When Stopping the Use of Botox, Do Wrinkles Become Worse Than Before Treatment?

Doctor Answers 23

Do wrinkles become worse when botox treatment is stopped?

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Hi Karen. Thank you for your question, which is frequently asked by patients. The simple answer to your question is no. Compared to before any botox treatment, dynamic wrinkles in botox-treated areas should not become worse due to stopping the botox treatment. Good luck. 

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

Wrinkles do not become worse, rather better,then before treatment, after stopping Botox

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I often see patients who were not able to return for one reason or another, for a long while after their last Botox and typically the lines present are better than before their first treatment they ever received.  The muscles can get retrained by you and after having Botox for a while, you tend not to reflexively frown or squint as much so that even when the Botox is not effective any longer, your more relaxed facial state keeps the skin smoother than before your onset of treatment.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

After Botox Wears Off . . .

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About three or four months after you’ve had an injection with Botox, your muscles will slowly start functioning again and once the Botox has completely worn off, your wrinkles will be back again. Also, over time you’ll start to lose fat and collagen and elasticity, so you may need to add other treatments to address future aging. But, no Botox does not make your wrinkles worse than before. Think of Botox as a maintenance treatment that you’ll need every three to four months if you want to keep the wrinkles relaxed.


Timothy Jochen, MD
Palm Springs Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

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NO, you will just return to how you were before the treatment. If you use it for 5 years and stop, you will likely return to how you were 5 years ago when you started IF you were using it regularly. In essence you have stopped the clock on aging for those 5 years, this is due to those muscles becoming weak and therefore unable to make the movements that worsen the lines which "age" you.

Robyn D. Siperstein, MD
Boynton Beach Dermatologist

When you stop BOTOX, wrinkles do not become worse than before the treatments

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When you stop BOTOX, wrinkles do not become worse than before the treatments.  In fact, after having BOTOX for several years, the lines completely fade and often come back much slower than if you never had BOTOX in the first place.  But, BOTOX does not stop the aging process.  Overtime wrinkles come back to where they were and as you age they may continue to get worse. 

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Wrinkles will not be worse after Botox wears off

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Neuromodulators such as Botox and Dysport soften wrinkles that are caused by hyperactive muscles of expression such as the corrugator muscles that cause the "11" between the eyebrows. Once the effect wears off, the muscles will re-form the wrinkles as they were before. It is possible that if the effect is maintained with regular injections, you could prevent wrinkles from becoming worse since they would tend to worsen over time without any treatment..

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Wrinkles should return as they were before

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While Botox is in effect you are making less muscle movements than you would be without Botox so your wrinkles cannot be worse. If you do not continue treatment you just go back to the way you were before your treatment.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 117 reviews

Botox Shouldn't Worsen Wrinkles Long Term

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If you stop using Botox, your wrinkles should not worsen compared with how they were to begin with.  Usually, they will either go back to how they looked you started getting Botox, or, the wrinkles may be slightly less noticeable, depending on how long you have been getting injections, which can sometimes weaken those front muscles longer-term over time with repeated treatment.  The texture and thickness of your skin is not effected one way or another with Botox, however, so your skin will continue to age regardless of Botox usage.

Steven Svehlak, MD
Los Angeles Plastic Surgeon
4.6 out of 5 stars 32 reviews

When Stopping the Use of Botox, Do Wrinkles Become Worse Than Before Treatment?

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Botox temporarily paralyzes your muscles so wrinkles go away.  Once the Botox wears off, the wrinkles should not be any worse then what they would have been had you never received Botox.   You will just see a significant change once the Botox wears off, but this will actually be what you would look like without Botox. 

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Are Wrinkles Worse after Botox?

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Hi Karen.  Maybe the wrinkles would look worse if you have been using Botox continuously for 10 years or longer.  Other than that, the wrinkles should look exactly the same.  

Botox does not change the makeup of the skin, it is only capable of temporarily relaxing the facial muscles.  Any smoothing effects will last only as long as the Botox does (3-4 months) and your face will look exactly as it did before the treatments if you do not use it again.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 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.