Botox to Tighten Skin?

I hear that Botox is used to tighten skin. Does this work well? Thank you.

Doctor Answers 9

Tightening Skin with Botox

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Thanks for your question about Botox for tightening skin.

Botox is a neurotoxin that when applied to a muscle group relaxes them.  

A key insight is that muscle groups can have opposing actions.  For example, in the face there are muscles that pull downwards (depressors) and those the pull upwards (elevators).  Normally, each part of the face will be affected by both types of muscles

By using Botox to target depressors, elevators act without opposition, lifting and tightening the parts of the face affected by these groups. There are many factors that affect the efficacy of this approach, including skin thickness, skin type, lifestyle, and so on.

The amount of tightening that can be achieved from Botox injections is moderate.  It can be quite effective for mildly sagging skin at the onset of signs of ageing.  One of its advantages is that it is a non-surgical treatment that is relatively inexpensive.

Having a consultation with a cosmetic dermatologist or cosmetic surgeon should be able to provide you with more information on your specific case.

Botox and skin tightening

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Botox can make the skin of the loose neck drape back against the angle of the neck by decreasing the tightening of the “platysma” muscle. When this muscle tightens from the chin to the collarbones, it pulls away from the curved angle of the neck and sticks out. So here, Botox relaxes the muscle and the skin looks tightened. If the forehead muscles or outer eyelid muscles (crow’s feet) are weakened, then the skin no longer constantly folds onto itself and becomes less wrinkled or “tighter” in appearance, but the skin doesn’t truly tighten.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Botox and Skin Tightening

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By now you know that Botox does not tighten skin, but there have been several recommendations for lasers that tighten skin. You need to ask questions when you go to a laser physician to see if this is right for you based on your goals and expectations versus what the laser can actually do. Ask the laser physician (preferably one who does all forms of skin tightening - usually a board certified plastic surgeon or facial plastic surgeon,ENT) - what is their experience? Which Lasers do they use? Why do they prefer this particular laser? What will the laser treatment achieve and how many treatments will it take? How long will the results last? Is the laser non-ablative or ablative (the ablative or fractionally ablative lasers may give longer lasting and more prominent results), etc. Ask to see pictures of patients that have had the proposed procedure and/or talk with patients who have had it done. It is up to you to get as much information as possible. If the only laser that a physician has is Thermage, then he/she will only recommend Thermage. But if the Fraxel re:Pair will give you better and longer lasting results, wouldn't you want to consider that? Get a second opinion if still confused or uncertain.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Botox and Skin

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Botox does not tighten skin but helps the dynamic wrinkles go away in time.  It paralyzes the muscles that cause the skin to wrinkle so when the muscle is activated it will not function and cause any of the wrinkling.

Good luck.

Botox to tighten skin?

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Dear Maggie777,

Botox is best used for relaxing specific muscles in the face and neck that lead to wrinkling with repeated contraction.

To tighten skin, best to look at chemical peels, laser or radio-frequency skin tightening, and fractional laser resurfacing like the DeepFX, TotalFX treatments.

Make sure to discuss your expectations with an experienced provider, who can explain your different options, results and maintenance care.

Good Luck!

Botox to tighten skin

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Botox does not tighten skin. When a certain area such as the forehead is relaxed from Botox, it might appear that the skin is tighter but in reality it is more relaxed.

For smoother skin in the forehead, between eyebrows and crows feet use Botox.

If you need tighter skin under the eyes or elsewhere in the face you might need laser or chemical peel.


Botox does not tighten skin

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Botox works on hyperactive muscles, such as the "corrugator" muscles that cause the vertical lines between the eyebrows. Skin tightening requires something that stimulates rebuilding of the collagen in the skin, and there are several things that do that. These include Thermage and lasers, either non-peeling such as Titan, fractional peeling such as Fraxel, and others. Chemical peels do this as well but injectable products as a rule don't.


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Botox works on muscles.  Certain muscles cause wrinkles when they contract.  Injecting them with Botox relaxes them and the wrinkles smooth.  While the skin overlying these muscles that are injected may appear smoother, Botox does not tighten skin.  For skin tightening think Titan laser.

Edmond A. Zingaro, MD
San Francisco Plastic Surgeon

Skin tightening from Botox is an illusion

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Botox does not tighten your skin but the relaxation of the muscles from the botox injections can give the skin a smoother appearance and the illusion of more youthful, tighter skin. Dysport does the same as regular botox but may work quicker and last longer but still only gives the illusion as Botox does.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

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.