What Are the Individual Variables That Can Determine How Long Botox and Other Fillers Last?

Though companies give guidelines as to the longevity of Botox and other fillers, there seems to be some variables that determine how long it actually lasts for each person. What are the factors that determine how long Botox lasts? How long Resty or Juve lasts? Even Radiesse? And, if it's the skill of the injector that impacts this - what is the skill? Is it knowing what layer to inject?

Doctor Answers 12

Lots of variables

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Many variables affect duration of neurotoxins and fillers both.  Neurotoxins wear off quickest in areas where the muscles are used the most - such as the Crow's feet, since we are blinking continually while awake.  The longer you have been getting botox, the weaker the muscles will become, so over time you many not need as much or need as frequent treatments.  When companies do duration studies, they first "fill" the patient to the max (which is frequently much more than an actual patient can afford), and when they determine how long it lasts, they wait until there is nothing left.  This is "their" duration of the filler.  However, most people will not wait until no filler is left before they seek re-treatment, since most will notice a decrese in 40-50% of what was injected.  Instead of waiting until there is nothing left, they'll come in when the filler has disappeared enough to make the wrinkles noticeable again.  This is why the duration that the companies quote is often shorter than what patients notice.  The experience of the injector is definitely a factor.  Injecting a product too deeply is like putting it in a black hole - and so the effect may not last as long as one would expect, while injecting too superficially can create bumps or lines.  This is why it is important to go only to a very experienced cosmetic dermatologist for your injectables!  Also, other factors such as exercise habits can affect how long fillers and botox will last.  Intense exercise leads to the development of free radicals in the body which can attack the neurotoxins and fillers and decrease their duration.  I have several patients who are marathon runners and have very little body fat - they seem to "eat through" their fillers much more quickly than the average patient.  For this reason I recommend taking anti-oxidants to help decrease the effects of intense exercise.  Good luck!

Boca Raton Dermatologic Surgeon

Much of this is personally subjective.

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Consequently there is no one right answer.  For the botulinum toxin products, the time frame is 4 to 6 months.  Because the perception of when the product has worn off enough to have retreatment is subjective, one person may decide they need retreatment at 2 months but someone else at 12 months.  The dose relative to the muscle mass being treated also has some bearing.

For fillers it is also subjective.  These products often last well over a year and possibly two years.  It is very hard for people to precisely remember what the original issue was after a year.  Did the product wear off or has the face changed, or does the brain simply desire a more profound change?

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Predicting duration of effect for Botox and fillers

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Botox and Dysport both work the same way, which is to relax muscles of expression such as the "corrugator" muscle that causes the furrow between the eyebrows characteristic of a stressed or worried look. Once the effect sets in, the duration of effect depends on the body's healing response to reconnect the muscle to its nerve. This is not something that can be controlled with injection technique, other than making sure the initial dose was not too low.

With fillers, there are almost too many variables to count. These include where the filler is placed (for example in the cheeks lasts longer than in the lips), the type of filler, how the effect is measured, and so forth.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

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Quantity, dosage and placement have an effect on longevity of of injectables.

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There are many factors contributing to the longevity of each injectable such as the quantity used and placement. For Botox, dosage is key to the length of time your treatment will last. Fillers have many more contributing factors due to the wide variety of choices. Placement, consistency of the product and volume will play a large factor as to how long they will last. There are also external factors that may reduce the longevity of your filler including illness, sun exposure and smoking. To optimize your treatments, do not wait for the effects to completely wear off before coming back for your next treatment.

Manish Khanna, MD, FRCP(C)
Montreal Dermatologic Surgeon
4.6 out of 5 stars 27 reviews

Duration of effectiveness of Botox and Restylane / Juvederm & other fillers for wrinkles

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Yes, there are many variables. The most important ones that I have clinically seen are:

1. The number of units used per site with Botox

2. The volume of filler used for folds.

There is a tendency on patients and physicians' parts to spread out the filler as much as possible to reduce the cost as these are expensive treatments that don't last indefinitely. A study many years ago revealed that dissatisfaction was related more to underfilling and often one syringe of filler is not enough for both smile folds. In today's treatment we know that the cheeks, temples, prejowl sulcus, often need volume as well and this adds to the cost as well but if the areas are not adequately augmented, the result will not last as long.

Layering is now done more commonly with thicker fillers placed deeper to the superficial fillers, and this adds to the longevity of the aesthetic result.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox and Fillers variables

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Factors such as stress, illness, or sun exposure can decrease the longevity of fillers and toxins. Each filler and each toxin has it's own individual properties and they are injected into different layers of the skin. It is therefore critical that the injector know not only the structure and the function of the skin but also the properties of the substance that is being injected.

Peter L. Kopelson, MD
Beverly Hills Dermatologic Surgeon

Botox and fillers - variables that determine duration

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There is definitely variability among patients on how long the effects of these products may last.  Some patients may break down one filler faster than another and overcome the effects of Botox more quickly than another.

For Botox, stronger muscles may need to be treated more frequently and areas of high motion such as the mouth may need more frequent treatment.  It is important that the product is placed correctly and that an appropriate dosage (number of units) is used.

For fillers, using the proper amount of product trying to achieve full correction of the treated area is ideal to ensure the longest lasting results.  Areas of high motion such as the mouth area may not hold the correction as long as less mobile areas such as an acne scar.  Proper placement is crucial so go to an experienced injector.  If the product is placed too deep, it will be reabsorbed more quickly.  If it is placed too superficial you may see the product as a lump or visible line.

Botox lasts on average 4 months.  Fillers range from 6-12 months.

Lori Stetler, MD
Dallas Dermatologic Surgeon

What influences how long Botox and Fillers last.

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Botox lasts about 3 months however fillers can last from 6 months to around 12 months based on the type of filler and layer of tissue where its placed.  Restylane and Juvederm are thinner fillers that are meant to be placed more superficially and last about 6 months.  perlane goes deepr and last about 9 months while radiesse lasts about 12 months.  There's no magic in these fillers, so look for an MD that has good aesthetic judgement as well as experience using fillers and neurotoxins (Botox, Dysport).

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Factors that affect Botox & Filler Duration

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There is a variety of answers from the panel members.  All good feedback; however, we believe training over title will always be the best predictor of end outcomes.

A good injector will take into consideration the following:

Choosing the correct product for the treatment goal, the correct amount for "full correction", correct expectations given to the patient, and the best technique are all necessary for the best recipe.  Because different dermal filler products have different durations, be certain that you are aware of the differences.

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

Botox Is Not A Filler

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First of all, from the way your question is phrased, it sounds as if you think Botox is a filler and it is not.  Botox is a derivitive from botulism toxin which causes muscle paralysis.  This is a temporary phenomenon.   The only thing which seems to influence the length of action is repeated use; it seems to last a bit longer with repeated usage.  The time that fillers last is most influenced by muscle action; they seem to last longer in areas in which there is less muscle movement.

John Whitt, MD (retired)
Louisville Plastic Surgeon

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.