Manhattan, NY

"Why is my Botox wearing off so fast?" Top NYC Medical Aesthetics Experts Weigh In

Bryce Gruber

Botox and its competitors account for the most popular non-invasive cosmetic procedures according to the American Society of Plastic Surgeons, but some frequent users and newbies are left wondering, "Why is my Botox wearing off so fast?"

That three months number? It's more of an average.

"Neurotoxin generally lasts anywhere around three to four months," shares Christina Tewfik, a physician associate working as an aesthetic practitioner at SkinSpirit, one of the world's leading Botox providers, in Manhattan.

"There have [also] been cases of a common brand of neurotoxin called Dysport, lasting around 5 months.

How long will Botox treatments really last?

"The dose, target area, the number of receptors the Botox (or Dysport, Xeomin, etc.) needs to block will change the length of time it lasts," shares Stafford Broumand, a board certified plastic surgeon practicing at 740 Park Plastic Surgery on Manhattan's Upper East Side. "The patient’s metabolism will also affect the longevity of the product. The larger the patient’s muscle, the more product is potentially needed."

Dr. Stafford urges patients to keep in mind that everyone's muscle tissue is different, and that can ultimately impact the longevity of neurotoxin treatments like Botox, Dysport, or Xeomin. "The more the muscle is used, the more quickly the potential breakdown. Plus, every injector has their preference with product, the amount of product used, and the overall look they want to give their patients."

While 20 to 40 units spread across one average woman's forehead area may last 100 days, a marathon runner or hot yoga addict may actually metabolize the same treatment significantly faster—and there's really no way to know in advance. The jury seems to still be out on if facial fitness (or exercise in general) is a negative thing when it comes to Botox, though, because one relatively recent study from Northwestern University even suggests that it may help encourage the onset of wrinkle reduction at a hastened pace.
Botox before/afterInstagram/lisasweatt_rn

Are skincare products reducing the lifespan of Botox treatments?

It's a natural leap to make. One of the most Googled questions about Botox treatments is actually about whether or not you can use retinoids before or after your Botox, and there's good news—yes. "Generally, there is nothing that one can do purposefully shorten the lifespan of neurotoxin treatments," Tewfik says. "It is, however, very important to listen to your practitioner regarding how many units are needed per area. Different areas of the face have stronger muscles and need more units to maintain efficacy," she adds, clarifying that some patients ask for the Baby Botox trend du jour, which tends to offer a smaller dose. "Baby Botox rarely lasts all the way to the three to four months mark."

It's something Broumand agrees with. "We do not have any clinical studies that show doing something or not doing something will help maintain the results from Botox longer. We suggest a good skincare routine and sunscreen to help the antiaging process," he says. "The treatment's longevity is dependent on the patient and the injector. For me, it’s a balancing act because I want the product to last as long as possible for a patient but I don’t want to over-inject a patient to get a possible longer-lasting result."

The takeaway:

  • Botox and competing neurotoxin brands are marketed as having a three-to-four months longevity depending on a variety of factors. In reality, that time frame is somewhat fluid and can be significantly shorter or longer.
  • Skincare likely doesn't affect how long Botox treatments last. Medical experts agree you can use your favorite cleansers, serums, lotions, and more without worry—but don't skimp on the sunscreen.
  • Discussing your past experiences with neurotoxins can help your injector find the right treatment plan for you to hopefully get the longest possible results.

We're curious! How long do your Botox treatments last on average? We'd love to hear your feedback in the comments section below.

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Bryce Gruber covers women's lifestyle content and news ranging from shopping to travel, beauty to parenting, wellness and delicious eating. Find her at @brycegruber on social media, and across a variety of women's lifestyle and parenting topics at, Readers' Digest, Bravo,, Martha Stewart, and on your TV screen through national talk shows including The Tamron Hall Show. She lives and works in New York's Hudson Valley with her five small children.

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