Muscle Restoration After Botox?

How long does it take for muscles to rebuild after Botox has worn off?


Doctor Answers 3

It is the nerve-muscle connection that must rebuild, not the muscle

Botox works by blocking the release of acetylcholine from the nerve fibers that are in connection with the muscle. This blockade results in the relaxation of the muscle due to the inability of the nerve fiber to stimulate the muscle. Over a period of 3-4 months, this blockage is overcome by the nerve fiber and the nerve is again able to stimulate the muscle.

The muscle is unaffected by the Botox treatment. However, over time, the muscle may atrophy slightly due to its in activity which allows for the ability of the Botox treatments to last longer. We develop those frown lines and crow's feet from the development of muscles over time that is why we do not see those lines in children.

I hope that helps!

Austin Dermatologist
5.0 out of 5 stars 3 reviews

Two- Four Months

Botox blocks the release of acetylcholine which normally would travel from the nerve ending to the muscle. Without acetylcholine, the muscle is inactivated and can no longer functiion. It becomes paraylyzed and relaxes. This causes the relaxation of the affected muscle(s) and the disappearance, or at least the diminution, of wrinkles.

Gradually, the nerve finds ways to get around that blockage and the acetylchoine is no longer blocked. It takes 2-4 months before that happens. When these new linkages are set up the muscle will resume full function.

It may gradually become more difficult for these new linkages to be set up. Thus the more frequently Botox is used the more difficulty the nerve has in finding new areas to link to the muscle. This may account for the fact that in people who have had Botox say ten times, it seems to last longer than in rookies.

I hope this helps explain a rather difficult concept.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews


Botox works by blocking transmission from nerve to muscle.  The Botox starts off and nerves start refiring again at around 3 months following injection.  By 4 months, the Botox is generally totally worn off.

Edmond A. Zingaro, MD
San Francisco Plastic Surgeon
4.1 out of 5 stars 8 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.