Why Do Botox and Undereye Injections Disappear So Quickly?

Had filler under eyes and Botox at least 3 times and never last more than a month. Could it be a medical problem? Why do fillers and Botox not last more than 1 month on me?

Doctor Answers 7

Botox and fillers didn't last - bad injection technique or unrealistic expectations?

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It is entirely possible that you were underdosed, or that the Botox and fillers were not injected in the optimal place.  This is the easy answer.  Hopefully you are seeing a reputable plastic surgeon or dermatologist for your injections so this is not the case.

The more difficult answer is that the Botox and filler were simply used to try to treat too large a problem.

Occasionally we see patients who are in their 60's and have never had any plastic surgery.  They expect a single syringe of hyaluronic acid and Botox to "fix" their problems.  It would indeed be possible to improve the patient's appearance greatly, but six syringes might be required for optimal effect.  Even then, hyaluronic acid fillers and Botox do not accomplish what surgery does.  They are just not powerful ennough to restructure the deep tissues and move them to a higher, more youthful position, or to remove excess skin, or to resurface that skin.

Your doctor should be realistic with you about what results fillers and Botox are capable of producing.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Botox seems to wear off quicker around the eye than anywhere else

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There is no widely accepted explanation for this but I agree with you and it has been my patient's similar observation that the Botox wears off quicker and wrinkles return sooner around the eyes.

My explanation is that the turnover is faster here due to the repetitive motion and the excellent blood supply. We similarly observe that local anesthetics injected into other parts of the face may last 2-3 hours but when injected around the eye they tend to last no more than an 1-1.5 hours.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Botox usually lasts 3 to 6 months.

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Botox typically last 3 to 6 months and most fillers last anywhere from three months to nine months. Additionally, the metabolism of Botox and the fillers is different, so it would be very unusual if you had some "medical condition" causing increased metabolism of both substances. I am curious how and where the Botox was injected into your face and which filler was used. I hope that you are going to someone with extensive experience in injectables and Botox. Of note, there is a rare instance of people becoming immune to Botox. This happens in less than 1 out of 10,000 people. These people form an antibody to the Botox molecule so a different variant of Botulinum toxin must then be used to achieve the same effect. However, this would not affect the filler issue that you are having, so I doubt that you are one of these people.

I hope this is helpful.

David Shafer, MD

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Botox lasts 4 months.

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1)  I don't think you are getting good care.

2)  Botox lasts 4 months, if enough is used.

3)  Fillers under the eyes like Restylane can last one year!

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Short Botox and Dermal Filler duration

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We find in our practice that dermal fillers last up to 9 months in the under eye area because there is not a lot of movement in this area. Botox around the eyes usually lasts approximately 3-4 months.

In the rare case that you did have a "medical problem" such as resistance to Botox, it would not affect the dermal fillers.

A one month duration for dermal fillers and Botox is very unusual for any area of the face and we would definitely suggest getting a referral for another practitioner to see if the results are different.

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

Try a different Botox injector and/or a larger dose

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Botox should last at least 2 months, usually 3 months. After you've been using Botox regularly (every 3 months) for a year or so, you may be able to stretch your treatments out to every 4-6 months as the muscles atrophy.

If your results are lasting only 1 month, then the most likely reason is that not enough units are being treated for your muscles.

Try going to another experienced provider and see if you notice a difference.

Also, use sunglasses to prevent squinting and frowning, and avoid over-consumption of calcium supplements which may contribute to speeding up Botox metabolism.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon

Under eye Botox treatment is effective for wrinkles

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Botox is a selective inhibitor of Acetylcholine release at the neural synapse. The effectiveness of Botox at the neural synapse is dependent on the muscle activity due to neural firing at the neuromuscular junction. In general, Botox will last 3 to 4 months if sufficient is injected.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 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.