What is long term effect of Botox on the facial muscles?

Do muscles become thinner and atrophied? What happens to people's faces? Especially to people who received Botox injections regularly 2-3 times a year for a long period of time (lets say 5-6 years) and then stopped? Does Botox weaken the immune system in general?

Doctor Answers 14

Long Term Effects Of Botox

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Botox does not affect the immune system. Botox works by blocking signals from the nerves to the muscles. The injected muscle then can no longer contract, which causes the wrinkles to relax and soften. When used for a long period of time Botox can cause atrophy (shrinking) of the muscle. After you stop using Botox, the muscle will regain its size and strength.


Summit Emergency Medicine Physician
5.0 out of 5 stars 47 reviews

Long term botox effects

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Although muscular atrophy occurs, regeneration of extrajunctional receptors and terminals limits the duration of activity to a few months. Functional recovery of the muscles develops in 3–6 months, but sprouting and remodeling may continue for as long as 3 years.

There is not evidence that Botox weakens the immune system.

Joseph Doumit, MD
Montreal Dermatologist

Long Term Effects Of Using Botox

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The long term effects of Botox have been well studied.  Firstly, it depends on where the medication is used, how it is used, and in what dosage.  For typical upper face wrinkling, and when used in the appropriate dosages and time intervals, the long term effects of Botox are actually quite pleasing.  Studies have demonstrated a marked reduction in long term wrinkling, a smooth anti-aged appearance without looking unnatural, and an increase in skin quality and texture.  Long term use of the medication and then stoppage does not have any bad effects other than the gradual loss of whatever benefits were accrued from the Botox therapy.  When treating other areas of the face, for example the masseteur muscle for jawline sculpting, the goal of therapy is to induce a degree of muscle atrophy which results in an aesthetically pleasing slimming of the jawline in the right individuals.  In this situation, yes a degree of muscular atrophy is expected and desired.  In terms of the immune effects, Botox has absolutely no impact on the immune system and does not weaken it in any way.  Hope that helps!

Botox and Facial Muscles

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Botox relax the muscles of facial expression.  This will prevent wrinkles and stop new wrinkles from forming.  There is no effect described on decreasing immunity. Best, Dr. Green

Botox and facial muscles

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Botox when used over time tends to result in facial muscles becoming thinner and less prominent.  There's no evidence that Botox depresses the immune system

Long-term effects of Botox

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Thank you for your question medarts. Botox is a purified protein used to address wrinkles associated with facial expression. There are no ill effects of Botox that I am aware of in people who regularly have treatments for several years and then stop. Botox relaxes the muscles and smoothens out the overlying wrinkles. The bulk of the muscle can get smaller over time; this is the intended effect when treating the masseter to contour the lower face. Botox is not known to affect the immune system. Please consult with a doctor for specific recommendations. Good luck!

The long-term effects of Botox on facial muscles

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Botox has no ill effects on the immune system.  Botox is a medication that decreases a muscle's ability to move.  For the typical volume of Botox used for facial wrinkles, the long-term effects on muscles are minimal for the majority of patients.  For any muscle in the body, disuse can cause atrophy (aka shrinking).  Some physicians leverage this to treat masseter muscles that are excessively large by injecting higher-than-usual volumes of Botox.

Jill C. Fichtel, MD
Columbus Dermatologic Surgeon
5.0 out of 5 stars 16 reviews

Botox and long term effects

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Botox is a medication injected into target muscles to selectively weaken them for fewer/softer wrinkles.

If Botox is used consistently for a long duration, the muscles of the face can affected. It's the opposite of going to the gym. The longer any muscle holds still, the smaller it will get. After you stop Botox , the muscle will regain its size and strength. There are no reported effect on the immune system. 

Muscle and botox

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Botox will neutralize the action of the muscle and may cause some flattening from disuse.  Best of luck.

Long term botox effects

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Over time with repetitive use, often people see some thinning (atrophy) of the muscles being botoxed. If botox is not used anymore, they will gradually strengthen again and become more pronounced. There is no long term adverse effect and Botox is FDA approved for other medical uses in the body that require much more than is required for the face, and these patients obviously  don't have any long adverse effects either so it is definitely safe to use!

Lesley Rabach, MD
New York Facial 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.