Beauty Blog

Why doesn't my Botox® last as long as it used to?

This is a question we get a lot. But what a lot of people don't realize is how many different variables go into the duration of your tox. Recall that all the brands (Botox®, Dysport®, Jeuveau®, Xeomin®, Daxxify® and Letybo®) are the same active ingredient, botulinumtoxinA. The just have different stabilizers, proteins or concentrations. Occasionally some people's bodies interact with proteins differently and sometimes one brand works better in one person while another brand works better in someone else.

When we are younger and have more collagen in our skin, neurotoxin seems to last longer. As we age and lose collagen we "need" it more frequently. When I first started getting Botox® in my 20s, I got it about every 6 months. Now I "need" it about every 3 months.

Did you know that the person injecting you needs to reconstitute the medication before injecting it? This means that it is mixed with saline. Some practitioners use more saline (making it more dilute) and some use less (making it more concentrated). Also, the more recently it was reconstituted, the more efficacious it will be.

The more that is injected, the longer it will last (and this can be confusing since Daxxify® and Dysport® are dosed differently than the other brands).

The higher your metabolism and the stronger your muscles, the faster neurotoxins wear off. (Sorry, Skinny Minnie, that is your cross to bear.)

Xeomin® usually has the "softest" block (meaning you still might have some movement following injection) and often wears off a bit faster than the other brands. But many people are willing to exchange a shorter duration for a more "natural" look.

If you get injected regularly--before the block fully wears off--your muscles will stay weak and atrophied and it will seem to last longer.

So, when you went to a new injector and ended up with a shorter duration, I don't know why. There are lots of possible reasons! But probably not because they were/are a bad injector. There are many variables. And never forget: it is an art (that includes science)!

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Harvard Medical School
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