If Botox Relaxes the Muscles Wouldn't They Become Weaker?

One would think that muscles that go unused for a period of time would become weaker causing wrinkles to actually get worse hen the botox wears off, they haven't been working for 3-6 months. Or, do we want them to become weaker which means no wrinkles? It's like a double negative, not sure where the truth lies.

Doctor Answers 17

Neuromodulation with Botox

Facial rhytids (wrinkles) are caused by the action of facial muscles.  You are exactly right to think the muscles become weaker during the 3-4 months Botox is active, and this is actually a positive.  The wrinkles in the skin become softer during this time, since they are not continuously being made and imprinted into the skin, and because the muscles become weaker, they will not produce wrinkles as deeply as before.  

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

BOTOX Causes Temporary Weakness of the Muscles

Facial wrinkles are often due to hyperactivity of muscles, so relaxing them (low doses of BOTOX) or paralyzing them (higher doses) makes for less wrinkles.  Over time the body sends out new nerve growth to overcome the receptors blocked by BOTOX.  The muscles then recover full activity over time.  If BOTOX is used on a weak muscle, the muscle becomes weaker, but then will recover to its previous strength as the BOTOX is metabolized.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 18 reviews

Botox to weakness muscles

Overtime the muscle becomes weaker. But in reality relaxing them and paralizing them makes less wrinkles. And that is what you want as yo age.

Jhonny Salomon, MD
Miami Plastic Surgeon
4.3 out of 5 stars 45 reviews

If Botox Relaxes the Muscles Wouldn't They Become Weaker?

The facial wrinkles that we treat with Botox are caused by repeated contractions of the muscles.  By temporarily paralyzing or weakening the muscles, the wrinkles become less pronounced or may disappear completely depending on the severity to begin with.  As the Botox wears off, the muscles start contacting and getting stronger again.  The wrinkles will gradually come back unless you use Botox again.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.4 out of 5 stars 39 reviews

If Botox Relaxes the Muscles Wouldn't They Become Weaker?

 Yes, they do in fact become weaker if you maintain the effects of the Botox, Dysport or Xeomin with repeated injections every 3 months.  This is how hypertrophied facial muscales (Masseter are currently treated).

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

If Botox Relaxes the Muscles Wouldn't They Become Weaker?

Botox is a temporary fix. The muscles might slightly weaken over time but most patients regain similar amount of muscle movement after allowing Botox to totally "wear off." The wrinkles will NOT be worse if you decide to stop Botox at some point down the road. The are typically less significant than if you had chosen not to use Botox. I hope this information is helpful.

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

How Does Botox Work?

Hi This,    Botox does work by weakening the muscles that cause wrinkles.  The muscles do become weak over time, and if not allowed to move (by repeated treatments over time), the muscle atrophies (just like when a muscle is in a cast from a broken bone).  It is the muscle contraction that causes the lines that are effectively treated with Botox.  Good luck and be well.     Dr. P 

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Does Botox weaken muscles?

Yes, it has been demonstrated that Botox does weaken the muscle, which is, in layman's terms, why it works to alleviate the wrinkles. As it wears off, the muscle should regain its strength...and then you will need a repeat dose.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Does Botox weaken muscles?

Botox , Xeomin and Dysport all relax muscles so yes, after an injection, they are weaker. If you continue to maintain the correction, over time you will relax these muscles for longer periods of time. If you were to measure the muscles after an injection, they would be weaker but over time they regain their strength.

Kenneth Beer, MD
Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Botox Relaxes the Muscles

You are correct in your understanding that Botox causes muscle weakening.  Prolonged paralysis of the muscles will cause progressive weakening of those muscles.  The weaker they get, the longer they will take to recover their strength.  That leads to a prolonged period where the creases will not be as deep.  So the wrinkles do not get worse when the Botox effect wears off, but if you don't re-treat those muscles, they will get back to full strength and the wrinkles will re-appear.  

Daniel J. Pyo, MD
Morristown Plastic Surgeon
5.0 out of 5 stars 1 review

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.