How quickly does Botox start working and how long do the results last?

Expert tested

Avdeyuk Elena Vladimirovna Dermatovenerologist, cosmetologist

Publication date: April 30, 2022

Review date: November 07, 2022

A person's face is in constant motion. We smile, frown, squint our eyes, raise our eyebrows, purse our lips in displeasure... And all this several hundred times a day.

The facial muscles located under the skin are under constant tension because of this: they stretch or, conversely, contract. As a result, more and more wrinkles appear on the skin, it stretches and sags.

Botox (Dotox) will help you relax spasmodic muscles and “wean” your face from harmful facial expressions.

Today, the name Botox has become almost a household word; it is used to refer to the procedure for smoothing wrinkles on the forehead.

Zhmurina Natalya Borisovna

Director, Chief Physician of “A Clinic” Dermatovenerologist, cosmetologist

But in fact, Botox is a world-famous American drug created on the basis of botulinum toxin type A.

History of Botox

Bacteria that temporarily paralyze muscles (Clostridium botulinum) were discovered at the end of the 19th century, but more than 60 years passed before scientists came up with a rational use for them. In the late 1960s, Edward Shantz and Alan Scott began testing botulinum on monkeys. Later, this substance began to treat excessive sweating, strabismus, blepharospasm and achalasia of the esophagus.

In cosmetology, botulinum toxin began to be actively used at the turn of the 20th and 21st centuries. This happened after the discovery of ophthalmologist Jean Carruther: she noticed that under the influence of botulinum toxin, the orbicularis oculi muscle “crow’s feet” in the corners of the eyes noticeably contract.

Negative result

The most common side effects after botulinum therapy:

• Drooping of the eyebrows due to excessive relaxation of the forehead muscles.
• Temporary spasm of the eyelids due to incorrectly selected dosage for the correction of crow's feet.
• Asymmetry of facial features. Occurs due to a violation of the ratio of the administered drug to opposite sides of the face.
• Hematomas and subcutaneous hemorrhages appear due to rough technique.
• Articulation disorders develop when the medication is injected excessively into the area above the upper lip, chin and lower jaw.

How does botulinum toxin work?

In youth, the skin is elastic, and small wrinkles that appear as a result of the movement of facial muscles are easily smoothed out. However, with age, elasticity decreases and wrinkles become deeper. In addition, facial muscles acquire the ability to fixate in one position. For example, if a person is used to frowning, the facial muscles are fixed in a constant spasmodic position. A person has to make a huge effort of will to give his face a friendly expression.

Botulinum toxin drugs block neuromuscular transmission. When Botox is injected into a muscle, its ability to contract is reduced. And when the muscle does not contract, the skin over it does not fold. Wrinkles are gradually smoothed out. In this case, the muscle does not atrophy, because the blood supply to it does not stop, which means that nutrients continue to flow to the muscle fiber.

Contrary to rumors, facial expressions after using drugs based on botulinum neurotoxin do not disappear, but simply become calmer and more controlled. The face will not turn into a mask and will not lose its expressiveness. You will still frown, smile, be surprised. Only longitudinal grooves will disappear on the forehead, deep folds on the bridge of the nose, “crow’s feet” around the eyes, and “marionette lines” between the nose and the corners of the lips. The skin will glow with health and youth!

Indications for the use of Botox

Botulinum toxin can smooth out wrinkles in almost any area of ​​the face. However, Botox shows the greatest effect in its upper third. So, the drug allows you to get rid of:

• horizontal and vertical wrinkles on the forehead and between the eyebrows;
• wrinkles around the eyes (so-called “crow’s feet”);
• folds on the back of the nose;
• so-called “marionette wrinkles” - labiomental folds;
• cords on the neck.

Botox is also used by highly qualified specialists for:

• correction of the shape of the eyebrows, their height position;
• narrowing of the wings of the nose and raising its tip;
• raising the drooping corners of the lips;
• visual lengthening of the chin;
• correction of facial asymmetry caused by blepharospasms and other spastic effects.

Botulinum toxin is also often injected into the feet, palms and armpits to reduce sweating. This procedure is indicated for people with hyperhidrosis, but it is often used by healthy patients on the eve of summer.

Where is Botox injected?

Botox is most effective in the upper third of the face. The forehead and area around the eyes are its zones of influence. This is where the results of the procedure will be most noticeable.

Wrinkles and folds in the lower part of the face in most cases are not the result of excessive muscle work, but depend on the characteristics of the bone structure of the face, the elasticity and density of the skin and subcutaneous fat, as well as age-related loss of facial volume.

It is recommended to correct the lower part with Botox if there is an obvious muscle spasm: for example, a person constantly clenches his jaw or purses his lips. In this case, Botox will be able to soften the emerging nasolabial folds, relax the jaw, and even slightly enlarge the lips if the pursing of them is eliminated.

There is also the mesobotox technique. This is a subdermal injection of microdoses of the drug, which allows you to smooth out fine purse-string wrinkles around the mouth.

Cost of Botox injections at the Doctor Grishkyan clinic in Moscow

Botox injections cost

How is the procedure performed?

Botox should be administered only in a trusted clinic, and not in the first one you come across. Despite the fact that the drug has been on the market for a long time and has proven itself, it is still a toxin that is injected into the facial muscles. Therefore, injections should be given by a doctor who understands the mechanism of how the facial muscles work “from” to “to” and knows exactly at what point and how many units to inject in order to achieve the desired effect.

Botox injections are placed shallowly into the muscles and leave virtually no marks. The procedure takes about 15 minutes.

Immediately after the injections, small papules are noticeable at the injection sites, but they resolve within 10-20 minutes. Therefore, immediately after the injections you can go about your business: work, walk, relax. The only rule: for 3-4 hours do not take a horizontal position and do not lower your face down. This is required for better absorption of Botox by the muscles and to prevent swelling.

In the first days after the procedure, it is recommended to frown and grimace more often so that the drug is evenly distributed in the muscles.

What factors affect how long Botox lasts?

• Physical activity. In athletes, results disappear faster. This is due to increased metabolism and developed muscles that are difficult to block. Even increasing the dose does not always help. Extensive physical activity immediately after injections is especially harmful. When moving, botulinum toxin may shift inside the tissues and will not penetrate the desired points. In the worst case scenario, displacement of the drug will lead to facial asymmetry.
• Place of injection. Constantly working muscles, for example, those that cause the eye to blink, are quickly released from Botox, so the drug often has to be pinned in the area around the eyes.
• Features of metabolism. The more intense it is, the faster the drug is eliminated from the body.
• Thermal procedures. As the temperature rises, blood and lymph flow increases, which accelerates the elimination of the drug. Therefore, after the administration of Botox, it is not recommended to abuse the sauna, steam bath and other procedures associated with general heating of the body.
• Physiotherapy aimed at working muscles. Various interventions involving muscle stimulation enhance toxin removal, especially if they are carried out immediately after injections. It is undesirable to use magnetic therapy, intense massage, ultrasound therapy, or infrared laser in the Botox injection area. All this reduces the activity of botulinum toxin and accelerates its elimination.
• Medicines used. The effect of Botox is influenced by taking a number of medications. Some can strengthen it, while others can lubricate it. In some cases, the combination of drugs and Botox is unpredictable. Against the background of botulinum toxin, it is undesirable to take tetracycline antibiotics, lincosamides, polymyxins, erythromycin, Succinylcholine, Quinidine, Darifenacin, Orphenadrine, Disopyramide and some other drugs. Therefore, when prescribing medications, you need to inform your doctor about the injections performed, especially if they were done recently.
• Drinking alcohol. It is not advisable to drink alcohol within 7 days after botulinum toxin injection, as it interacts with the drug, reducing its effect. The product may be distributed unevenly, which will lead to facial asymmetry.

These factors explain the difference in the speed and strength of the effect and the different duration of action of Botox. To speed up and prolong the result, you need to coordinate your lifestyle with the recommendations of a cosmetologist.

How long does the effect last?

The effect of Botox begins to appear 3-4 days after injections. A person is getting younger right before our eyes. At the same time, a good doctor will make sure that you can smile, frown and raise your eyebrows in surprise, as before, but wrinkles and creases will not remain on the skin.

The effect of Botox will last for 4-6 months, sometimes longer. This depends on the rate at which the drug is eliminated by the body. Botox is a biodegradable drug; it does not accumulate in the body, but is removed from it through the lymphatic system. By the way, with regular administration of Botox, the effect of the drug lasts longer and the frequency of procedures can be reduced to once a year.

How Botox works

Forehead correction with BOTOX before and after the procedure

When the drug is injected into a muscle, botulinum toxin blocks the transmission of excitation in the terminal sections of the motor nerve, which leads to relaxation of the muscle fibers. This controlled release of muscle tension leads to a smoother face and the disappearance of facial wrinkles while maintaining lively natural facial expressions. Acting precisely at the injection site, it leads to a long-term effect lasting up to 4-6 months in a short time (7-14 days). It is important to remember that by reducing facial activity, BOTOX does not affect muscle nutrition. And it remains the same.

Botulinum toxin type A is a protein neurotoxin produced by the bacteria Clostridium botulinum. Neurotoxin type A blocks the transmission of motor impulses from the nerve to the muscle fiber.

The ability of botulinum toxin to smooth out wrinkles was accidentally discovered by ophthalmologist Jane Carruthers. A cosmetic effect was noticed by a patient being treated for blepharospasm: after completing a course of therapy, her wrinkles in the bridge of her nose became less pronounced. Then they began to study the drug in other areas of the face and the assumption about the effect associated with the toxin was confirmed. Many dermatologists were interested in this discovery, and as a result, many subsequent clinical trials were conducted around the world to study botulinum toxin type A.

The drugs Botox, Dysport, Xeomin, Lantox are registered and approved for use in the Russian Federation.

Pros of Botox

The procedure is quick and simple, there is no rehabilitation period. You can get Botox injections during your lunch break. The procedure takes even less time than a traditional manicure.

Gradual and increasing effect of smoothing wrinkles over two weeks. This is very important for people who do not want to advertise their visits to beauty clinics.

Another significant advantage of Botox is that even after the botulinum toxin is completely removed from the body, a person retains the habit of not wincing or raising his eyebrows. Having gotten used to the new reflection in the mirror, a person will no longer want to return to life before Botox and will strive to maintain a beautiful face at all costs.

But it is worth remembering that Botox is not able to cope with deep wrinkles that have already appeared. In this case, only filling them from the inside with fillers based on hyaluronic acid or other modern fillers, such as calcium hydroxyapatite, will help.

What happens if you stop injecting Botox?

If you adhere to a competent approach to manipulation, observe the correct dosages and time intervals between courses, then stopping botulinum therapy will return the muscle to its natural state at that time.

Of course, if you have had the procedure done for many years, the muscle and skin will not be as “young” as before. Botox does not prevent age-related changes, but only temporarily masks them.

Treatment of local hyperhidrosis

Hyperhidrosis of the palms, armpits, feet or face is often associated with endocrine disorders, neurological disorders, and hormonal changes in women. In some cases, excessive sweating can occur for no apparent reason, based on a genetic predisposition.

The most popular way to treat excessive sweating is Botox injections. The drug injected into the problem area blocks the transmission of nerve impulses and the functioning of the sweat glands. In conditions of lack of response to external stimuli, the amount of sweat produced is significantly reduced.

Therapy is local in nature. It does not disrupt the sweating process of the entire body, but acts in specific problem areas. Injections are made with thin needles, do not cause complications and have a narrow range of contraindications. The effect of the procedure becomes noticeable on days 2-4 and lasts stably from six months to one and a half years.

How long does Botox last and how to prolong its effect?

Anti-aging injections have long become an integral part of our lives. They help prolong youth, correct facial features, and improve skin condition. But they have, by and large, one drawback - sooner or later the miraculous effect will definitely end.

How long does Botox last? This question is usually asked when the procedure has been performed perfectly and you want the result to last as long as possible. But it also happens that the specialist’s hand, as they say, trembles and it is necessary to return the face to its previous appearance as quickly as possible. Will it be possible to prolong the effect of the toxin in the first case and what can be done to make the muscles mobile again in the second? What medications and procedures will help? Why are 1-2 sessions a year enough for some people, while others have to go to a cosmetologist every 2-3 months? TecRussia.ru tells in detail:

↑ How long do injections last?

• Manufacturers of drugs based on botulinum toxin type A promise that the pronounced effect of injections lasts for about 3-6 months.
• Practicing cosmetologists agree with this: they consider the duration of action to be from 2 to 6 months as the norm, and 3-4 months as the average.

However, this period will be strictly individual for each individual patient, since it depends on many additional factors. The most important of them is the frequency of procedures. It is believed that for the best results, Botox should be injected regularly (“the gold standard” is 3 times a year) into the same areas of the face: firstly, if the target facial muscles have not had time to fully recover after the previous session, then new injections will work much better. And secondly, the permanently paralyzed fibers weaken over time, decrease slightly in size and no longer pull the adjacent skin into wrinkles and folds even after the toxin ceases to act.

• Review of drugs based on botulinum toxin: which analogue is better?
• Complications and side effects of Botox: what consequences can there be and how to avoid them?

However, sometimes the exact opposite situation is possible: with each subsequent session, the patient’s sensitivity to botulinum toxin decreases slightly, and the ability of muscles to contract is restored in a shorter time, sometimes up to 2 times faster - i.e. a kind of vaccination effect occurs.

In this case, in order to achieve a good result without constantly increasing the dosage, you should maintain a sufficiently long period of time between injections. For the most popular areas of injection of the drug - the forehead, between the eyebrows and the area in the corners of the eyes - it would be optimal to carry out one procedure every 9-12 months. With this scheme of botulinum therapy, the initial muscle paralysis caused by the toxin persists for about 3-5 months, then for another 2-3 months these areas remain relatively motionless due to the fading of the habit of wrinkling the forehead or squinting. The muscles will need some more time to restore their original tone and contractility - and only after that does it make sense to conduct another session.

↑ What other factors influence the duration of the result?

In addition to the frequency of procedures, a number of other circumstances are also significant, including:

• How many units were administered: the more, the longer the drug will work (however, the difference here is not linear, so it is not advisable to overdo it for the sake of a longer-lasting effect).
• In which specific area are the injections given? On average, Botox lasts longer in the forehead and between the eyebrows than around the eyes. The exception is people with a massive, “heavy” eyebrow area. Usually the muscles in this area are very strong and therefore restore their activity after paralysis much faster than any others.
• The metabolic rate in the body: the higher it is, the faster the original tone in the treated area will return.
• Gender: men's facial muscles are slightly stronger than women's, so the results from the same amount of the drug will last less on average.
• Age: in older patients the effect always lasts longer, since they have weaker regeneration abilities, incl. and tissues recover more slowly from paralysis.
• Peculiarities of local immunity: in some people, the body is able to recognize botulinum toxin molecules as foreign and destroy them before the connection between muscle fibers and nerve endings is disrupted. The result of the procedure in this case will be minimal and will not last long.

↑ How to extend the resulting effect?

In addition to the above, it is also important how the patient behaves after the injections, how carefully he follows the cosmetologist’s recommendations, and how often he is exposed to treatments that prolong or reduce the effect of botulinum toxin:

↑ Can a cosmetologist influence the duration of the result?

• The main tasks of the doctor performing the injections are to follow the correct technique, as well as inject Botox with an understanding of the anatomy of the facial muscles and where exactly the toxin should go. Simply injecting a given dosage somewhere into the area of ​​emerging wrinkles will be a waste of the drug (and the patient’s money). And the ideal option is if the injections are performed by a plastic surgeon, one who constantly works with the muscular structures of the face when performing a lift of the upper third or blepharoplasty and knows everything about their structure and functions. Of course, experience is no less important: good cosmetologists also develop the necessary qualifications over time, and a surgeon who has never touched a syringe is unlikely to be able to immediately provide the desired result. But other things being equal, it makes sense to give preference to the surgeon.
• Also, the preparation of the toxin is of great importance: it must be diluted immediately before injection. After just a few hours, such a solution begins to rapidly lose its quality. What can we say about cases when a syringe with the prepared drug waits for the patient in the refrigerator for several days!

↑ Briefly about the most important:

How long Botox will last directly depends on the individual characteristics and behavior of the patient. Normally, the paralyzing effect on muscle fibers lasts for 3-5 months. This period can be slightly extended or shortened:

• If you are satisfied with the resulting effect, it is enough to follow the doctor’s recommendations regarding the rules of facial care and not violate the basic prohibitions (alcohol, thermal procedures and active sports are especially dangerous in the first days after injections).
• When complications, side effects occur after the procedure, or for other reasons the reflection in the mirror is not pleasing, you can speed up the resorption of botulinum toxin with the help of physical therapy and facial massage.
• The best and longest lasting result will be if you do injections without waiting for the previous ones to completely wear off - on average, every 4 months. Those for whom this approach does not work should, on the contrary, increase the pause between sessions to 9-12 months.