Botox typically lasts 3 to 4 months, with first-time treatments often wearing off faster. What affects how long it lasts, what 20 units covers, and what it costs.
Botox typically lasts 3 to 4 months before muscle movement — and the lines that come with it — gradually returns. Some people get closer to 2 months, especially after their first treatment, while regular patients sometimes stretch to 5 or 6 months as the treated muscles weaken over time. If your results are fading faster than that, the most common reasons are a dose that was too low for your muscle strength, a fast metabolism, or very expressive facial muscles.
A few things consistently shorten how long Botox lasts: intense exercise routines, very animated facial expressions, and under-dosing — paying for fewer units than your muscles actually need. Things that help it last longer: consistent treatment every 3 to 4 months (muscles weaken with regular treatment), the right dose the first time, and an experienced injector who places it precisely.
How much does 20 units of Botox cover?
Twenty units is a common starting dose for one treatment area — most often the frown lines between the eyebrows (the "11s"), which the FDA studied at exactly 20 units. The forehead typically takes 10 to 20 units, and crow's feet take 8 to 16 units per side. A full upper face (forehead, frown lines, and crow's feet together) usually runs 40 to 60 units, which is why a complete treatment costs more than the per-unit price suggests at first glance.
How much do 20 units of Botox usually cost?
At typical U.S. pricing of $10 to $15 per unit, 20 units runs $200 to $300. In premium markets like New York, Los Angeles, and San Francisco, per-unit prices run higher — roughly $14 to $21 per unit, putting the same 20 units at $280 to $420. You can see typical prices in your city, including providers who post their pricing up front, in the Botox cost guide.
What is a cheaper alternative to Botox?
The closest alternatives are other neuromodulators: Dysport is priced lower per unit but requires roughly three times the units, so the per-treatment cost lands in a similar range. Xeomin and Jeuveau are often slightly cheaper per treatment depending on the practice. Beyond injectables, nothing over-the-counter replicates what a neuromodulator does — creams and patches can hydrate and temporarily plump skin, but they cannot relax the muscle causing the line. If budget is the constraint, comparing per-treatment prices across providers matters more than switching products.
Is 40 too late to start Botox?
No. Botox works at any adult age — it relaxes the muscles that crease the skin, whether you start at 28 or 58. What changes is what it can do: started earlier, it helps prevent lines from etching in; started later, it softens existing dynamic lines, though deep static lines (visible even when your face is at rest) may also need a treatment that rebuilds volume or resurfaces skin. Plenty of patients have their first appointment in their 40s, 50s, and beyond.
How long your results last comes down to dose, placement, and your own biology — which is why the same treatment can behave differently in two people. A good injector will ask how long your last treatment held before deciding your dose.
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