Botox is not permanent, so if you are enjoying your recent results or are considering treatment for the first time, it's important to understand that in order to maintain your results, you will want to return for follow-up procedures every 12 to 16 weeks, on average. Treatment frequency depends on numerous factors and is highly personalized, as every patient and situation is unique. Patient age and metabolic rate, original or past treatment duration, wrinkle severity, unique concerns, complaints, and aesthetic goals can help determine the frequency of treatment. Botox efficacy is approximately 3 to 4 months, after which your original facial lines may begin to reform. Over time, however, patients can develop a tolerance or resistance to Botox, like many other drugs, which can weaken facial muscles and may require more units than previous treatments to get similar results, greater spacing between follow-up procedures, or product substitution to maintain the current injectable treatment course. Should a patient decide to skip a treatment, wrinkles will not become worse than prior to treatment because Botox doesn't permanently change underlying muscle structures, it simply relaxes them, so they don't move as your face does. The best decision a patient can make about the frequency of their Botox injections starts with a consultation. It's vitally important to choose a board-certified physician or master injector, as your results are married to your provider's skills, training, and experience.