If Botox paralyzes facial muscles, won't they atrophy?

Doctor Answers 15

If Botox paralyzes facial muscles, won't they atrophy?

  Yes, however not very much.Botox injections are stopping your muscle from contracting therefore they are “ not working out “ and looses strength. This can lead to mild atrophy which is beneficial since on long term less Botox may be needed to be injected or the intervals of treatments can be longer . Once the Botox treatments are stopped the muscles will start contracting and will regain their strength.


Montreal Dermatologist
5.0 out of 5 stars 2 reviews

If Botox paralyzes facial muscles, won't they atrophy?

Hello, and thanks for your question. The short answer is yes. This is why people tend to require lower doses of Botox with time if they maintain it every 3-4 months. Best of luck, Dr. Frucht.  

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Does botox cause muscle atrophy?

Over time and with repeated consistent use, Botox can and will cause muscle atrophy. If the muscles are never really allowed to regain their strength by consistently and regularly doing Botox, then the treated muscles will atrophy. If you reduce your treatments or stop them for awhile, the muscle can move again thereby strengthening and thus it wont atrophy.

Lesley Rabach, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

BoTox - leads to muscle atrophy

Yes this can happen if you are consistent with the use of BoTox or other neuro active agents. You often hear patients say that ""their BoTox is lasting longer" due in part to the atrophy of the muscle. However if you do not keep up with your frequent treatments, the muscle activity level returns. 

Michael Kulick, MD, DDS
San Francisco Plastic Surgeon
4.1 out of 5 stars 10 reviews

Botox Light

That is a good question. You do not have to completely paralyze a muscle for the Botox to effective in reducing fine lines and wrinkles. Botox an weaken the muscle and still be effective. If the muscle is paralyzed, it is important to let the effects of the BOTOX wear off and let the muscle build up strength. Muscle atrophy comes repeat paralyzation of the muscle without giving the muscle time to regain strength in between treatments. Many patients today, prefer to have a more natural look, leaving motion in the muscles after Botox treatment. Patients request for the  "Botox Light ".  

If Botox paralyzes facial muscles, won't they atrophy?

In my over two decades of use of Botox I have seen patients where repeated use of Botox has permanently (seemingly) weekend their muscles of expression to their benefit.  Whether this affect remains present over a long term, permanently or short-term it is difficult to say.  It usually is not a problem however and for many would be considered a benefit reducing the requirement for Botox injection in the expense involved.  Best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Does Botox cause muscle atrophy?

Muscle atrophy will occur if the Botox is done routinely on a regular basis. If the muscles are allowed to regain their strength by skipping treatments or waiting too long between treatments, the muscle won't atrophy.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Botox and facial muscle atrophy #plasticsurgery

Muscle atrophy of bulky masseter muscles that contribute to excessive facial width can be achieved with high-dose Botox on a regular basis. The typical Botox treatments used for other muscles of facial expression do not atrophy to any substantial degree with regular Botox dosing

Botox & Atrophy

It wouldn't be permanent. If you stop treatments of Botox and use the muscles they will rebound.  How long that takes is dependent on how many units were used.  It will take time, but they will come back. See an expert for a formal evaluation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Botox and muscle atrophy

Over a long period of time and many injections of Botox into the same muscles the muscles will become atrophic.  Whether this will be clinically significant is a moot point

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 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.