Botox injections are wearing off around mouth after only 4 weeks. What should I do? (photos)

Would it make sense to get a Botox touch up this early? The other injected areas held. I don't want a stronger dose for fear of side effects. Would the Juvederm help the results last longer? What would be the best placement? My injector thought I had nice lips and shouldn't use too much. Any other suggestions? Thanks!

Doctor Answers 13

Treatments for the lips

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Thank you for your question kismet1005. Botox is a purified protein used to address wrinkles associated with facial expression such as the vertical lines above and below the mouth seen when one purses the lips. A small amount of Botox must be used in these areas because too much Botox can have various side effects including difficulty speaking, breathing, and eating and an asymmetric smile. Fillers such as Juvederm can work well on such wrinkles, as can laser skin tightening or fractional laser resurfacing. Please consult with a doctor for specific recommendations. Good luck!


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Thank you for your question in regards to Botox. Botox in small dosages, especially around the mouth area typically do no tend to last the full 3-4 months. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Botox injections are wearing off around mouth after only 4 week. What should I do?

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Thank you for your question. Typically a very small dose is injected around the mouth area. You may require an increased amount of Botox to obtain longer lasting results.


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

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Lip Lines -- Lasers, Microneedling/PRP, Botox, Fillers

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I find that lasers and fillers work better than botox to this area.  Please see an expert.  Best, Dr. Emer.

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For now, you may want to get a bit of filler in the upper lip lines.  A combination of filler and small amounts of botox can be very beneficial to the area.  I would wait until your other Botox has worn off before injecting Botox in your lips again.  However, filler can be added now.

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Injectables for mouth/lips lines

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Botox injections around the lips usually do not last as long as when injected in other areas, so lore frequent injections are usually needed. Fillers can also be used in small amounts to fill the deeper wrinkles.  
I would consult your injectore for your best option.
Best of luck!

Botox for Lip Lines

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I would not recommend having large doses of Botox in the upper lip area.  You can have filler placed in the lips and lines around the lips and this will improve the area with a much better and longer lasting result.  Best, Dr. Green

Botox in lips

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Typically low doses are administered around lip area to avoid complications.
1. You should see your original physician to see if a slight increase in the dose is possible. 
2. Certainly injectable fillers including juvederm can be used to soften such lines but inevitably in some women administration of filler can augment the lip. If done cautiously it might enhance your appearance although so,e women are not interested in any degree of lip augmentation.
3. Laser procedures including erbium and CO2 resurfacing can also help diminish your lines although they will work best on static lines.
4. Do you drink with a straw? If so try avoiding it as it will accentuate the motion of dynamic lip lines.
5. You might consider Dysport to see if it lasts longer (similar substance to Botox) that is often used interchangeably. 

Andrei Metelitsa, MD, FRCPC, FAAD
Calgary Dermatologic Surgeon
5.0 out of 5 stars 15 reviews

Botox for lip lines

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The purpose of Botox to relax lip lines is primarily preventative rather than curative - meaning it does not remove lines but does soften them when there is a tendency to strong pursing with natural movement.   It does not help lines that you see at rest.  Those lines are best helped with dermal fillers such as Juvederm or Restylane, and use of lasers for resurfacing if the lines are deep and fixed.  Only small doses of Botox can be used for the lips because the intention is to gently relax while preserving normal function.  Small doses tend not to last as long as traditional doses that we can use in other areas of the face, such as for frown lines.  Nevertheless, most patients will manage to space out treatments at least 3-4 months apart.  In this particular case, I would recommend to follow up with your injector to ensure that the result is not only reasonably long lasting but also even and symmetric.  It is also a good opportunity to discuss whether dermal fillers and/or laser resurfacing might be considered and which have longer lasting effects.  Dermal fillers and Botox often complement each other; Botox may increase longevity of the filler - while fillers can give more immediate results that more fully address those lip lines.  The key to best results is to choose an injector with significant medical experience and an excellent aesthetic sense.  It is very easy to over-treat lips so take time to ensure you are happy with the injector that you choose.  The end result should not look treated and should be very natural.

Mark Lupin, MD
Victoria Dermatologic Surgeon
4.3 out of 5 stars 3 reviews

Botox around mouth

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I use botox for fine lines of the lips but only in very small aliquots they are not suppose to freeze the entire mouth. It should look better in repose or in a relaxed state.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.