How Long Does Botox Last?

How long does Botox last? What determines how long it will work for each person?

Doctor Answers 275

MANY factors determine length of Botox effectiveness.

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Botox works by irreversibly binding to receptors that send nerve signals for muscles to contract. But, since your body makes new receptors and neurotransmitters all the time, each patient will have different lengths of effective paralysis. 2-6 months is the range; average is 3-4 months. But wait, there's more!
To complicate the matter further, Botox (and Dysport, another company's botulinum toxin) is a labile protein, meaning it is sensitive to heat, excessive agitation, and time. Careful reconstitution, use while fresh, and keeping it refrigerated is essential. Beware offices or spas that advertise Botox days (especially if it's Friday)--they are simply trying to use up their reconsituted Botox so it won't sit over the weekend and lose effectiveness. Particularly beware of Monday morning Botox in such centers!
Then there's the skill and accuracy of the injector. Since Botox works where it's placed, simply shooting in a blob of liquid Botox in the general vicinity of the target muscle is a waste (of your money)! The most experienced injectors are plastic surgeons who actually operate on the target muscles in patients having forehead or brow lifts, facelifts, and eyelid surgeries. In my humble opinion, non-surgeon doctors and nurses can become experienced Botox injectors over time without operating on these areas, but consider who is best trained and experienced in the anatomy of the treatment areas.
Remember: the bitterness of poor quality remains long after the sweetness of low price is forgotten! Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Number of Units of Botox needed? "Depends"

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Botox can last typically 3-4 months. The results may longer-lasting if more units are used.

The number of units not the volume injected that has direct correlation with the effectiveness of your Botox injections.

Your  Plastic Surgeon can also create longer lasting results if you have these muscles injected regular lay. This is because the Botox will have more impact on the muscles that are still not fully active. Also, you learn to animate and use different muscles. This also makes your result more pleasing.

Hope this is helpful.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

How Long Does Botox Last?

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The blockade action of Botox on the nerve terminal is irreversible. Therefore, we must "sprout" or grow new nerve terminals in order for Botox to "wear off" and for the muscles to recover function. How long this process takes depends on a number of factors including age and genetics.  Botox lasts slightly longer in older patients because they don't recover as quickly.  Botox also lasts longer in patients that have atrophy or "shrinkage" of their muscles from regular Botox use.  Higher dosages of Botox can extends the duration of effect, but only modestly. 

Botox works well for 3 to 4 months on average in a majority of patients. Most patients are satisfied with treatment 3 times a year. Consistent use of Botox over a period of several years may result in muscle "shrinkage", extending the treatment interval to 6 months or longer.

Brock Ridenour, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

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Botox Cosmetic lasts 3 to 6 months

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Botox Cosmetic lasts a variable amount in each person. I usually tell my patients that it will last somewhere between 3 and 6 months.

People with heavier frown lines tend to have stronger muscles and in turn tend to see the motion of the muscle return quicker than those with less bulky muscles in the area between the brows. In some men and even some women with prominent muscles, it may only last 2-3 months.

You will typically see a return of the movement of the muscle prior to the deepening of the furrows caused by the contraction of that muscle. At that time, it is best to get back in for another treatment of Botox Cosmetic. This way you are not letting the furrows or lines to continue to worsen.

Kent V. Hasen, MD
Naples Plastic Surgeon
4.8 out of 5 stars 67 reviews

How Long Does Botox Last?

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The longevity of "Botox" effects and other Botulinum toxin products that are chemically similar such as "Xeomin" and "Dysport" will depend of many factors including anatomic location of injection, (forehead injections for "worry lines" typically last somewhat longer than for "crow's feet"), the degree of muscle use, the number of units injected ( 22 units injected into the frown lines or "11's" will last longer than 11 units ) and to some extent the age of the patient.

Typically the visible effects with optimal dosing will last close to 4 months although this may be shorter or longer depending on the above factors.

Some patients will notice increased longevity of effects after they have been injected repeatedly into the same areas (the muscle mass shrinks with repeat injections and there is some "unlearning" of the repetitive subconscious muscle contraction as with spontaneous frowning).

Victor Michalak, MD
Issaquah Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Botox duration depends on patient and chronic usage

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Botox generally last 3-4 months but this is not entirely accurate.  Patients new to Botox will generally start to see a return of paralyzed muscles at 6 weeks.  I recommend a touch up for new users at about this time.  After the touch up they generally get 4 months of effect.  I generally recommend every fourth month treatments for the first 2 years.  Once the muscles have but habitually paralyzed it will take less Botox and less frequent injections.  There are many patients who only get Botox twice a year once they have been using the product for many years.

How Long Does Botox Last?

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When injected properly by a board-certified dermatologist or facial plastic surgeon at an acceptable dilution and with proper technique, Botox should last about four to five months.  Occasionally it may last a little longer than 5 months, but it should last at least four months. We offer all our Botox patients a courtesy follow up visit at 1-2 weeks after the initial treatment to check the areas and see if any additional Botox is needed (at no additional cost). Patients really appreciate this. Click on the link below for before and after photos of patients receiving Botox for dynamic wrinkling. 

Channing R. Barnett, MD
Boca Raton Dermatologist
4.1 out of 5 stars 8 reviews

Is Botox forever?

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Botox generally lasts 3-6 months and will wear off gradually.  The longevity of the Botox will vary from patient to patient.

Francis X. Fleming, MD
Kennewick Plastic Surgeon
4.5 out of 5 stars 18 reviews

How long does Botox last?

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The average length of time that Botox remains effective is 4 months. That said, I have a few patients who swear it wears off after 2-3 months and others who see the effect for more like 5-6 months. 

Which category you fall into can depend on how strong your muscles are, how diluted the Botox is when it is mixed, and how long you have been getting Botox. With regular use of Botox over many years (meaning you don't let full muscle movement come back before getting more), your muscles may weaken, and some patients can either use less or go for longer periods of time between injections. 

Dana Goldberg, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 41 reviews

Botox and Dysport duration

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I have found that when my patients first start using Botox or Dyport, they typically return for treatment about every 3-4 months. However, with time, they are able to stretch out their injections to 6 months or more as they retrain themselves not to make the repetitive facial motions (such as frowning) which create the wrinkles in the first place. Be sure to consult with a reputable facial plastic surgeon, plastic surgeon, or dermatologist to ensure that you are being treated with the appropriate dosage, dilution, and in the correct treatment areas. Don't be afraid to ask how many units your physician is using per area. 

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 52 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.