When Botox Begins to Wear Off, How Quickly Does It Dissapate?

Question

In other words does it suddenly wear off in a few days or does it gently ease away over many weeks? Can crow's feet be gone one day and back in full force the next? How much time do you normally have to get back in for treatment?

Nelson Lee Novick, MD · Answer

I have very extensive  personal experience (nearly twenty years) with the use of Botox for the treatment of wrinkles, furrows and scowl lines. In that time, we've come a very long way from just treating frown (scowl) lines between the eyes. Now,  routine uses include worry lines along the forehead, bunny lines on the sides of the nose, crow's feet on the sides of the eyes, crinkles of the lower lids, lipstick bleeding (smoker's) lines around the mouth, turkey necks and crepey chests.

	We've also learned a great deal about how best to use these neuromodulating materials. Gone are the severe restrictions on exercising for several  days after treatment and upon lying down for four hours after treatments. Also gone are the slavish need for the doctor  to use the material within four hours after reconstituting it and the recommendation for the patient to do facial mimicry exercises for six hours after a treatment session.

	What's more we have developed ways of significantly prolonging the results of treatment. Ordinarily Botox or Dysport last on average about four months. One way to increase the duration of effect is to combine their use with the injection of filler materials. In some cases the combined treatment has resulted in as much as a year's worth of improvement.

	Another method is to repeat the Botox or Dsyport injections, at least initially, with a series of treatments spaced at fixed four month intervals (regardless of whether any return of the wrinkles is seen). Recent evidence suggests that after doing so for a while, results may be prolonged for six or more months. I have found this method useful for reducing both the frequency of patient visits and overall cost to the patient and have actually been recommending this approach for several years.

Dennis Wolf, BScHons, MBBCh, MRCSEd · Answer

The effect of botox gradually wears off over 3-4 months.  There is a gentle transition between minimal movement of the  muscles to complete function.  Results do vary between individuals.
You dont wake up one morning with a wrinkled forehead. :-)

Jerome Edelstein, MD · Answer

The results of your Botox will disappear gradually in about four months or so. It's doesn't just disappear all of a sudden. Usually, Botox injections can be scheduled every 4 months or so, depending on the area and how you react to the treatment.

Otto Joseph Placik, MD · Answer

Botulinum Toxin (Dysport or Botox) tends to wear off gradually beginning at 3 months and typically completiely dissipated by 5 months.

Houtan Chaboki, MD · Answer

The results from Botox Cosmetic slowly fade with time. Botox Cosmetic generally lasts about 2-4 months. Around this time, one may notice facial wrinkles slowly coming back. You may be retreated at that time or wait until the Crow's feet are back in full force. Generally, it's better to get retreated with Botox Cosmetic before wrinkles are fully back.

Kevin M. Robertson, MD, FACS · Answer

I would agree that the effects of botox slowly wear off.  To add a little more information, studies have shown that botox degrades after 90 days.  After that time, patients develop different patterns of nerve function return.  One group seem to return to full muscle movement quickly, and they often find themselves back in our offices shortly after 3 mos.  I have found these patients to be the ones with very active metabolism, ie really stressed, type A personalities, hyper patients, or serious athletes (marathon runners, personal trainers, competetive athletes). 

	Most patients are not like that, and see a slow return of function that is gradual.  Maybe over three more weeks, maybe over three more months.  I tell patients to return for reinjection when they feel most comfortable with this process.  Some ride it out as long as possible and do botox twice a year.   Some, as mentioned above, never want to see movement creap back in, and so reinject every three months.

	Regions for botox injection clearly have a threshold dose that must be met, in order to provide the anticipated response.  Again, this is established by studies, not just my opinion.  Doses above that threshold dose are often encouraged in order to establish a pattern of prolonged effect.  More drug means more duration, to a degree.  Titrate your dose with your physician.

David Shafer, MD, FACS · Answer

In most cases, Botox wears off in a couple of days. Most people say that they wake up and see some wrinkles in the mirror and then by the end of the day the wrinkles are getting worse. Over the next few days, the wrinkles start to return to baseline. Most patients call to make an "Emergency Botox Visit" at the first sign of returning wrinkles. Good luck.

Ron Shelton, MD · Answer

Most people note that the Botox gradually wears off around the third to fourth month. A few of my patients do notice good results until, one day they "wake up" and it's gone, that suddenly. Others who have good improvement in their frontal headaches, schedule repeat treatment three or four, or five months later when the headaches recur suddenly.

Michael A. Persky, MD · Answer

Hi,

	Botox wears off gradually.  It is best to get retreated before the muscle function returns.  When you first have a hint of movement, drop what you are doing (just kidding) and make an appointment.  Studies have shown that when the muscles are not allowed to function for about 2 years, there is atrophy and then the injections are needed less frequently.

	  Crow's feet will not return overnight.  Enjoy and be well.

	Dr. P

Monika Soni, MD · Answer

Thank you for your question! Botox generally lasts 3-6 months and will wear off gradually. When you request a Botox treatment, you should probably ask how many units you are receiving and how the bottle was reconstituted or mixed. This information will help you to predict how long the blockade will stay. It tends to wear off gradually beginning at 3 months and typically completely dissipated by five months. Best of luck!

When Botox Begins to Wear Off, How Quickly Does It Dissapate?

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