Because 'If You Don't Use It You Lose It' is That True for Botox? You Paralyse Muscles...

because you paralyze muscles, doesn't it stand to reason that the muscles are going to atrophy because they are not being used? Just asking..

Doctor Answers 5

Botox will not cause muscle atrophy in the short term

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If there is consistent Botox treatment, without letting it wear off in between treatments and the treatments have or will occur over years, then the muscle that is forced to relax will atrophy to some degree.  This atrophy is beneficial in the cosmetic arena.  It helps lessen the wrinkles in the future even when there isn't Botox being done as commonly because of one's schedule or other reasons.  This type of muscle atrophy is not permanent and the muscle will bulk up again if you choose not to continue the Botox treatments.  The muscles being treated for cosmetic facial reasons are not important functional muscles so that is why the Botox can be done safely.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Muscle atrophy and Botox

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While we normally don't like anyone to have muscle atrophy, in the case of facial muscles and Botox, this is actually a good thing. Getting Botox before you return to your baseline, i.e., when you start to notice that you can move your muscles in the forehead, glabella, crow's feet, etc. again, is the best because over time your muscles won't be able to make all those creases, lines, and wrinkles that you originally wanted treated. This doesn't mean the muscles will shrink or sag or anything else, it just means they won't have the ability as much to constrict and cause those to appear as obviously on your face. Most physicians refer to this type of atrophy as controlled atrophy, because we are intending for this to be the affected outcome.

Does Botox Cause Muscle Atrophy?

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Hi Michelle.  Yes, Botox does cause some muscle atrophy when you use it repeatedly.  Relaxing forehead muscles, crow's feet and other areas of the face over a sustained period of months or years will cause these muscles to weaken.  This is a good thing when it comes to wrinkles because the lack of movement and strength in these muscles means that these areas of the face will be smoother.

Take a look at the forehead line in the first picture at the link below.  This patient achieved significant muscle mass in the forehead which significantly reduced the appearance of this crease.  For him, muscle atrophy was a blessing!

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Because 'If You Don't Use It You Lose It' is That True for Botox? You Paralyze Muscles...

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  Yes, excatly and I've always been confused why this isn't discussed by those of us who have used Botox and other neurotoxins like Dysport and the newer Xeomin for over 20 years.  However, this controlled atrophy of affected muscles is a good thing because it will eventually result in that muscle(s) having a decreased ability to create the unwanted line or wrinkle.  It also serves as a reason for not using Botox, or any neurotoxin, anywhere where muscle atrophy could cause problems with facial animation.  

BOTOX and muscle atrophy: A VERY GOOD thing!

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This is actually one of the goals of repeated BOTOX use. We want the muscles to lose their muscularity permanently. We are in effect putting a cast on the muscles we inject, allowing that cast to wear down a bit, then recasting it. This is why we recommend not letting your muscles become too active before your next session. We eventually are able to go longer between BOTOX sessions.

Barry Resnik, MD
Miami Dermatologist

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.