Treated Area Worsens After Botox or Juvederm Wears Off?

I want to have Botox and maybe Juvederm. Is it a myth that I heard that if you get these procedures that they make the treated area look worse after they wear off. That's the only thing that has me scared to do it because it might be true. Please help get me on the right track with an honest answer. Thank you.

Doctor Answers 16

After effect of Botox and Juvederm

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There is no medical theory to explain that myth and it is not seen clinically. In fact, studies have shown that there is an increase in the amount of collagen production often, as a response to filler injections. I have not been aware of patients who have delayed their next treatment or have stopped their treatments altogether and ended up worse than before their treatment started. Of course if it is many years later, the aging process does continue and it is not fair to compare the appearance ten years later to how the skin looked before the onset of treatment.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Do you worsen when Botox and Fillers wear off?

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Quite to the contrary, most patients have some permenant residual benefit from chemical relaxers (Botox/Dysport) because the prolonged relaxation often results in behavior modification where people tend to not frown as much. Further, if done for a long time, there is some significant muscle weakening. As to fillers like Juvederm, and others as well, recent research has shown that the stretching of the fibroblasts (cells that make collagen) by the fillers causes your skin to make new and more collagen, resulting in some permenant benefit. That having been said, nothing we are doing is stopping the relentless march of time.

Stephen Mandy, MD
Miami Dermatologic Surgeon

Treated area worsening after Botox or Juvederm wears off

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urban legend / old wives' tale / nothing to it.

Dawn, I have never seen this in any of my patients and as you can see from the vast majority of posts there is really nothing to it.

The reason why we take before-and-after photographs is that human nature and memory being what they are we forget what we looked like before the treatment or the surgery. I think that when the treatment wears off, SOME people with short term memories need to be shown what they looked like before. Things are not worse. Things slowly revert to what they were before.

Go ahead and see a qualified board certified Botox and juvederm surgeon and see what it could do for you.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Botox, fillers, restylane, non-surgical treatments

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Dear Dawn

Botox and soft tissue fillers are excellent for facial shaping and rejuvenation. The results are long lasting for the fillers and the Botox will last 3 to 6 months. As these wear off the tissues will return to the prior state and not to a worse state. As you repeat the treatments you will get longer lasting results and a maintained appearance.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Treated areas don't look worse after Botox or Juvederm wears off

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Botox and Juvederm are both temporary appearance improvers. Why some people "think" they look worse after the products wear off is that they had become accustomed to looking better while the Botox and Juvederm were still effective!

Who wouldn't prefer fewer wrinkles and a more pleasant look? Botox takes out the frown and worry lines (actually it has been studied and seems to have a positive psychological effect) and Juvederm will erase folds, non-dynamic wrinkles and plump up lips. So, looking more youthful and admittedly probably a little sexier is a preferred appearance change. When that goes away, you're almost where you started.

Some people do, as noted by other doctors responding to this post, find that repeated injections of either Botox or Juvederm tend to provide some semi-permanent improvements. Fillers tend to spur a small amount of collagen response and Botox gets you out of the habit of frowning.

We tend to forget how we looked "before". I'd suggest to anyone who is skeptical to take before and after photos. Most doctors will snap both before and after pictures - why not do this yourself?

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 reviews

Botox and Juvederm after effects

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Once the Botox and Juvederm have dissolved, you will most likely go back to the way you were before, not worse. Although, the fillers now can last up to 18 months and sometimes longer and the aging process does not stop. So, once the fillers dissolve you will go back to the way you were before, but with the additional months of aging. As an aside, a facelift can last up to 10 years for a possible consideration. Good luck!

Urban legend, and not true

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There is no evidence to support this, and I have not seen it in my practice.  In fact, with regard to Botox, wrinkles tend to improve with prolonged use because the muscles atrophy. 


Botox and fillers

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 I do not believe that your description is accurate. You may feel like you look worse after they wear off because the improvement probably looked so good!

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Botox and Juvederm have long term benefits too

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Hi Dawn,

You don't need to worry that you will look worse when Botox or Juvéderm wear off. Of course, we all know that they make you look better when they are working. But what many people don't realize is that you will benefit even when they wear off.

When you smile or frown, the muscles contract and crunch up the skin, causing wrinkles. That mechanically damages the skin. Eventually, there is enough damage to the skin that there are wrinkles even when you don't smile or frown. If you use Botox to relax those muscles that are causing wrinkles, the skin will not be damaged more. If you stop using Botox, you will still benefit from the time that your skin wasn't subject to that damage.

Juvéderm also provides a long term benefit. It has been discovered that Restylane (a hyaluronic acid filler just like Juvéderm) helps your skin rebuild your natural collagen. The collagen that your skin makes today will last about 15 years. So if you get Juvéderm or Restylane injections, your skin will make more collagen, and that will likely benefit you for the next 15 years!

Nancy Swartz, MS, MD, FACS
Philadelphia Oculoplastic Surgeon

I don't think that treated ares look worse after Juvederm or Botox wears off

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People tend to forget about how they used to look like after they get their improvement from Botox (or Dysport / Botulinum toxin / bo tox) and fillers (such as Juvederm / Restylane / Radiesse / Perlane / Cosmoderm / Artefill / Sculptra / Alloderm). This is a very common occurence. Hence when the effects wear off, people tend to think they look worse when in fact they are just returning to a previous less optimal state. In fact, Botox will only help make the muscles weaker the more you do it which will essentially leave the muscle less likely to make more wrinkles.

Fillers also have a possibility to make things better even after the effects are long expected to be gone. Sometimes, fillers develop scar tissue around it which makes the fillers last longer and hence the beneficial effects last longer. The scar tissue prevents the body from breaking it down. This is something that I have noticed in many patients. But, back to the question, I don't think your appearance is usually made to look worse after these temporary treatments. In general, Botox can improve the appearance of dynamic wrinkles (wrinkle treatment / facial line treatment) while fillers can improve more static wrinkles by filling in loss volume.

Thanks for reading!

Philip Young, MD
Bellevue Facial Plastic Surgeon

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.