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Botox - When to Come Back?

July 2, 2008
Hello, Dr. Rivkin,

I'm wondering if you have an opinion about how long someone should wait between Botox injections.

I have an appointment for one coming up next week. I realized looking at the calendar that it will have been exactly 12 weeks since my last appt. It's beginning to wear off.

I've had botox twice -- in my crows feet and between my brows. The first time it worked really well for about a month--and then very quickly wore off. I waited 3.5 months after the first injection and got my 2nd--this one has lasted longer than the first, but as I said it's beginning to dissipate.

My Doc might say it's okay, but I'm just wondering what your experience has taught you--about why sometimes botox wears off more quickly, and if one should wait a while for the stuff to wear off, or treat it as soon as it begins to do so. And then there is the problem of developing antibodies to it if you do it too quickly.

botox usually lasts about 3 months.
the variability is usually due to dosage. the more botox you put into an area, the longer it will last, up to a point. the price you pay is that the more units you put in, the more paralyzed you are. i would much rather have my patients get less botox and look natural and have good movement. too much botox and they start to look like nicole kidman, and not in a good way.
my patients usually come back anywhere from 2 to 4 months after each dose. if the botox has not completely worn off, that's fine, i just give them a smaller dose and they pay less (i charge by the unit for botox).
don't worry about antibodies - it is exceptionally rare that people develop these to botox.
i would go in when the lines start to bother you. don't worry about timing it.

One thought on “Botox – When to Come Back?”

  1. kim says:

    thanks for your answer, Dr. Rivkin! it’s very useful for me! I started a treatment with botox injection last week and I didn’t know when to come back too! indeed, if you want to look more natural, you have to use less botox!

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