Frequently Asked Questions - BOTOX® Cosmetic

Botox is a purified form of botulinum toxin type A that temporarily relaxes the specific muscles responsible for expression lines. When injected in small amounts, it blocks the nerve signal that tells those muscles to contract. The skin above them smooths out, and lines caused by repeated movement soften. It treats dynamic wrinkles — the ones that appear when you frown, squint, or raise your eyebrows.

The most common treatment areas are the frown lines between the eyebrows, horizontal forehead lines, and crow's feet at the outer corners of the eyes. These three are FDA-approved. Many patients also ask about a "lip flip," bunny lines on the nose, chin dimpling, neck bands, and jaw slimming through masseter injections. During your consultation we'll look at how your face actually moves and recommend only the areas where Botox will make a real difference.

Most people notice a change within 3 to 5 days, with the full result at about 10 to 14 days. Don't judge your results in the first week — the muscles relax gradually. If you're treating for a specific event, schedule at least two weeks ahead.

Botox typically lasts 3 to 4 months. Your metabolism, how strong the treated muscles are, how much you exercise, and the dose all affect it. Patients who treat consistently often find results last a little longer over time, since the muscles gradually weaken with less use. Most of our patients come in three to four times a year.

Most patients describe it as a brief pinch, and no anesthesia is needed for a standard treatment. The needle is very fine and each injection takes a second or two. A full appointment usually runs 10 to 15 minutes, and you can return to work immediately. We can apply a topical numbing cream or use ice beforehand if you're nervous about needles.

Botox is priced either per unit or per treatment area. A frown-line treatment commonly requires around 20 units, crow's feet about 24 units total, and the forehead 10 to 20 units. Beware of pricing that seems unusually low — it can indicate diluted product or an inexperienced injector.

No — a frozen look comes from too much product or poor placement, not from Botox itself. Our approach is conservative: we treat the specific muscles causing your lines while preserving natural expression. You should still be able to smile, frown, and look surprised. If you've seen overdone results on other people, you're seeing technique, not the treatment.

At a board-certified dermatology practice, your injector is a physician or a clinician working under direct physician supervision, with full training in facial anatomy. That matters, because the difference between a good result and a droopy eyelid is millimeters. A dermatologist can also tell you when Botox isn't the right answer — some concerns respond better to fillers, lasers, or a prescription topical, and a practice that offers all of them has no reason to steer you toward one. If a complication occurs, you're already in a medical setting.

Before: avoid alcohol for 24 hours and, if your physician approves, skip blood thinners like aspirin, ibuprofen, and fish oil for about a week to reduce bruising. After: stay upright for 4 hours, don't rub or massage the treated areas, and skip strenuous exercise, saunas, and facials for 24 hours. Normal facial expressions are fine — actually encouraged.

Botox isn't recommended if you're pregnant or breastfeeding, have a neuromuscular condition such as myasthenia gravis or ALS, have an active infection at the injection site, or have a known allergy to any ingredient. Tell us about all medications, especially antibiotics and muscle relaxants, which can interact. We review your full medical history at your consultation.