If the the effects of Botox are allowed to wear off completely before your next treatment then a similar duration of effect will occur with your next treatment. However, if you keep the effect of Botox working, the treated muscles will atrophy (shrink) and the overlying skin will have more opportunity to repair surface flaws. It has been observed that after 18 - 24 months of continuous Botox induced muscle relaxation, there may be a longer interval of time needed for muscle recovery when Botox is stopped. Many of my long term Botox clients have experienced this benefit and now find that a treatment every 4-6 months allows them to keep looking their best. Combining Botox with other synergistic treatments like Medical grade Skin Care and Hyaluronic Acid Fillers works very well for a large variety of patients.