Botox - Are the Lines Supposed to Completely Disappear? AND my First Shot Lasted One Month

Hi SS.  In terms of how long your Botox should last, one month is definitely too little.  When properly dosed you should receive 3-4 months of benefit.

In regard to the line that was being treated.  It almost sounds by your description that the line is horizontal because you say it goes "across" the bridge of the nose.  Botox is primarily used to treat vertical lines between the eyes, but may still work if you have a horizontal line.  The other possibility is that you have a deeper vertical crease that may need some dermal filler to treat completely.  We use Restylane or Juvederm usually in this case.  See the pictures in the link below to see a female with a deep furrow line that required both Botox and dermal filler (4th set of pictures down).

Botulinum toxin should last about 3 months but every patient is different in terms of the number of units they require for good effect and the duration of effect. Botulinum toxin weakens muscles and softens lines created by muscle movement. It does not treat lines that are imprinted in the skin. These lines can require dermal filler to be eliminated. Sometimes botulinum toxin and dermal fillers are used simultaneously.
Best,Stephen Weber MD, FACS

Quite frequently it takes 30-40 years for lines to develop and it is unlikely that they will completely disappear with treatment. Furthermore, some pateints are very expressive and when they believe that the botox effect has worn off, I observe use of other "substitute" muscles that have been recruited and are responsible for the persistence or recurrence of the lines.

The dynamic lines which are created by years of activity in the brow area are not always eliminated by Botox.  Some patients have very deep lines which will be softened, while other patients have lines/creases which are effectively erased after treatment with Botox. Immobility of the forehead is possible with larger doses (number of units received) if desired. The average duration of Botox is about 3 months.  Generally, a short duration of Botox (1 month) is related to an inadequate dose  or handling issues with the Botox.

Skin creases may take a while to disappear as they were created over many years. If the crease is a static line, one that is there from sun damage not muscle movement, then it won't improve with botox injections. If the line is related to years of muscle contraction in that area, and if those muscles can safely be treated with botox injections without interfering with vital muscle function (such as muscles that allow us to smile and speak correctly) then that line may improve over time. Botox usually lasts three to four months as does Dysport.  You may need more units to get a longer duration of effect, but again, if it's not the glabellar muscles which make your skin crease on the nasal bridge, but the nasal muscles, then botox injections would have to be directed to a different area. It is possible though that working lower on the bridge of the nose and sides of the upper nose to accomplish this could interfere with the upper lip muscles.