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

Question

I realize the wrinkles come back and my question is what happens to the botox chemical as it circulates out in your body ?Does it go thru the liver or get stored somewhere else? Is it simply water soluable and gets flushed out by normal body functions. I am wondering about long term effects does it cause arthritis ? effect your immune system? Do we even know? Thank you Groovinda

Julia Ann Sullivan Miller, MD · Answer

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.

Kenneth Hughes, MD · Answer

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.

Jason Emer, MD · Answer

There is no evidence that Botox negatively impacts the immune system or causes arthritis. Botox results resolve in 3-4 months, then the treated area will go back to normal. See an expert. Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question. I recommend having a consultation with an expert to discuss your concerns and to determine the best treatment plan for you.The body metabolizes Botox through the liver and kidney excretion.   Botox lasts about 3-4 months. Botox works by binding to nerve endings, preventing them from contracting. Other alternatives to Botox are Xeomin or Dysport. Best of Luck!

Sean Doherty, MD, FACS · Answer

One of the best things about Botox (other than it works) is that there are no long term side effects associated with the procedure. And trust me, with the amount of Botox performed every year, we'd know if there were problems. While the results last for 3-4 months, the protein in Botox is actually quickly metabolized by the body. Hope this helps.

Melvin Elson, MD · Answer

Botox has no long term side effects even though it has been injected in millions of patients.  The effect of the Botox does wear off in a few months but the Botox itself is metabolized rather quickly in the same manner of most proteins and is gone very soon after it is injected its effect taking place without its continued presence

Lisa Vuich, MD · Answer

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

Lisa Vuich, MD

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

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