Botox peak? (Photo)

I am seeing so many different advice on when it peaks and when it will dissipate it is really important to me as I have a totally paralyzed side of my face from to much.

Doctor Answers 12

Peak effect of Botox

Thank you for your question leelou1957. Botox is a purified protein used to address wrinkles associated with facial expression. In the pivotal studies on Botox for the crows feet (available on the Botox website), results were assessed at 1, 7, 14, 30, 60, 90, 120, and 150 days after a treatment. The maximum effect was seen at day 14, although the effects at day 30 were close. While it has not been studied the peak effect may be somewhere between days 14 and 30. Please consult with a doctor for specific recommendations. Good luck!

Encino Physician
5.0 out of 5 stars 1 review

Botox – What to expect

Thanks for your question. This is a question that we get asked often by our patients.  As far as Botox treatments, muscle hyperactivity would likely require treatment 3 times a year.  Botox effects can last anywhere from 4-6 months and with recurrent treatments, this will lead to mild atrophy of the muscle, and some prolongation of Botox's effects.  Botox effects are never permanent, however, if you elected to stop, your muscle would hypertrophy back to its original size. These are advanced techniques so be sure to get an experienced cosmetic dermatologist consultation for recommendations and treatment options.   Results are expected to start in 2-10 days and peak within 14 days after injection. In some patients, it may take up to 30 days to reach full results. On average, results will last for 4-6 months.

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
5.0 out of 5 stars 10 reviews

Botox and Paralysis

I have never seen this type of side effect from Botox.  It is possible that you had a stroke or Bell's Palsy and need to be emergently evaluated.  Please keep us posted.  Best, Dr. Green

Botox peak

Botox generally begins to work in 3-5 days, reaches a peak in 7-10 days and generally will last about 4 months depending on the area and the dose and then gradually fade

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Botox peak?

Hello leelou1957,

Botox when injected for cosmetic purposes should not give you the result you are having.  You are correct in that the entire side of your face is paralyzed.  There can be several causes of this including a stroke, so you need to be evaluated ASAP.  Other causes include a Bell's palsy which tends to develop over a series of a few days but this is a diagnosis of exclusion (meaning more serious things are determined to not be the cause before giving this diagnosis).  

To answer your question, Botox will reach its maximum effect in about 10-14 days but it varies based on the individual. It will then go away in about 3-4 months if a true therapeutic dose has been used, sometimes sooner than that if you weren't given enough.  Once you have been evaluated for the paralysis you should follow up with your injector to see where your Botox was injected and what doses were used.  

So to reiterate you need to see someone ASAP to be evaluated as what you are seeing should not have been caused by a Botox injection when done for cosmetic purposes (or even for non cosmetic purposes unless you were having sweating from your cheek when you ate and the Botox was injected deeply and then this could happen).  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews


I agree with Dr. Bosch. It is important to know where you had the Botulinum toxin injections, the amount in units, the brand, etc. You should check with who did your injections, as this is unusual and you may have a Bell's palsy at the same time or a stroke. The botulinum toxin usually get the full effect 7 days after the injection and the peak it is between 2 to 3 weeks after, usually after 3 months the effect starts to go awasy, but in some patient it may last up to 6 months.

Botox and Results

I am very sorry about your experience with Botox. Botox takes 10-14 days to see optimal results. Unfortunately, it takes 2-4 months to resolve. I suggest you see an expert in cosmetic dermatology for future treatments. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

Botox peak

Thank you for your question and for sharing your photograph. Botox tends to peak in effect at 10-14 days after treatment and lasts from 3-4 months in most patients.  Hang in there and you will see steady improvement starting at 2-2.5 months.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

2 -3 months, but see a doctor!

I am terribly sorry for your poor outcome. I have never seen this exceesive amount of paralyses from botox.  Where was the botox injected? How long after the injection did this happen? It is important to make sure that this is indeed the result of botox and not another condition such as Bell's palsy or a minor stroke, that might have coincided with your botox injection. Please see your doctor for a neurological evaluation.  If this us the result of botox it should go away in 2-3 months. 

Neda Vanden Bosch, MD
West Palm Beach Physician
5.0 out of 5 stars 8 reviews

Botox Duration

Sorry about your experience. Botox can take 5-7 days to start working, but can take up to 2 weeks for full results. It usually lasts 3-4 months. You may start seeing some improvement around 2 months. Please find an experienced injector next time. Best wishes. 

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 9 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.