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.

Without knowing exactly how much BOTOX you actually had (# of units), this is very difficult to answer.  For the most part, if you are treated effectively the results generally last around 3-4 months and sometimes even longer.  The problem is that many injectors try and keep the costs down and so do not inject enough.  The end result is that your result doesn't last.

I would recommend avoiding the cheapest injector and, instead, going for reputation.  As a national speaker and trainer for Allergan, I know first hand that there is a wide range of experience among injectors and that you generally get what you pay for.

I hope that helps!

If you are not seeing the effects that you and your physician talked about after your treatment, make sure to contact your provider to discuss this.  Most of the time, a small addition of Botox to the remaining active muscle(s) will quickly get you the results that you desire.

In this case, I would consider the following:

A. You may need a few more units of Botox

B. You may not have had the muscles that were causing the problem injected with the Botox (i.e. it was injected into a less effective place).

Hope this helps.

Botox typically lasts 3-4 months, but I have seen it last longer in some patients. If you don't see any change after one month, then you should return to your injecting physician. It is likely that you were under-treated. You should be aware, however, that not all of the lines will 'erase' in many patients. If there are deep lines from years of activity, these may persist after a Botox treatment.

Botox/Dysport  typically last 3-4 months in most patients.  Lines that are deep, from years of facial expression, do not typically disappear with one time injection.  They may soften over time with repeat injections, however they may never completely go away.  Sometimes, combining a Botox/Dysport treatment with a filler, such as Restylane or Juvederm can give you a better result.