Do Botox Dysport cause muscle sagging or atrophy long term?

Hi Dr. Irwin! Thank you SO much for helping so many people out. I've been following your blog for a couple years now and is my go to resource for all things concerning my face and beauty regime. After much research I went ahead and with botox for the first time. I am happy with my results but am curious, if the botox causes facial muscles to "freeze", does that mean those muscles will experience atrophy? I am concerned that with continued long term use the muscles will atrophy, and should I discontinue botox in the future, that could result in more sagging of those areas. I haven't found any research articles that address long term side effects. Thanks again for your help! I look forward to your answer. Jessica

I can see why you and other readers might be concerned that Botox Dysport cause muscle sagging or atrophy in the long term. More on Botox questions.

Basically the answer is no……..because using Botox/Dysport  correctly in the face, isn’t permanent.  If you stop using relaxers like Botox, the muscle will get more active and get larger again. Kinda like going to the gym.  You can affect the size of your muscles in your body by how hard you are working them.

Also the temporary muscle relaxers like Botox/Dysport/Xeomin and others in Europe, are injected into certain muscles usually because they are TOO active. In other words, you want that muscle to shrink a little.

One thing to watch out for is that in some women/men, too much relaxation with Botox of the muscle around the eyes – the orbicularis oculi – can aggravate a tendency to puffiness in the under eye area. It doesn’t happen often, but if you are person who needs that muscle to be active to prevent puffiness under the eyes and at the top of the cheek, relaxing the crow’s feet with Botox/Dysport may not be your best option.

Hope this helps on your question of whether Botox Dysport cause muscle sagging in the long term,  Dr Irwin


Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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