How Long Does Botox Last?

Written by Lisa Rhodes, MD, Board Certified Dermatologist on April 25, 2019 One Comment

how long botox lasts

Botox has the power to dramatically decrease the appearance of lines and wrinkles in the areas where it is injected. Botox works by relaxing the muscles and preventing them from contracting, thus reducing the source of persistent lines and wrinkles from appearing. While the results of Botox are significant, it’s very important for patients to understand that they are not permanent.

Botox (and other neuromodulators like Dysport and Xeomin) will eventually lose the ability to relax the muscles after it’s cannibalized through the body’s natural metabolic process. At that point the underlying facial muscles regain the ability to contract, causing the re-emergence of wrinkles. The treated area will eventually return to its pre-treatment state.

The results of Botox vary per individual, but commonly last from 3-6 months. The rate of how long a Botox treatment will last can depend upon a number of variables:


The primary factor that determines how long Botox lasts is the body’s metabolism rate. Patients with high metabolism (often athletes or people who are very fit) may experience a shorter result duration as their bodies metabolize Botox more quickly than patients with lower metabolism.


Some patients may find that both the onset and offset of Botox improves after they undergo multiple treatments. These patients may require a few Botox treatments before their muscles fully respond to the treatment. Additionally, they may also notice improvements in longevity after their second or third session.

Dosage Amount

Larger doses of Botox affect the target muscle for longer than a more conservative dose. This is another reason why patients may realize longer last results as they receive more treatments – many providers will do a more conservative injection to first-time Botox patients to ease them into the effect. Over time, the injector will develop an understanding of how much Botox each individual patient can tolerate.


Botox is usually diluted with 1 to 4 ccs of a saline solution. The exact level of dilution can vary depending on the area being treated, as some facial areas will benefit from receiving a more diluted form of Botox which can treat both target muscle and surrounding areas.

Overall, the higher the concentration the longer the result. This is one reason why its important to seek out a Botox treatment from a properly licensed injector. Many fraudulent injectors over-dilute their Botox (or worse, inject fake Botox) resulting in shorter term results.

Injection Area

Botox that is injected into larger, stronger facial muscles lasts a shorter period of time compared to injections into smaller facial muscles.


Typically, older patients will realize a shorter period of results compared to younger patients. This is due to their skin characteristics. Oftentimes older patients have deeper wrinkles and less elasticity or collagen production in their skin. This equates to a faster reappearance of their lines and wrinkles.

Expressive Tendencies

Patients who are more facially expressive will require more Botox in order to freeze the underlying muscles, compared to patients who are less facially expressive. Additionally, expressive patients may notice that the results of Botox may wear off quicker than the baseline 3-6-month average.

Extending Botox Results

Patients can maximize the results of injectable treatments over longer periods by undergoing regular maintenance treatments. These are touch up injections that are done prior to the results wearing off completely. Recurrent treatments are especially useful for Botox as they may actually train targeted muscles respond to the neuromodulator for longer periods of time.

Besides maintenance treatments, there are other lifestyle choices that can extend Botox results. These include practicing safe sun protection, maintaining a sound skin care regimen, and eating a healthy diet. For more information, read our blog post on how to make Botox last longer.


Lisa Rhodes, MD

Lisa Zanetti Rhodes, MD received her Dermatology specialty training at the McGaw Medical Center of Northwestern University in Chicago, where she served as Dermatology Chief Resident in her last year. Dr. Rhodes is Board Certified by the American Board of Dermatology, and is a member of the Texas Medical Association, the Travis County Medical Society, and the Alpha Omega Alpha Medical Honor Society. Dr. Rhodes serves as a community preceptor at The University of Texas Medical Branch School of Medicine.

One Response to “How Long Does Botox Last?”

  1. Avatar Rebecca says:

    But Botox injections in smaller facial muscles can last even longer than what you put 🙂

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