Signs of an effect can usually be seen from the fifth day onwards. However, it may also be 14 days before any difference is noticed. In rare cases there may be no effect at all. This can have several causes. One assumption is that there may be relative immunity against botulinum toxin as a result of an inoculation (e.g. tetanus). In many cases a second treatment, possibly with a double dose, will produce the desired results. In most patients the effect of the first injection lasts for approx. three months, that of the second injection approx. six to eight months and further injections probably longer.
Here too there may be exceptions both above and below these figures, which can have a wide range of reasons. Unlimited repeat treatments are possible if tolerance is good. It is better not to wait until the effect of the active substance has fully worn off. The best results can be obtained if you consult your surgeon again before the muscles have regained their full mobility and lines are able to form again. In this way a long-term personal treatment strategy can be decided on. A muscle which is still partially relaxed reacts to subsequent treatment to a greater degree and for a period of longer time.