How Long Does Botox Last? A Dermatologist’s Guide to Botox, Dysport, Xeomin, Jeuveau, Letybo & Daxxify

If you’re considering Botox in New York City, one of the first questions you’re probably asking is:

“How long will it last?”

It’s a simple question, but the answer isn’t exactly the same for everyone. For most patients, Botox lasts about 3 to 4 months when used to soften facial wrinkles. Some people notice their results fading sooner, while others continue to see an improvement for longer. And today, Botox isn’t the only option.

You may have heard of Dysport, Xeomin, Jeuveau, Letybo, and Daxxify. These are all neuromodulators used to temporarily relax muscles that contribute to dynamic wrinkles.  So which one lasts the longest? Is Daxxify really different from Botox? Does Jeuveau last longer? And how do you know which treatment is right for you? As a dermatologist, I think the answer starts with understanding how these treatments work and then looking at your face, your goals, and your individual response.

Botox, Dysport, Xeomin, Jeuveau, Letybo & Daxxify: What Do They Have in Common?

If all of these names are starting to sound confusing, you’re not alone.

Botox, Dysport, Xeomin, Jeuveau, Letybo, and Daxxify are all neuromodulators. More specifically, they are formulations of botulinum toxin type A used to temporarily reduce the activity of targeted muscles.

When we make facial expressions – frowning, squinting, or raising our eyebrows our muscles repeatedly contract. Over time, those movements can create dynamic wrinkles, such as forehead lines, frown lines between the eyebrows, and crow’s feet. Neuromodulators work by temporarily reducing the nerve signals that tell those targeted muscles to contract. The result is less muscle movement and softer-looking wrinkles. The products are related, but they are not identical. They have different formulations, dosing systems, and clinical data.

That’s why choosing a neuromodulator isn’t simply about asking, “Which one is strongest?”

The better question is: Which treatment is the best fit for my face and what I want to achieve?

The Short Answer: How Long Does Botox Last?

For most patients, Botox lasts approximately 3 to 4 months. Botox doesn’t wear off all at once. Instead, the effect gradually fades as muscle activity returns. You may first notice a little more movement in the treated area. Over the following weeks, your facial muscles continue to regain their activity, and dynamic wrinkles may slowly become more noticeable. Some patients get closer to three months. Others get four months or longer. There is no exact expiration date because every face responds differently.

When Does Botox Start Working?

Botox isn’t an instant treatment. Most patients begin noticing an effect within several days, with the result continuing to develop over the first two weeks. For this reason, I usually recommend giving Botox about two weeks before judging the final result. At that point, we can better assess how much movement remains and whether any small adjustment is appropriate.

*  These are general estimates, not guarantees. Results vary based on the patient, treatment area, dose, muscle strength, and other factors.

One important point: units are not interchangeable between these products. A higher number of units of Dysport, for example, does not mean that it is a stronger treatment than a smaller number of Botox units. Each product has its own dosing system.

Botox: The Classic Choice

Botox is the brand name for onabotulinumtoxinA and remains one of the most established cosmetic treatments for dynamic facial wrinkles. It works by temporarily reducing communication between the nerves and targeted muscles. When those muscles contract less strongly, the wrinkles created by repeated movement become softer. For the vertical frown lines between the eyebrows, often called the “11 lines” – Botox typically provides about three to four months of improvement. That’s why many patients schedule Botox approximately three or four times a year. But Botox isn’t about simply eliminating every facial movement. A good treatment should take into account how you naturally express yourself and how much movement you want to maintain.

Does Dysport Last Longer Than Botox?

Dysport contains abobotulinumtoxinA, another botulinum toxin type A formulation. One of the characteristics patients often notice is its relatively fast onset. In comparative research, Dysport has demonstrated onset in approximately two days in some studies. In terms of longevity, however, Dysport and Botox are generally quite similar at standard aesthetic doses, with many patients seeing results for roughly three to four months. So if you’re wondering, “Should I switch from Botox to Dysport because it lasts longer?” there isn’t strong evidence that Dysport routinely lasts longer. The better question is which product and treatment approach are most appropriate for your particular anatomy and goals.

Botox vs. Xeomin: Does Xeomin Last Longer?

Xeomin contains incobotulinumtoxinA. One important difference is that Xeomin is manufactured without complexing proteins. Patients sometimes assume this means Xeomin will last longer than Botox. It doesn’t necessarily. For cosmetic wrinkle treatment, Xeomin and Botox generally have comparable durations. Individual studies can show somewhat different results, but there isn’t a simple rule that Xeomin always lasts longer. The formulation is one consideration. Your dose, muscle strength, anatomy, and response to treatment are also important.

Jeuveau vs. Botox: Does Jeuveau Last Longer?

Jeuveau is the brand name for prabotulinumtoxinA. If you’ve been researching Botox alternatives, you may have seen claims that Jeuveau lasts longer than Botox. The evidence is more nuanced. One study found essentially identical median durations at a 20-unit dose, approximately 149 days for Jeuveau versus 148 days for Botox. More recently, a 2025 randomized clinical trial published in JAMA Dermatology compared Botox, Dysport, Jeuveau, and Xeomin using three-dimensional measurements of muscle movement. Jeuveau had a relatively fast onset and was one of the formulations that continued to demonstrate a measurable effect at Day 180. At that six-month measurement, Jeuveau also demonstrated greater reduction in glabellar strain than Botox. That’s an interesting finding, but it doesn’t mean that every patient receiving Jeuveau will have visibly smooth skin for six months.

Clinical-trial results and what you see in the mirror aren’t always the same thing. Your result depends on your individual muscles, anatomy, dose, and treatment goals.

What Is Letybo?

If you’ve recently started researching wrinkle relaxers, you may have heard about Letybo. Letybo is the brand name for letibotulinumtoxinA. It was FDA approved in the United States in 2024 for the temporary improvement of moderate-to-severe glabellar lines in adults. Letybo is a newer option, so we don’t yet have the same depth of long-term comparative data that exists for Botox. That means I would be cautious about claims that Letybo definitively lasts longer than Botox or another neuromodulator. Instead, think of Letybo as another FDA-approved option that can be considered based on your individual treatment needs.

Daxxify: Does It Really Last Six Months?

This is where things get particularly interesting. Daxxify contains daxibotulinumtoxinA-lanm and was developed with longer-lasting results in mind. In pivotal clinical trials for glabellar lines, Daxxify demonstrated a median duration of approximately 24 weeks, about six months, at the FDA-approved 40-unit dose. That is substantially longer than the typical three-to-four-month duration associated with Botox. For patients who don’t want to come in for treatment three or four times a year, that can be a major advantage. But there’s an important distinction: six months is a clinical-trial median, not a guarantee. Some patients will notice movement returning earlier. Others may continue to see an effect beyond six months.

Botox vs. Daxxify: Which Is Better?

There isn’t one right answer. If your biggest priority is longevity, Daxxify may be especially appealing. If you prefer a treatment with an exceptionally long history of cosmetic use, Botox remains an excellent choice. Some patients also prefer a shorter duration because it gives them the opportunity to reassess their look and adjust their treatment several times a year. Longer-lasting doesn’t automatically mean better. The goal is to find the treatment that gives you the result you want—not simply the one that lasts the longest.

Why Does Botox Wear Off?

Botox temporarily reduces muscle activity. It does not permanently change the nerve or muscle. Over time, communication between the nerve and muscle gradually returns, and the treated muscle becomes active again. That’s why movement comes back.

You may notice:

• A little more movement in your forehead
• More expression between your eyebrows
• Crow’s feet becoming more noticeable
• Dynamic wrinkles gradually returning

This happens gradually. Botox hasn’t suddenly “stopped working.” Your muscles are simply recovering.

Does Botox Make Your Wrinkles Worse When It Wears Off?

No. This is one of the most common concerns I hear. When Botox wears off, your facial muscles gradually return to their normal activity. As that movement returns, the wrinkles associated with that movement can become visible again. You are not typically experiencing a sudden rebound of wrinkles because the Botox wore off. Think of it as returning toward your natural baseline rather than your face becoming worse than it was before treatment.

What Makes Botox Last Longer?

There isn’t a secret trick that guarantees longer-lasting Botox. Several factors can affect how long your results last.

Dose

In general, higher doses can produce longer-lasting muscle relaxation. But more is not necessarily better. Using too much can cause unwanted weakness, heaviness, or changes in facial expression. The goal is the right dose for the right muscle not the highest possible dose.

Treatment area

The glabella, forehead, and crow’s feet all involve different muscles and anatomy. A treatment that lasts four months in one area doesn’t necessarily last four months everywhere.

Muscle strength

People with stronger facial muscles may notice movement returning sooner. This is one reason two people receiving the same product and dose can have different experiences.

Previous treatments

Patients who have received neuromodulators consistently sometimes find that they can go longer between treatments. However, this doesn’t mean that everyone should progressively increase their dose.

Treatment intervals

There is generally no advantage to receiving treatment more frequently simply because you want a longer-lasting result. Your dermatologist can help determine an appropriate maintenance schedule based on your response.

Can You Become Resistant to Botox?

This is another common question. The good news is that clinically significant antibody-related resistance appears to be uncommon in typical cosmetic use. Neutralizing antibodies are a bigger concern in certain medical conditions where patients may receive much higher doses or more frequent treatments. Some botulinum toxin formulations have characteristics that may reduce immunogenicity, including products that are manufactured without complexing proteins.

However, patients receiving standard cosmetic treatments generally have a low risk of developing clinically meaningful treatment failure from antibodies. If Botox or another neuromodulator seems to stop working, there are many other possible explanations—including changes in dose, injection technique, muscle activity, or the treatment area. That’s why it is worth discussing the situation with an experienced injector before assuming you’ve developed resistance.

How Often Should You Get Botox?

For many patients, Botox treatments are spaced approximately three to four months apart. But you don’t necessarily need to schedule your next appointment the moment you see the first bit of movement. Some patients prefer to maintain very little movement. Others want a more natural amount of expression. Your treatment schedule should reflect your preferences and your response, rather than a rigid calendar.

What About Botox for the Forehead?

Forehead lines deserve special consideration. The forehead muscle, called the frontalis, helps raise your eyebrows. If it is weakened too aggressively, some patients can experience a heavy feeling or an unwanted change in eyebrow position. That’s why forehead Botox is not simply about counting lines and injecting a predetermined number of units.

An experienced injector evaluates your:

• Natural eyebrow position
• Forehead anatomy
• Muscle strength
• Existing asymmetry
• Facial expressions
• Desired degree of movement

The goal is to soften forehead lines while maintaining a balanced, natural appearance.

Which Botox Alternative Lasts the Longest?

If we’re specifically talking about glabellar lines, Daxxify currently stands out for duration. Its pivotal clinical trials demonstrated a median duration of approximately six months at the approved 40-unit dose. Botox, Dysport, and Xeomin generally provide approximately three to four months of improvement for many patients. Jeuveau has demonstrated comparable duration to Botox in some studies, with newer research showing measurable effects at six months. Letybo is newer, so its long-term comparative data are still developing. But again, duration is only one part of the equation.

Does the Brand Matter More Than the Injector?

In my experience, patients sometimes spend too much time comparing products and not enough time thinking about who is performing the treatment. The injector matters enormously. Botulinum toxin treatment requires an understanding of facial anatomy, muscle movement, proportions, symmetry, and how small changes can affect the overall appearance of your face.

Two patients can receive the same product and have completely different results because their anatomy and treatment plans are different. The goal shouldn’t be to make your face completely still. For most patients, the goal is to look rested, refreshed, and natural. You should still look like yourself.

Choosing Botox in NYC

If you’re searching for Botox in NYC, you’ll find many options. That can make choosing a treatment and choosing an injector, overwhelming. Rather than asking only, “Which product lasts the longest?” I recommend asking:

What result am I actually trying to achieve?

Do you want to soften your frown lines while keeping plenty of expression?

Do you want a very smooth appearance?

Would you prefer to have fewer treatment appointments each year?

Are you new to neuromodulators?

Do you have particularly strong facial muscles?

These questions can help determine whether Botox, Dysport, Xeomin, Jeuveau, Letybo, or Daxxify makes the most sense for you.

At L’AVENUE Derm, the goal should never be to choose a product simply because it is newer or because an advertisement says it lasts longer. Your treatment should be customized to your face.

The Bottom Line

So, how long does Botox last? For most patients, about 3 to 4 months is a realistic expectation.

Dysport and Xeomin generally have a similar duration. Jeuveau can provide a similar duration to Botox, with some newer evidence suggesting a longer measurable effect in certain circumstances. Letybo is a newer FDA-approved option, but we need more long-term comparative data before making strong claims about whether it lasts longer than Botox. And Daxxify stands out for longevity, with clinical trials demonstrating a median duration of approximately six months for glabellar lines at the approved dose.

But here’s the most important takeaway: Don’t choose your injectable based on the number of months alone. The best treatment is the one that gives you the right balance of natural movement, wrinkle reduction, longevity, and overall facial harmony. Because the goal isn’t for people to know you’ve had Botox.

The goal is for you to look refreshed, rested, and like yourself.

Frequently Asked Questions

How long does Botox last?

Botox typically lasts about 3 to 4 months for facial wrinkles, although individual results vary.

How long does Daxxify last?

For glabellar lines, Daxxify demonstrated a median duration of approximately 24 weeks, or six months, in pivotal clinical trials at the approved 40-unit dose.

Does Daxxify last longer than Botox?

Yes. For glabellar lines, clinical trial evidence demonstrates a longer median duration with Daxxify than the typical three-to-four-month duration associated with Botox.

Does Jeuveau last longer than Botox?

Jeuveau and Botox can have similar durations. Some newer research suggests Jeuveau may retain a measurable effect longer in certain patients, but this does not mean every patient will experience six months of visible results.

Does Dysport last longer than Botox?

Generally, no. Dysport and Botox have broadly comparable durations at standard aesthetic doses, although Dysport may have a somewhat faster onset.

Does Xeomin last longer than Botox?

Generally, their durations are comparable. Individual results can vary.

What is Letybo?

Letybo is the brand name for letibotulinumtoxinA, an FDA-approved botulinum toxin type A treatment for moderate-to-severe glabellar lines in adults.

Which Botox alternative lasts the longest?

For glabellar lines, Daxxify currently has the strongest evidence for a substantially longer duration, with a median duration of approximately six months in pivotal clinical trials.

How often should I get Botox?

Many patients are treated approximately every 3 to 4 months, although the ideal interval depends on how quickly your muscle activity returns and the result you want.

Can Botox permanently remove wrinkles?

No. Botox temporarily reduces muscle activity. When movement returns, dynamic wrinkles can gradually become visible again.

Can you become resistant to Botox?

Clinically significant antibody-mediated resistance is uncommon in typical cosmetic use. If a treatment seems to stop working, your dermatologist should evaluate other possible reasons before assuming antibody resistance.

Considering Botox or another wrinkle-relaxing treatment in NYC? Schedule a consultation with L’AVENUE Derm to determine which treatment is right for your goals and facial anatomy.

Medical Disclaimer

This article is intended for general educational purposes and does not replace individualized medical advice. Botulinum toxin products are prescription medications and should be administered by an appropriately qualified medical professional. FDA approvals, indications, dosing, safety information, and treatment intervals differ by product. Results and duration vary from patient to patient.

References

1. Lemdani MS, Honig SE, Habarth-Morales TE, et al. Comparison of Botulinum Toxin A Formulations for Glabellar Strain Treatment in Women: A Double-Blind Randomized Clinical Trial. JAMA Dermatology. 2025.
2. U.S. Food and Drug Administration. Drug Trials Snapshot: Letybo (letibotulinumtoxinA).
3. U.S. Food and Drug Administration. BOTOX Cosmetic Prescribing Information.
4. U.S. Food and Drug Administration. DAXXIFY Prescribing Information.
5. Clinical studies evaluating prabotulinumtoxinA and other botulinum toxin type A formulations for glabellar lines.