For years, the injection of neuromodulators has been the most popular nonsurgical cosmetic treatment in the US. This group of medications includes botulinum toxin, or botox. In fact, the term “botox” is generally used as shorthand for any neuromodulator, although the category includes the brand name medication Botox along with others, like Dysport and Xeomin.

We get quite a few questions from people who are curious about botox and how it works. One of the most common questions is about how long a botox treatment lasts. Is it permanent? How often will you need touch-up treatments if you want to maintain your results? Although this does vary somewhat from person to person, there are some general guidelines.

How does botox work?

First, it’s important to understand how a botox treatment works. It actually doesn’t directly act on wrinkles. Instead, botox works by relaxing certain facial muscles. When these muscles are activated, they create folds in the skin. Over time, as these folds are created repeatedly, they start to turn into more permanent wrinkles and grooves. By keeping the muscles relaxed, botox prevents the formation of these wrinkles and grooves, and allows those that have already formed to gradually fade over time.

Botox relaxes muscles by interrupting communication between the nerve and the muscle. It binds to certain proteins on a nerve cell, preventing it from releasing the chemicals that activate the muscle it’s connected to.

How long does botox treatment last?

Botox permanently binds to and inactivates proteins. For each protein that botox binds to, it will never be active again. In fact, no known treatment is able to reverse this effect. 

However, nerve cells (like all cells in the body) are constantly replacing their proteins. Even though those specific proteins are now inactive, the nerve cell will make more of the same protein to replace the inactive ones. Over time, as the nerve cell replaces the proteins, it will regain its ability to activate the muscle.

It takes about three to four months for the effects of a botox treatment to wear off noticeably. At this point, there will start to be activity in the facial muscles again, with resulting folding of the skin and therefore wrinkles and grooves reforming. Once this starts happening, if you’d like to maintain your results, you’ll need to repeat the treatment. Most people are happy with getting botox treatments two or three times a year.

Does botox get more effective over time?

If you continue to use botox, you’ll likely notice that the effects seem to last longer and longer with each treatment. This is because a muscle that stays consistently relaxed begins to atrophy, meaning that it shrinks and gets weaker. Even once the nerve regains its ability to activate that muscle, it won’t fold the skin as much, because it’s not as strong.

In addition, for any wrinkles or grooves that you already have, botox won’t directly get rid of them. It will prevent them from getting worse, by stopping the folding of the skin that deepens them. Over time, when the skin consistently remains unfolded, these wrinkles will tend to smooth out. This is why the best results from botox are achieved in people who use it long term. When the skin is consistently allowed to remain unfolded, the surface will smooth out, and there will be fewer visible wrinkles. 

In fact, some people choose to get botox before they have any signs of aging at all. This is sometimes known as prejuvenation. By preventing the skin folds before they’ve developed into wrinkles, the smooth surface of the skin can be maintained for a much longer time.

Achieve Youthful Skin with Botox and Other Treatments

If you’re considering your anti-aging options, please come in for a consultation. Botox is a popular option, and you might want to consider other nonsurgical options as well, such as fillers, chemical peels, or laser skin resurfacing. If you want more dramatic anti-aging results, it might be time to consider a surgical facelift. Simply contact our office to schedule your appointment.

Botox injections are quick, safe, and virtually painless, and there’s no downtime required. This is part of why botox is so popular – it’s extremely convenient, and can even be done on your lunch break. However, it’s also important to choose an experienced injector, because botox can lead to some unwanted effects if proper injection techniques aren’t meticulously followed. All botox injections are personally administered by Dr. Caniglia


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