Botox loyalists claim something amiss with their favorite injectable. The neurotoxin, which has been the go-to treatment to reduce the appearance of fine lines, is supposed to last three to four months. But some allege online that Botox isn’t working as well—at least, as it well as used to work.
From accusing providers of diluting solutions to get you to spend more on treatments to people believing they are now immune to Botox altogether, the theories are conspiracy-level complicated. But before anyone freaks out and cancels their next appointment, read what the experts have to say on what’s really going on with your Botox.
Your Botox Isn’t Less Effective
The good news is that Botox itself hasn’t suddenly stopped working. As New York City-based board-certified dermatologist Hadley King, MD, explains, because Botox arrives at a practice as a freeze-dried powder and is turned into a liquid with sterile saline before injection, there isn’t one universal correct way to dilute it. Different injectors use different dilution volumes based on their technique and treatment goals.
Dr. King says it’s more important to pay attention to the amount of units you’re receiving, and not the concentration of the saline; the units you’re receiving determine how long it will last. “20 units is still 20 units whether it’s delivered in a smaller or larger volume,” she says.
The Real Reasons Why Your Botox Isn’t Lasting
In reality, there are many reasons why your Botox isn’t lasting as long as you’d like it to. Some common ones include:
Low Dosage
Dr. King says that under-dosing is simply the biggest reason. “Many people are requesting a softer, more natural look (sometimes called baby Botox), which intentionally uses fewer units [and] less product generally means a shorter duration of effect,” she says.
Brian J. Abittan, MD, director of skin and hair rejuvenation and hair transplantation at the Kimberly and Eric J. Waldman Department of Dermatology at Mount Sinai, adds that patients want more movement in their faces and less of a “frozen” look, which can sometimes result in lighter doses that wear off faster.
Muscle Strength
Dr. King explains that people with very strong facial muscles (men, athletes, those who have very expressive faces, etc.) often metabolize Botox sooner because their muscles are more powerful.
Your Biology
How someone is going to respond to Botox varies from person to person. Dr. King says some patients may experience their Botox last three to four months, while others may only get to two to three months despite getting the same dose and treatment. It really just depends.
