset" of the effect depends on the kind of botulinum toxin used and the visibility of the result, on average, on the severity of the problem treated. The result is normally noticeable at about 2 weeks and carries on improving well beyond that.If this is the first time you have been treated, the best way to monitor the cosmetic result is to have photographs taken before and 4 weeks after the treatment  in the same conditions of light, same place, same camera.Hope this helps.Kind RegardsAndrea Marando

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. Typically, the results following Botox injection are seen at 1 week post treatment and do not improve much following repeat injections. Results can last longer following multiple treatments over years. Good luck,

Alim R. Devani, MD, FRCPC · Answer

Thanks for your question. This is a question that we
get asked often by our patients.  As far as Botox treatments, muscle
hyperactivity would likely require treatment 3 times a year.  Botox
effects can last anywhere from 4-6 months and with recurrent treatments, this
will lead to mild atrophy of the muscle, and some prolongation of Botox's
effects.  Botox effects are never permanent, however, if you elected to
stop, your muscle would hypertrophy back to its original size. These are
advanced techniques so be sure to get an experienced cosmetic dermatologist
consultation for recommendations and treatment options.

Chad Robbins, MD · Answer

Thank you for your question.  Botox will relax those lines which will be less noticeable and prevent them from getting deeper if you get the area treated every 3-4 months .

Jennifer Trent, MD, FAAD · Answer

Botox can take up to 2 weeks for maximal effect to be seen, but some patients will see results in a few days.  Botox targets dynamic lines, or lines that result from muscle movement.  It may over time soften the lines you have at rest, but it does take several treatments.  Botox is not an eraser, just a muscle relaxer.  Good luck!

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