Does Botox Offer Long Term Benefits?

Is Botox a pause button? And does it retrain muscles to the extent that I will have less visible wrinkles upon cessation of Botox cosmetic? I assume that if a muscle atrophyies because it hasn't been used for 10 years, combined with other muscles growing dominant - that the effect could be lasting without the use of Botox? If paralyzed muscles haven't developed, will the wrinkles simply return to what they were before Botox use, or will they return as if Botox was never used? Thanks!

Doctor Answers 16

Long Term Effects of Botox

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With regular use of Botox, I generally find you may be able to slowly extend the time between treatment cycles-- often to about every 6 months-- after treating for a few years.  This probably has to do with some general long term weaking of the muscle, as well as some "retraining" of the body in the use of facial musculature.  You never see significant atrophy, because the effects of Botox fade gradually--- and we see a gradual restoration of muscle activity.  So whild initially the muscle may have near total paralysis, after 2-3 months, some activity is returning, resulting in muscle activity and tone.

Botox is definitely helpful in preventing the development of lines and creases in the first place.   Regular use of Botox in your '20s can help to prevent the development of the deep, etched in lines that we see in our late '30s and '40s--- because Botox has prevented this repeated muscle activity over years that results in those lines!

Metairie Dermatologic Surgeon
4.3 out of 5 stars 6 reviews

Long term benefits of Botox

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You ask an excellent question. In general the effects of Botox wear off after several months and patient's muscle return to their normal activity. However, If one were to start using Botox early on, it is quite possible one could prevent the development of those permanently indented lines that occur from chronic frowning, raising one's forehead or crow's feet. This is what you might hear when doctor's discuss the difference between static lines as opposed to dynamic facial lines. Botox works best against dynamic lines whereas static lines are those lines present even when the muscle is at rest. Another possible long term benefit from chronic usage of Botox is that your face may be trained to use other facial expressions when you are anxious or stressed etc. For some the need to frown, raise ones forehead is an ingrained habit that could be broken. This though would probably take many years of treatment before this benefit is seen and is only speculative in nature.

Ted Brezel, MD
Long Island Dermatologic Surgeon

Long term botox

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While your thought process is logical it doesn't seem to work that way. The muscle function and wrinkles will return. It's probably because unlike muscle atrophy that occurs when a nerve is cut and the entire muscle is permanently denervated, with Botox there is probably always some degree of muscle activity at motor end plates not totally blocked as well as recovery going on at a variable rate. As the effect wears off it may not be enough to spoil the effect until that reaches a critical level of recovery but it's still enough to prevent permanent atrophy.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

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Are there long term benefits from Botox?

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It's true that with longer term use, the muscles get smaller and there is less Botox required.  When Botox is not used for a long time, the function of the muscle will return as will the wrinkles caused by its action.  It may take some time to develop them again because of the decreased bulk of the muscle, but eventually it will come back.

Emily Altman, MD
Short Hills Dermatologic Surgeon

Long Term Benefits from Botox

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Botox Cosmetic provides temporary softening of the underlying muscles which helps reduce overlying dynamic wrinkles - wrinkles which occur with movement of the muscle.  Over time, there is also an effect on the static wrinkles - wrinkles which are present at rest.  When you stop using Botox, the dynamic wrinkles return.  However, there are benefits from the long term use of Botox which include reducing stress on your skin and helping the reduction of static wrinkles.  However, most of the benefits of Botox are temporary and relate to the mechanism discussed above.


Good Luck.

Facial lines return after stopping Botox

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Good questions. As your muscles will no longer be relaxed after stopping Botox, facial lines or wrinkles will gradually return. Facial muscles do weaken over time after having Botox injected regularly though, so the longer you had Botox consistently injected, the longer it should take for the wrinkles to return. Remember that Botox does not stop aging, so if you stop using Botox, you will also continue to naturally develop wrinkles. 

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.7 out of 5 stars 170 reviews

Wrinkles can disappear with botox but return less apparent after botox cessation

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If the botox is stopped, after it has been regularly used for many years, the muscles will awaken and as they contract the skin overlying will crease and wrinkle again, but the lines won't appear as bad as they were prior to the botox first being used.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Long Term Effects of Botox

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The question of whether or not Botox and filler treatments will increase the risk of worsening of the lines after they have worn off has come up frequently. In my experience, the opposite has been the case. Wrinkles can be made to disappear using Botox and the new hyaluronic acid fillers such as Juvederm and Restylane. They not only eliminate lines but will also prevent new ones from forming. Eventually, when everything has worn off, I believe you will still be much improved and will be better off than if you had no treatments at all.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Does Botox offer long term benefits?

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Yes, Botox and Dysport offer long term benefits. For some , the injections break the habit of frowning or teeth grinding. For others, the process of injecting gradually mnimizes the tendency to do these. However, it does not get rid of these habits so the injections need to be maintained.

For other injections, such as for increased sweating, the treatments offer improvement that lasts for up to six months. In some instances, the injections can last longer

Kenneth Beer, MD
Palm Beach Dermatologic Surgeon

Botox can work like a pause button.

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I believe you are correct when you mention Botox working like a pause button.  It will reverse time a little (wrinkles that took years to develop improve), but once you stop, you will move forward again.  Now, will they return to what they were before you started?  Well, I think this depends on how long you have been consistently using botox.  I have found that with chronic users of botox, static wrinkles (wrinkles present even when you stretch the skin) do improve.  If you have enough improvement, then it would take time for the muscle to return to its strength after prolonged paralysis and the skin would have to develop the wrinkle with time.  However, they would ultimately return.  

This is all speculative based on experience, but I believe that there is some truth to that.  However, no real data.

Daniel I. Wasserman, MD
Naples Dermatologic 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.