Recently we had a patient return to us for Botox treatments after a 4-year hiatus. During her absence, she’d had 2 babies, and between pregnancy and breastfeeding she had been unable to safely receive her beloved injection treatments.
After 4-years, she was so excited to be back in the treatment chair! Even though 4 stressful (but happy!) years had passed since her last treatment, she wanted to stick to her original Botox dosing, confident that the magical treatment plan that had always made her happy back then would still work now. After explaining why this would not be the best plan, we compromised by agreeing to follow her original treatment plan; she thought she was making the smart decision, and we knew we could always add more at the 2-week mark to get her results where she really wanted them to be.
Fast forward to her 2-week follow-up visit: Historically for her, this was when her results should have been in full-effect. After not being able to devote time to herself for so long and finally getting a chance to treat herself, she was disappointed to see that, in fact, her upper-face did still have a lot of movement. Ultimately her body needed a stronger treatment to acheive the desired results with her current anatomy.
Why did this happen? She got the same exact dose that used to work perfectly for her. What was different this time?
Consider: It takes way more air to inflate an empty balloon than to top-off a slightly wilted one. In relation to Botox, it takes more units to freeze a full-strength muscle than it does to freeze a muscle that is still mildly weakened. If you wait until your Botox has completely worn off, you can expect to need 10 to 20 more units to get you back to your happy place versus if you had stayed on a schedule and been retreated before your muscles could get back to baseline.
This patient had not had any Botox in years, and on top of that she now had 4 additional years of aging to contend with. (They were a very happy 4-years, but the aging process never stops, and inherently there was a lot of stress, sleep deprivation, and other non-skin favorable factors occurring.) When dealing with super-strong muscles, thinner skin, and less overall volume, there was no way that her 2021 dose was going to make her happy in 2025.
Fortunately this was fixed with the quick addition of more units to get her to the smooth result she was looking for, and an important Botox lesson had been learned: the more time passes, the more product will be needed to acheive the desired results, and consistency is vital.
As with any medication, when you are consistent with your dosing you will receive the maximum benefit. (It’s why pain management doctors advise never letting your pain go back to baseline. Your pain is easier to control if you take that next Aspirin when the first one is starting to wear off instead of waiting until it has completely worn off and your pain is full-throttle again.)
If a smooth forehead is important to you, there are multiple benefits to keeping up with regular, consistent treatments:
- Your cost per treatment will go down! (Experts recommends adding 10 to 20 units per treatment when you’re starting from baseline!)
- You’ll need less units per visit.
- You’ll never get deeply ingrained static lines and wrinkles.
- You’ll earn more Reward Points!
- Your skin will stay smoother and tighter looking.
- The best strategy for long-term prevention.
- By booking your next appointment in advance, you’re more likely to get the time / day that works best for you versus when you wait last minute.
Botox Treatment Timeline:
- Your results peak at about 3-weeks, and then slowly tapers away from there.
- If you get your next treatment around the 3 to 4 month mark, there is still some residual product there which your subsequent treatment can build-off.
- If you wait 6-months or more in between treatments, your muscles have regained full movement and your treatment will need to essentially start from scratch.
*Anywhere Botox is mentioned, feel free to mentally swap it with your neurotoxin of choice — this info is true for all neuromodulator products!
