Can Botox Eventually Cause Muscles to Atrophy Enough that Botox is no Longer Necessary?

Botox works by paralyzing the muscle (e.g. the glabellar muscles). Eventually the muscle starts working again, necessitating repeated injections. I've read that the frequency of botox decreases over time but is there a point where you don't need it anymore, provided you've changed habits (not frowning for the mouth, not furrowing for the brows, etc.) and you'll be back to the point of someone who didn't have those lines in the first place?

Doctor Answers 6

Can Botox Eventually Cause Muscles to Atrophy Enough that Botox is no Longer Necessary?

Botox will only temporarily paralyze and relax the muscles and can typically last 3-4 months on most patients. Overtime with use of Botox the muscles will relax but this means less wrinkles. As you mentioned, with changed habits and not frowning as often, this CAN lead to not requiring Botox as often or at all

Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Botox Does Not Cause Permanent Weakness of the Muscle

Botox is injected directly into a muscle to weaken it. Repeated injections can cause the muscle to atrophy, but it will not cause the muscle to become permanently still. If a patient if off Botox long enough, all function of the muscle will return.

That being said, patient tend to use less Botox overtime and need injections less frequently. It patients are able to "re-train" their muscles that is an added benefit. I do not think the muscle re-training is secondary to the effect of Botox.

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

Can Botox Eventually Cause Muscles to Atrophy Enough that Botox is no Longer Necessary?

After continued use of Botox in patients, they typically are able to cut back on the amount and frequency of injections.That being said, Botox is temporary and is not a permanent solution.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

Botox and muscle atrophy

The paralysis of botox is temporary in the sense that the muscles recover as new endplates develop. Eventually the muscles will regain there original size. If you maintain your treatment schedule you may find that you can get away with needing less.

Arthur N. Falk, MD
Albany Facial Plastic Surgeon
4.6 out of 5 stars 10 reviews

To a certain extent this is possible.

Any muscle that is not used will atrophy and get weaker. This includes facial muscles that are consistently botox'd. I personally have used BOTOX since it was first approved, and I have also learned how not to use my facial muscles to express my emotions as much as I did before Botox came out. I no longer have to use as much to get the same effects, and I do not have to do it as often. So my answer from personal experience is yes, the need for botox can decrease after using it for a long time.

Laura E. Skellchock, MD (in memoriam)
Boca Raton Dermatologic Surgeon
4.3 out of 5 stars 28 reviews

No, unfortunately that's not quite the way it works...

the good news is the effects of botox are temporary...and the other good news is the chemical modification botox makes in the cells is corrected over time...much on the same order as you'll need a haircut again soon no matter how many times you get your hair trimmed...and to a certain extent even though we're discussing voluntary muscles, to some degree your nervous system dictates when the muscles contract...which of course gets right back to the next botox appointment in 3 or 4 months...

Ken Landow, MD
Las Vegas Dermatologist
4.6 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.