Will Getting Regular Botox Injections Lead to Long Term Results?

No one really knows the long-term cosmetic benefit of continuous Botox use. There have not been any good research studies to show a cumulative benefit. There is some evidence, however, that redosing Botox before it has completely worn off will lead to longer term, more effective wrinkle reduction. But does getting Botox continuously for 20 years make a difference? Again, no one knows.
If you are having financial difficulty acquiring Botox, then don't obtain it. Go back to the basics of good skin care that everyone should follow: Hydration, healthy diet, regular exercise, limit sun exposure, avoid smoking, adequate sleep, stress reduction. These basic guidelines are the fundamentals of good care, and inexpensive too. Your skin will ultimately look better 20 years from now by following these basics, than by regular Botox injections alone.
There is no known harm to long-term use of Botox Cosmetic. Repeated Botox Cosmetic injections every few months may be too expensive for many individuals. How you balance the cosmetic benefit versus the cost will depend on your financial situation, and is a personal decision. Speak to your plastic surgeon or dermatologist about long-term benefit of Botox.

It's best to have touchups once you notice that the results are starting fade away. Studies have shown that doing this can prolong your results.

If you get treatments performed regularly, studies have shown that your results can last longer.  However, it is difficult to say when you would start experiencing the longer lasting results exactly so you should keep track of your results to figure that out, then adjust your treatment plan accordingly. You should make sure to have your next treatment while you still have some residual improvement, though.

Hi Momof2lilones. We have found that our patients that have Botox injected very consistently every 3-4 months have an easier time maintaining their results. In patients that come sporadically, they can expect the results to be gone after 3-4 months. For those that come consistently, when they come at 3-4 month intervals, they are just starting to see their results slip.
We believe the reason for this is that when the muscles that cause wrinkles are consistently relaxed from the Botox, they atrophy (or shrink from lack of use). Because these wrinkles are caused by muscle movement, the visibility of these wrinkles lessen as the muscles weaken with repeated Botox use.
The bottom line is that our patients that are consistent users of Botox end up holding onto their results the longest and this is a compelling reason to stay consistent. Hope this helps. Good luck.

I personally have been getting Botox injections to the #11 lines between my eyebrows for over 4 years. Frankly, it looks better now than when I started, and I believe that by avoiding the "peaks and valleys" of letting it wear off, you can actually get some atrophy of the muscles which cause the wrinkles.
So, in summary, indeed I do think that there is long term benefit of regular Botox injections. As with all medical issues, you should discuss this with your personal physician for their advice.

Regular Botox decreases the stress on the skin and can help prevent dermal atrophy which results in static wrinkles. However, regular Botox may also increase atrophy of the muscles in which it is injected. This can be a good think or a bad thing depending on how you look at it.

Hi Momo,
Studies have shown that after two years of denervation, muscles atrophy (get smaller, weaker). The muscles that are causing your lines, if continuously treated with Botox for two years, will also atrophy and not be as likely to create wrinkles.
There are some added benefits of continuously treating with Botox including improved tone, texture, and pores. Michael Kane, MD of NYC presented his findings last year on this subject at the Aesthetic Show.
As far as expense goes, there is always "Poor Man's Botox", which involves growing out your bangs.
Good luck and be well.
Dr. P

Everything about cosmetic surgery is a balancing act between cost and down time. There is no evidence that one ages more or less slowly by maintaining the BOTOX effect. You should be guide by what is financially comfortable. So if you pass by a mirror and notice that your BOTOX is not working as much as it did in the past, there is no harm in putting off retreatment until it is financially comfortable to be retreated.

Thank you for your question overthere23. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.Despite having a natural appearance when performed correctly, many people are afraid of the results of their Botox treatment, in particular before their first treatment, which is natural. In these cases, a lower dose can be used. For example, sometimes I use 10 units in the glabella region instead of the recommended 20 units. In these cases, I advise my patients that the full results will be seen approximately two weeks after the treatment and have them return at that time to take after photographs. At this point, more Botox can be added if further enhancement is desired. I find that when lower doses are used, patients do not enjoy their results for as long; six to eight weeks as compared to three to four months. Therefore maintenance treatments must be performed more frequently.A common misconception is that Botox is only for those who are in their 60's or 70's. On the contrary, I have a lot of patients in their 20's who receive Botox. This is either for prevention or for those who have expressive faces. I find that the younger one is when one starts receiving Botox treatments the more signs of aging will be delayed. In other words, Botox can be used to prevent wrinkles from either appearing in the first place or from getting deeper over time.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

There is growing research that Botox can stunt the progression or development of dynamic wrinkles (the expression wrinkles that form around our eyes, brow, and forehead.)
A convincing argument for preventative Botox comes from two renowned dermatologists published in JAMA Dermatology” who assert, “Initiating regular treatment with a neuromodulator in an individual’s 20s or 30s will have a dramatic effect on the appearance of the face as seen in the person’s 40s or 50s. There will be few, if any, imprinted lines of facial expression present.”
“Long-term effects of botulinum toxin type A (Botox) on facial lines: a comparison in identical twins,”  a study published in Archives of Facial Plastic Surgery supports this claim.  The study followed identical twins over a 13-year period. One twin received regular Botox treatments. The other twin did not. The twin who received preventative Botox treatments showed dramatically less frown lines, crow’s feet and forehead wrinkles than the twin who did not undergo preventative Botox treatments. This led researchers to conclude, “long-term treatment with Botox can prevent the development of imprinted facial lines that are visible at rest. Botox treatment can also reduce crow's feet.”