Botox Q&A: How Long Does Botox Last and What Makes the Effects Last Longer?

Question – How long does Botox last? What determines how long it will work for me?


Answer – In most patients, Botox lasts between 3-4 months. However, there’s quite a bit of anecdotal evidence suggesting that it’s possible for patients to achieve results that last up to 6, 9 or even 12 months after consistent, long-term and properly-administered use of the Botox product.

In other words, what determines how long the effects of Botox lasts is:

  1. the dosage (and whether or not it’s been properly diluted)
  2. the duration & consistency of use
  3. the skill/experience of the injector or surgeon who administers the injection

The x factor within the “consistent, long-term and properly-administered” conditional I included is, of course, “properly administered”. After all, consistent treatments over several years will matter very little if the wrong amount of Botox has been injected imprecisely/incorrectly. That’s why 2 of the 3 factors explored in this post address it (re: ‘dosage’ and ‘skill/experience of the Botox injector‘).
 

1. Dosage: Why injecting & diluting the proper amount of Botox = key

Botox injection units dosage

Recommended Botox dosage (in units) – American Society of Plastic Surgeons.

The first factor that impacts the longevity of Botox’s winkle-reducing effects is the dosage. Botox is diluted for safe use regardless of the injection site, so the impact it has on the surface is largely dependent upon the amount of injections. The site of injection will determine the amount of injections you receive.

Botox Vial - Albany NY Plastic Surgeon William DeLuca

A single-use vial of Botox

There are 43 individual muscles in your face and each of them has different strengths depending on their placement within the face. Different areas require different dosages – and within each area, the dose-range varies widely – so it’s critical that the surgeon be able to accurately determine the correct amount.

For example, treatment of crow’s feet is relatively simple and requires 8 – 14 units per side. On the other hand, the knot of muscle between the eyebrows, known as the glabella area, is much stronger and requires 18 – 36 units to smooth out that area alone.

Of course, the patient’s physical makeup and lifestyle will also affects how long Botox has. On the one hand, patients with particularly thick muscles in their face will require more injections in order to enact the desired effect. The thicker muscles are more difficult to affect with injections because they require the same depth, so more shots are used rather than altering safety techniques.

On the other hand, the injections tend to dissipate faster in athletic patients. The body’s healing abilities will work faster to eliminate the solution. The good news is that regardless of your makeup, as with any beauty regimen, the longer you are consistent with Botox, the weaker the wrinkle-causing facial muscles will become, and thus, the longer the effects of Botox will last.
 

2. Frequency of Use: After several years of Botox, results often last longer

The second factor affecting how long Botox lasts is the duration and frequency of use. And while there isn’t much non-anecdotal evidence to support the widely held theory that consistent use of Botox over several years can lead to results that last up to 9 or 12 months, I expect we’ll see a long-term study published on the topic in the very near future).

That said, based on my own experience with several thousand Botox patients (and discussions with other plastic surgeons who’ve injected 1,000s of patients as well), I’m confident that the connection/correlation is strong.
 

3. Skill & Experience: Both are needed to optimally target each injected unit

This brings us to the third influencing factor: the injector who is heralding the needle. He or she carries the most knowledge about the proper applications, and will have a direct impact on whether the injections will have the desired effect.

It is essential that a trained professional is applying the Botox to your skin. In the wrong hands, botulinum toxin can be dangerous. It is extremely important that you always seek a physician who:

Although it is not a highly intrusive procedure, correctly and precisely administering Botox to wrinkles in the face requires a great deal of skill and experience. So do be sure to find a surgeon who does a lot of facial work and who will gently inject the precise amount of Botox into the specific muscles that cause wrinkles. Otherwise, your facial expressions may be negatively impacted by this minimally invasive procedure.

  • Jani P

    Do most cosmetic surgeons offer a guarantee if the Botox injections don’t last at least 3 months? The reason I ask is because I had approx 40-45 units for both eyes (crows feet area) its been 2 months & I don’t see any difference.

    • http://www.delucaplasticsurgery.com/ William DeLuca, MD

      Jani Usually there is no guarantee for longevity. That is a good amount for crow’s feet and should give you a good response. I usually touch up patients at cost or no charge if no response. Dr D

  • Gary

    I have been using Botox for 8 years now and I am finding twice a year now enough so keep it up and you will be happy at the results as the years go by.Botox plus sunscreen everyday means no wrinkles promise

    • http://www.delucaplasticsurgery.com/ William DeLuca, MD

      Can’t promise you won’t get wrinkles, but glad you like the results. Dr D

  • Chris

    I get Botox have a large forehead. 78 units for forehead, globella, crows feet. Finding it lasts less time not even really 3 months. The girl I use does her own face with it as well, wondering if she is “skimming” off the top and keeping some for herself. She tells me my body “eats it up.” What do u think?

    • http://www.delucaplasticsurgery.com/ William DeLuca, MD

      Chris If you workout a lot Botox may not last as long, but 78 units is a solid amount for a treatment . Should last 3 months. Dr D

  • linda

    Hi Dr. I have been having 70 units every three months for the last 15 years to treat blepharospasm. In the early years the shots would often fail after 8 weeks but now they hold my eyes for the full 3 months

    • http://twitter.com/TEnchantedattic Debra Cake

      You have blepharospasm because you have a magnesium deficancy, trust me I’m right! Do not take a multivitamin it will not do the trick! For reasons to long to explain! Go get 400 mg take one everyday till the spasm stops. It usually takes one dose , results in 2 to 4 hours . Doctors don’t want you to know this because they make 100s on Botox, magnesium 6 dollars a bottle While you at it grab some calcium too, if your magnesium deficant , that means your defiant in calcium. Your body can’t Absorb calcium without magnesium.

      • Guest

        Debra Cake is correct! I had a blepharospasm that drove me crazy for years. I tried almost everything to get rid of it, even Botox. Botox worked, but it only covered up the symptom. It didn’t get to the root of why I was having the problem, which is a magnesium deficiency. I also suffered with migraine headaches, which is caused by a magnesium deficiency, too. It took more than 400 mg a day to get rid of my blepharospasm and migraines, though. I had to experiment for several weeks until I got the dosage just right. Too little and not enough improvement is shown… Too much and it will cause diarrhea. The magic number for me is 1200 mg a day. Thank God, no more eye twitch or migraines!!

    • Cathy B

      Debra Cake is correct!! I had a blepharospasm that drove me crazy for years. I tried almost everything to get rid of it, even Botox. Botox worked, but it only covered up the symptom. It didn’t get to the root of why I was having the problem, which is a magnesium deficiency. I also suffered with migraine headaches, which is caused by a magnesium deficiency, too. It took more than 400 mg a day to get rid of my blepharospasm and migraines, though. I had to experiment for several weeks until I got the dosage just right. Too little and not enough improvement is shown… Too much and it will cause diarrhea. The magic number for me is 1200 mg a day. Thank God, no more eye twitch or migraines!!

  • http://www.lasertouchsoho.com/botox.html Lorraine Seth

    My doctor told me that my first Botox treatment will last for atleast 6 months, he wasn’t sure if i will get wrinkles again or not, this is the third month going and no facial lines so far, hoping for the best.

  • Bridetobe

    I made the mistake of getting botox before my wedding, I hate the results. At the time of the wedding it will be about 10 weeks post injections, do you think some of the effects could/will wear off by then?

    • Bridetobe

      I am terrified I will hate my wedding photo’s, I have put so much time and energy into my wedding… and I just want to like the way I look. So upset!

      • Never again

        1/11/14:How are you doing? I hope symptoms went away.. I too suffer from bad results due to over botox.