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

Question

Thanks in for your time and courtesy on answering my questions. I had my first treatment of Botox for a line that goes across the bridge of my nose (between the eyes). My Dr gave me 2 quick shots of Botox on Dec 2. It is now January 11 and movement has returned in the area. Also, the line I wanted treated never disappeared. It was always there even after the Botox. How long does Botox last? What determines how long it will work for me? Should I be asking my Dr for a specific strength?

Stephen Prendiville, MD · Answer

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.

Otto Joseph Placik, MD · Answer

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.

Ron Shelton, MD · Answer

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.

Gregory A. Buford, MD, FACS · Answer

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!

Steven E. Rasmussen, MD, FAAD · Answer

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.

Cheryl Lee Eberting, MD · Answer

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.

Ryan Greene, MD, PhD · Answer

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.

Lisa Kates, MD · Answer

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.

Robert Kasten, MD · Answer

Botox works well for the lines between the eyes, the "11". Usually the effect is stronger , if a good amount of units is used.

Frances Jang, MD · Answer

After years of repeating the same facial expressions, eventually expression lines will form in these areas even when the expression itself is not being produced. The only way to help prevent these lines from appearing at rest is to apply Botox to the muscles which form the expression to soften their movement. However, there are many factors which contribute to the result of your Botox treatment.
	When treating my patients with Botox, my goal is not to erase all of their lines, but rather to create a naturally smoother appearance. Botox is not capable of filling in lines as it is not a dermal filler, so it makes sense that your line did not disappear with Botox alone. The frown area between the eyebrows is a common area for a combination treatment of Botox to quiet the facial expression and a dermal filler (such as Restylane or Juvederm) to lift the line and create a smoother appearance.

	
	Your treatment result depends on how much Botox is used, its placement (which muscles are injected as well as location within the muscle), the strength of the muscles treated, and the technique and expertise of your injector. On average, you can expect to repeat the treatment every four months to maintain your results. After repeated treatments at this interval, many patients will eventually notice a longer term effect as the muscles remain quiet over a longer period, and require less drug to suppress their activity.

	
	The longevity of the dermal filler will also largely depend on the area injected and which product is used. When combined with Botox, I have found the filler to last longer, likely because the Botox is keeping the normally active muscles suppressed, so you are not &ldquo;pushing out&rdquo; the product through repetitive movement. In my experience when treating frown lines between the eyebrows, the filler does not require a touchup for at least one year (often times longer), particularly when used in combination with Botox that is maintained at regular intervals.

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

Answers (18)

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