What happens to Botox after it wears off in your system?

Botox and the other two brands Xeomin and Dysport are purified proteins. They bind to receptors on nerve endings, temporarily interrupting signal transmission. Our cells "turnover" receptors gradually over time- that is, they break up old ones and form new ones, which is why the neurotoxin effect is temporary. The botox protein thus is broken down the same way our cells break down other proteins as part of our metabolism. These proteins do not "cause" any other illnesses such as the arthritis you mention. They have been used at least since the 1970's, with no known long term effects on any organs. The doses used for cosmetic facial concerns are extremely small. When used in much, much larger doses (for example, to relieve muscle spasticity in cerebral palsy) there is certainly then some potential for "distant spread" which could affect other muscles temporarily, but this is not something we see with cosmetic use.

Lisa Vuich, MD

Botox is a protein that blocks the connection between the nerve and the muscle and prevents the muscles from contracting and forming wrinkles on the face.  Over a few month period the protein is broken down into simpler and smaller parts that do not have the ability to act like the original protein.  These smaller parts are then generally recycled by the body for other uses.

I know of no long term adverse effects of Botox when used for cosmetic reasons.  Long term consequences of routinely blocking muscle contraction are unknown, and to my knowledge none have been reported to date. Depending upon your physiology, Botox is metabolized and excreted over 3 to 6 months.There are certain risks that can be mitigated by selecting a board certified plastic surgeon who has specialized residency or fellowship training in aesthetic medicine. You want to schedule with a board certified plastic surgeon who can provide the best outcome with few or no complications.