Is it true that Botox can train your muscles?

i was told that after doing it many times it would last longer. i was also told that (to an extent at least) the muscles might eventually become permanently relaxed thus lessening the need for further botox

Doctor Answers 11

Botox duration with repeated treatments

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Thank you for your question.  The duration of action for Botox will increase over a period of years after repeated treatment. This is because the muscles may decrease in caliber after extended periods of inactivity.

Botox does NOT Train muscles

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Dear adrian23456:

Botox, Dysport and Xeomin are the FDA approved medications for injections for muscle relaxation. These medications do not alter your mind in any way to train or modify behavior. They do block the acetylcholine release from the end of a "motor" neuron at the neuro-musclular junction where it fails to trigger a muscle cell contraction.

Over time, these medications if injected consistently can atrophy the muscle disabling them from future use. Other nearby muscles may act to overcome the loss in expression strength; called recruitment. These muscle may then also need a Botox injection to relax them.

The "training" comes with your perception in reducing or altering that expression and making a mental alteration in future expressions of those kind.This would be similar to pressing against the muscle each time you contract the scowl or glabella muscles between the eyebrows and purposely relax then not to scowl. Over time, you will unconsciously not scowl when you wish to express yourself in that way. These drugs do not affect or trigger such a habit. It is the lack of activity that does create the habit. 

You are correct in that the injected muscles can be "permanently" relaxed (by micro-paralysis) but the medication does not create a expression habit.

Interesting question. I hope this has been helpful. All the best.

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 103 reviews

Long term effects

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This is true. Repeated use of Botox can cause a gradual relaxing of the treated muscles, making your results last longer. 

Botox makes muscles atrophy (weaker)

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Hi Adrian,
It's true. If you keep up with your botox it will help you learn how to re-train those muscles. You learn to not frown anymore if you botox the frown lines, the muscles in the area will atrophy and become less able to fire with movements. Eventually you need less botox, I have patients that come in every six months now. 

Renee Snyder, MD
Austin Dermatologist

Can Botox train your muscles?

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Thanks for your question, Adrian.  I have seen this phenomenon myself in my patients. Many who came for Botox injections every 3-4 months initially have now found they can come in less frequently, sometimes only twice annually.  Regular use of Botox can cause a muscle to atrophy and be more susceptible to future treatments.  This is one of the reasons I tell my patients who like their results to keep getting regular treatments and not let those muscles recover.

Alix J. Charles, MD
Hinsdale Dermatologic Surgeon

Botox will not permanently paralyze your muscles, but the effect can be additive if done regularly

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Botox makes it so you are not "using" those muscles by blocking the process that causes contraction. When you don't use muscles, whether it be that you stop exercising your muscles at the gym or you block the motion of facial muscles with Botox, the the muscles get smaller (atrophy). If you resume your Pilates, your muscles will increase in size, which is what happens if you don't have regular Botox treatments. So, if you receive Botox on a regular basis, you can weaken the muscles over time to the point that a single treatment can seem to have a longer effect since the muscle takes longer to resume action strong enough to create fine lines or wrinkles.

Jaron McMullin, MD
Grand Forks Plastic Surgeon
5.0 out of 5 stars 7 reviews

Is it true that Botox can train your muscles

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Thank you for your questions.  Yes, over time Botox's effects may result in muscle atrophy which may lessen the amount of Botox needed in subsequent treatment periods, or in longer overall effects.  If you were to stop with your Botox treatments, the previously injected muscles will hypertrophy, increasing back to their original size.  Hope this helps. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Is it true that Botox can train your muscles

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Dear Adrian, For the majority of patients, the more frequently you receive Botox the less units you will need over time since the muscle will atrophy.  It does not prolong the effects of Botox. Botox will last approximately 3 months. Consult with a Board Certified Plastic Surgeon for more information.

The Effect of Multiple Botox Treatments

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While it is true that some patients may experience longer periods between injections when the treatments have been done consistently over time, this is not absolute or predictable and varies from person to person. The treated muscles can get weaker the disuse seen with repeated treatment, but unfortunately the Botox effect will never be permanent and if the injections are stopped the muscles will have return of function.  

Patricia N. Mars, MD
Tucson Plastic Surgeon

Botox Effects Over Time

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Multiple treatments of Botox to the same area generally cause the treated muscles to become weakened over an extended period of time.  This can cause the treated muscles to shrink or atrophy to some extent, much the same as how other muscles in the body tend to shrink when not in regular use.  Such muscles may require less Botox over the course of time to achieve the desired effect because they are not as strong as they once were.  This is also why it may appear that the same Botox treatment may last longer.  Unfortunately though, Botox does not stop time from still marching on, and so you also need to account for the changes that will take place due to the natural course of aging.

Gregory D. Lewen, MD, FACS
Miami Oculoplastic Surgeon

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.