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What to Expect When Botox® Wears Off?

Botox® is a toxin that is used by medical practitioners to lessen the appearance of fine lines and wrinkles. 

Botox® also known as Botulinum Toxin was approved by the FDA for cosmetic use in April 12, 2002. 

Formal trials were conducted and it was proven to be a success in temporarily improving the appearance of moderate to severe frown lines and the effects are not permanent.

female patient getting facial injection

Botox® injections are administered by Botox® certified physicians or nurses in controlled amounts to relax muscles and give the face a fresh and youthful appearance. 

Once Botox® wears off, wrinkles begin to reappear and do not become worse after the treatment. However, since the patient has become used to smoother skin and a youthful appearance, it might come as a shock when the Botox® wears off. 

Botox® administrators should manage patient’s expectations in this regard.

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What Happens to the Muscles When Botox® Wears Off

Botox® paralyzes the point where the nerves are attached to the muscles making the muscle enter a relaxed state for an extended period of time. 

After a few months, new nerve endings develop that are not affected by Botox®. When these attach to the muscles, the muscle contracts, causing the wrinkles to slowly reappear.

There are 43 facial muscles and each area requires a different dosage of Botox®. 

For example, 8 to 14 units are injected around the eyes to help correct crow’s feet. The glabella area, which is the space between the eyebrows, has much stronger muscles and needs around 18 to 36 units to help smooth out the lines. 

Similarly, how long Botox® effect lasts depends on the area of the face in question. Thicker muscles require more injections to achieve the desired result as compared to the thinner ones. 

It is standard procedure to use more injections for thicker muscles than injecting deeper into the skin to ensure the patient’s safety.

What to Do When Botox® Wears Off

Botox® is also like any other beauty regimen and the effects improve over time with repetitive use. Using it consistently produces much better results since the muscles responsible for the appearance of wrinkles weaken with each use making Botox® last longer.

If the Botox® dosage is not strong enough or the correct number of units is not administered the results will not last as long as expected.

However, a skilled Botox® administrator can help reduce the appearance of wrinkles for up to six months by injecting the right amount of Botox® into the right areas.

Even though the timeline varies from patient to patient, the results can last for at least a couple of months.

A larger dose is required for men than for women and some areas have a shorter tolerance for the injection.

In most cases, 3 – 6 months is the average duration for which the effects of Botox® last.

If Botox® is applied regularly then after a few years the patient can go up to 9 months and even up to one year between treatments.

For first time Botox® users, Botox® injections usually wear off in less than 3 months.

To get the facial muscles conditioned to the Botox® injections, repeated treatments are required. The results can lengthen after a few rounds of Botox® treatments.

How to Prolong the Effects of Botox®

Train the muscles through correct administration of the drug

When a patient first begins receiving Botox® treatments, their muscles are much stronger. 

To ensure the proteins present in Botox® are at optimal performance it is important to make sure that the proper dose is administered to the target area. 

Lesser units are required over time because the muscles get weaker and weaker. 

The glabella area between the eyebrows takes around 20 units to make sure the muscles are properly frozen. 

The muscle gets weaker with time and the duration between treatments increases while the number of units required decreases. 

What starts at 20 units for every 4 months could progress to 15 units every 6 months once the muscles are trained.

Take zinc supplements to help absorb the solution

Since Botox® is a member of the enzyme group which depends on zinc it is recommended that the patient take supplements to help the body absorb the Botox®. 

Phytase present in the zinc supplements may help improve the results produced by Botox® injections especially in those who have a zinc deficiency. 

A study showed that Zytaze, a compound of zinc and Phytase taken four days prior to the Botox® injections showed long-lasting results in the patient’s skin after receiving injections.

Apply a Retin-A topical on the treated area

Combining the Botox® treatment with anti-aging topical such as Retin-A can help produce the desired results in the upper part of the face. 

Botox® injections paired with a topical retinoid help prevent the need for a large number of Botox® units and helps prolong the effects of the treatment.

Avoid direct sunlight and strenuous exercise

Aside from the recommended protection against sun exposure, it should also be avoided prior to the Botox® treatment.

Sunshine boosts blood circulations and causes the blood vessels to disperse the Botox® solution at a faster rate. The same applies to cardiovascular exercises.

Proteins need time to properly diffuse into the skin and affect the muscles in the targeted area after they are injected.

Exercising vigorously after being injected with Botox® can cause the solution to metabolize before it has had the time to properly diffuse, therefore reducing the effectiveness of the treatment.

Even after the prescribed 24-hour waiting period, patients are recommended to be careful when they return to their exercise regimen.

The facial expressions made while working out could make the muscles contract much faster and cause the effects of the Botox® treatment to wear off.

Botox® is administered into muscles in quantities that are suited to the body.

However, it is important that the person who is performing the procedure be a licensed medical professional.

The IAPAM recommendsextensive training for all those who wish to become Botox® administrators and be prepared to answer all the patient’s questions and address their concerns.

Side-Effects of Botox®

While Botox® does not require bed rest or the observance of a healing period, there is often slight swelling and bruising experienced after the treatment because of the needle. 

It can be easily covered by makeup and there are no side effects in the long run which means patients can continue with their normal daily routines at once and even take long flights if need be.

Who is Botox® for?

Botox® is suitable for many types of patients and is mostly used to rejuvenate the skin and reduce wrinkles and fine lines.

The best Botox® injection target area is between the eyebrows which will improve the appearance of severe frown lines for a period of a few months usually.

Another common injection site is on the side of the eyes to reduce moderate or severe crow’s feet.

Who should be advised against Botox®?

Patients with medical conditions like muscle problems or damaged nerves should be identified before the procedure to avoid post-treatment complications. 

Botox® is also not advised for pregnant or breastfeeding women. 

While there is no clinical evidence to prove the harmful effects of Botox® on the mother or the child, medical professionals prefer not to treat women under these conditions.

What are the Results of the Botox® injection?

Botox® softens the lines caused by frequent facial expressions and is adjusted according to the patients needs to make sure the results are natural. 

The duration for which the results last varies from individual to individual but is usually around 3 to 6 months.

Patients usually express their problem areas and what they need treatment for to the Botox® administrator. 

A Botox® administrator should go beyond this specific area and analyze the face as a whole. 

This is done to ensure that treating that specific area would not affect the natural look of the patient’s face. 

Sometimes patients complain of looking tired and grumpy all the time due to certain lines, but it is not usually attributed to these specific lines and multiple factors come into play which should be discussed at length with the patient.

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What to Expect When Dermal Filler Wears Off?

Female patient getting facial injection

As people age, elastin, natural collagen in the skin, reduces and cells are incapable of producing more of this youthful component. 

The skin gets dryer and thinner, losing the ability to heal itself. 

Humans are born with an abundant supply of Hyaluronic Acid (HA) in their body.

But as they get older, the amount of HA diminishes, reducing the support provided to the skin and causing lines to form. 

Dermal fillers lift and smooth out the targeted areas of all folds and wrinkles by adding a subtle amount of volume.

The person emerges with a visible difference and an overall fresher look.

Treating the fine lines and wrinkles using dermal filler involves injecting the naturally occurring HA into the area using a tiny needle.
There is minimal discomfort and the treatment procedure is not very long. 

The aesthetic results produced by the dermal filler treatment are visible immediately following the procedure. 

Treating wrinkles using fillers is a fast, no-scar process. There are different types of dermal fillers to treat different parts of the face such as fine lines on delicate areas and deep depressions in the skin. 

Fillers are also injected into the lips to add more volume by a safe and medically approved procedure.

As people age, elastin, natural collagen in the skin, reduces and cells are incapable of producing more of this youthful component.

The skin gets dryer and thinner, losing the ability to heal itself.

Humans are born with an abundant supply of Hyaluronic Acid  (HA) in their body but as they get older, the amount of HA diminishes, reducing the support provided to the skin and causing lines to form.

Dermal fillers lift and smooth out the targeted areas of all folds and wrinkles by adding a subtle amount of volume.

The person emerges with a visible difference and an overall fresher look.

Treating the fine lines and wrinkles using dermal filler involves injecting the naturally occurring HA into the area using a tiny needle. 

There is minimal discomfort and the treatment procedure is not very long. The aesthetic results produced by the dermal filler treatment are visible immediately following the procedure. Treating wrinkles using fillers is a fast, no-scar process. 

There are different types of dermal fillers to treat different parts of the face such as fine lines on delicate areas and deep depressions in the skin. 

Fillers are also injected into the lips to add more volume by a safe and medically approved procedure.

Side Effects of Dermal Fillers

The procedure is usually half an hour to 45 minutes long and produces visible results that last for up to 18 months following the treatment. 

In some cases, the results may even prolong up to 24 months, however, the treatment is totally reversible. 

Patients can expect slight swelling or bruising as expected with any injectable treatment. It only lasts for a day and can easily be covered up using a concealer.

Patients usually express their problem areas and what they need treatment for to the Botox® administrator. 

A Botox® administrator should go beyond this specific area and analyze the face as a whole. 

This is done to ensure that treating that specific area would not affect the natural look of the patient’s face. 

Sometimes patients complain of looking tired and grumpy all the time due to certain lines, but it is not usually attributed to these specific lines and multiple factors come into play which should be discussed at length with the patient.

Best Candidate for Dermal Fillers

Facial fillers are suitable for a variety of patients but it is mostly prescribed to rejuvenate the skin and reduce fine lines or wrinkles. 

Those who want to add volume or seek a symmetric facial structure also use dermal fillers. 

Fillers help restore the lost volume and reverse the natural aging process by giving patients a brighter and fresher appearance.

Who should be advised against Dermal Fillers?

Even though there are no known side-effects or risks to pregnant or nursing mothers, IAPAM strongly advises administrators against treating these patients with dermal fillers.

What are the results of Dermal Filler Treatments?

The results seen after injecting dermal fillers are very subtle making everyone else believe that it there is a natural glow to the face and minimal effects of aging. 

Treatment will last for about 18 to 24 months and the fullness begins to soften gradually, making the change in appearance almost unnoticeable. 

When the effects wear off, patients can come back for another series of dermal filler injections.

Patients often approach dermal filler administrators with a specific area they have a problem with and need a solution for. 

It is good practice to not just look into treatment for that specific wrinkle or line but consider the face as a whole and how the fillers will affect it. It is every dermal filler administrator’s objective to achieve a natural look when injecting facial fillers.

Often patients are told they look way older or much too tired because of their frown lines or worry lines but it is not only due to these specific lines that they face these problems, multiple factors come into play and they should be discussed at length with the patient. 

The key is to make the patient feel like they are in safe hands and reassure them using medical knowledge about the benefits of dermal fillers. 

Patients should be encouraged to speak about their concerns freely so the practitioners can fully understand what they hope to get out of this treatment and help them achieve their desired results.

Final Thoughts

Botox® injections are mainly used to reduce the appearance of fine lines and wrinkles on the forehead, between the eyebrows, or around the nose. 

Botox® when injected into the area reduces the amount of muscle contraction in that specific facial region to minimize the deepening of the lines and producing a reverse-aging effect.

Dermal fillers on the other hand are increasing the volume of muscle tissue underneath the fine lines and wrinkles. 

It is normally reserved for creases and folds in the lower half of the face, i.e. the nose to the mouth area. It also enhances the volume of cheeks, lips, and under-eye regions. 

Dermal fillers treat areas of the face where muscles are usually at rest as opposed to Botox® which is used to treat muscle tissues damaged by frequent use.

It is possible for a patient to require the administration of Botox® and dermal filler injections both depending on their facial structure. 

Patients who have severe facial lines that deepen as they make different facial expressions and are also visible when their face is at rest require injections of Botox® and dermal fillers. 

The treatments are not mutually exclusive and can be recommended to the same patient.

Medical professionals owe it to patients to fully inform them of the differences between dermal fillers and Botox®. 

Patients are mostly only aware of Botox® and think it can fix all types of aging skin problems. It is the duty of the medical professionals to properly guide them on the results and side effects of Botox® vs dermal fillers.

IAPAM urges all medical professionals to seek more information on the implications, indications, and precautions on the treatment they are specialized in to give their patients the best experience.

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