Wrinkles Have Returned Only a Few Months After Botox, Is That Normal?

I had botox a few months back and now I can see the wrinkles come out again, which means my botox doesn't work anymore.

Doctor Answers 19

Usually lasts 4 months or so

Generally, results last about 4 months or so, therefore it is normal to see wrinkles returning. With repeated treatments, results may last longer. It also depends on the area treated, as some areas (particularly those with less movement) may have results that last longer.

Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Botox normally lasts for up to four months or less

Some patients only receive two months of benefit from Bototx and others up to four. Of course, there are those who obain less and others, more, of a duration. Three months is very normal. There might be some longer duration if the provider gives you more units of botox but this might increase the risks so they are probably giving you an adequate dose, but they should tell you if you are getting enough or should try some more units the next treatment.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Botox lasts 3 months

Botox lasts approximately 3 months, after this you should return to your baseline, meaning your wrinkles will return.  Consistent treatments (usually 3-4 times per year) is necessary to continue the effect.

Melanie D. Palm, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 23 reviews


Thank you for your question.

Yes, Botox is not permanent.. usually lasts 3-4 months depending on the patient so it is normal to see the effects where off.  Best to have good communication with the doctor who is injecting the Botox for you and see what other options you have  for a longer result.

Good Luck!

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Botox Lasts About 3-4 Months.

Hi Naomi.  Yes, unfortunately Botox results are not permanent.  Your injector did not go over expected duration with you?

It's always disappointing to learn that patients have not been properly educated about their treatments before they leave.  Or at the very least that they are not given a handout that explains what to expect after treatment.  For our Dysport and Botox patients, we let them know that full effect should be seen within 7 days and we bring them back in for a complimentary checkup at 14 days to make sure the results are inline with their expectations.  This is not standard for the industry but is in our practice.  It helps to avoid just the kind of miscommunication you are highlighting.

Finally, for our patients that are using Dysport or Botox regularly, the effects will normally last about 4 months.  Some more, some a little less, but this is a good rule of thumb.  Hope this helps and good luck with the next injection.


Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Wrinkles Have Returned Only a Few Months After Botox, Is That Normal?

That's correct.  Neurotoxins like Botox, Dysport and Xeomin have effects that last for 3-4 months on average.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews


Botox is one of the substances that falls into a group of medications that physicians call neuromodulators.

These neuromodulators treat wrinkles that develop as a result of underlying muscle movement

For most people the effects of these treatments last only for 3-4 months.  If your wrinkles are returning it means that the Botox is wearing off. If you are pleased with the result of the prior treatment you may want to have a repeat treatment.  It is common for patients to come in for these treatments 2-3 times per year.

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Normal Botox Reaction

Your body naturally metabolizes the Botox after a few months.  Botox typically lasts three to four months for the average person, depending on dosage.  

Ava Shamban, MD
Santa Monica Dermatologic Surgeon
3.9 out of 5 stars 9 reviews

Usually, Botox lasts 3-6 months

Botox usually lasts 3-6 months.  So, yes this may be normal.  You may want to try Dysport next time.  

Robert Strimling, MD
Las Vegas Dermatologist
4.3 out of 5 stars 9 reviews

Possible Antibodies

It is possble that you are developing antibodies to the Botox protein. This is an unsual problem, and probably occurs less frequently than was feared when Botox first came out. Usually, patients require less Botox treatments, the more often they are injected. In fact, this afternoon I treated two patients back to back whose Botox lasted nine months. They both have been getting injected for 6 years. This is certainly unusual, but we all have seen patients like this. What is felt to happen is that the nerve has increasing  difficulty finding a potential muscle site to innervate that has not been affected by prior Botox toxin.

There are some suggetions so your Botox will last longer. 

1) Switch to Xeomin when this reaches wide distribution in March 2012. Supposedly this Botox me-too drug carries less antigen, meaning there will be decreased recruitment of antibodies.

2) Mention to your physician that less diluted Botox has been shown to last longer; on one study one month longer. Let him concentrate on that fact.

3) Try Zytase. This is a pill taken to prolong the results of Botox. Failing this you might try zinc gluconate 25 mg. 

You were not specific in your time frame and if your last injection was three months ago, this certainly fits into the Botox effectiveness window.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 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.