Does Botox have to be repeated throughout your whole life as the muscle regrows?

Dr. Dean Kane Q & A Q. Does Botox have to be repeated throughout your whole life as the muscle regrows? A. Botox and similar injectible muscle relaxers such as Dysport and Xeomin work when the molecule is delivered to the nerve end of the neuro-motor unit. It stimulates a receptor on the nerve membrane to absorb the toxin and when inside causes the nerve to stop emitting the muscle stimulator, acetylcholine. Therefore, no stimulation, no muscle contraction. The nerve is shutdown “so-to-speak” but not killed. It takes about 3 months for it to form another nerve end with more available acetylcholine messenger. So, Botox needs to be re-injected about every 3 months. Since the Botox action is not dependent on the drug, the drug cannot be made to last longer. There are other considerations: At some point, the muscles fibers relaxed by Botox will cease functioning and thereby no longer contract so Botox is not required at that site any longer. BUT, in general, other muscle fibers or other muscles will attempt to recreate a similar muscle action called recruitment. Botox may or may not be used to suppress activity in those muscles as well. If used to modify and rebalance the muscles of expression, it must be understood that the overlying skin will relax with aging and may not lift or change as effectively over time and other options such as skin tightening or surgical lift maybe required. A new option for some nerves is the use of ThermiRASE. This technique using the ThermiRF device identifies the nerves to be divided and using radio-frequency energy will “cut” the nerve with immediate effects for a 1 to 2 year duration before the nerve “grows back together”. These techniques and procedures are advanced skills. Please consult with a Board Certified Plastic Surgeon with the skills and talent to properly examine you and provide the best option for your concerns. I hope this is helpful. Good luck!   This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.
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