Doctor’s Note: Your Ultimate Guide to Botox and More
As dermatologists, we understand the importance of safe and effective treatments for enhancing your appearance. Botox is one of the most popular options for reducing wrinkles. In this guide, we’ll explore how Botox works, its benefits, potential risks, and what you can expect before, during, and after your treatment.
What is Botox?
Botox is a brand name for botulinum toxin, a substance that blocks certain nerve signals in the body. When injected into muscles, Botox prevents them from contracting, which reduces the appearance of wrinkles and lines on the skin. It can also be used for medical conditions, such as excessive sweating or muscle spasms.
While the treatment is often associated with cosmetic purposes, Botox has been used in medicine for decades to treat various conditions, from eye disorders to chronic migraines.
How Botox Works
Botox works by temporarily blocking the signals between nerves and muscles. Normally, when a nerve sends a signal to a muscle, it contracts. With Botox, this signal is blocked, which means the muscle can’t contract as strongly. When injected into areas of the face or body, Botox helps relax the muscles, which can smooth out wrinkles and lines caused by muscle movement.
In the skin, wrinkles are often caused by repeated muscle movements. For example, frowning or squinting over time can cause lines to form between the eyebrows or around the eyes. Botox can target these muscles, relaxing them and making the skin appear smoother and more youthful.
Common Botox Treatment Areas
Botox is commonly used to treat facial wrinkles and lines caused by repeated muscle movements. Common treatment areas include:
Forehead: Smooths horizontal lines from raising the eyebrows.
Between Brows ("11s"): Reduces vertical lines from frowning.
Crow's Feet: Reduces fine lines radiating from the eye corners.
Botox treatments are priced by either the unit or the treatment area:
By Unit: Price is based on the number of Botox units used (~$10 - $20 per unit in the USA).
By Area: Some providers offer set prices for specific treatment areas, such as the forehead or glabella, simplifying patient pricing.
The cost depends on factors like treatment area size, provider expertise, and location. Botox is typically performed every three months, so keep that in mind!
Other Botox Treatment Areas
Botox isn’t just for smoothing forehead lines or frown lines—it can also enhance other facial features and areas. Below, we’ll show before-and-after images of different Botox treatment areas that can help you achieve your desired look. These include treatments like DAO Botox to soften downward-turned mouth corners, gummy smile Botox for a more balanced smile, Botox for crow’s feet to smooth eye wrinkles, and even Botox for a brow lift to open up the eyes. We’ll also explore treatments for the neck, chin, and jawline, such as masseter Botox for a slimmer jaw and Botox for double chin reduction. Let’s get into each!
Botox Brow Lift
A Botox brow lift generally requires 2–5 units per brow to gently raise the brows. In the before photo, the eyebrows sit lower, which can make the eyes appear smaller. After treatment, the brows are lifted, giving the eyes a more open, refreshed look.
Botox for Crow’s Feet
For crow’s feet, 10–15 units are injected around each eye. In the before photo, fine lines and wrinkles appear at the outer corners of the eyes when smiling. After treatment, the crow’s feet are softened, creating a smoother look.
Gummy Smile Botox
Gummy Smile Botox usually involves 2–4 units to relax the upper lip muscles, reducing gum visibility. In the before photo, more gums show when smiling. After treatment, less gum is visible, resulting in a more balanced smile.
Botox Lip Flip
The Botox lip flip usually requires 4–6 units to gently roll the upper lip outward. In the before photo, the upper lip curls inward when smiling. After treatment, the upper lip flips outward slightly, making it appear fuller.
Masseter Botox Before and After
Masseter Botox, often used for jaw slimming, typically involves 15–50 units per side. In the before photo, the jaw appears wider due to prominent masseter muscles. After treatment, the jawline looks slimmer and more contoured.
Chin Botox
Chin Botox typically uses 2–6 units to smooth out any dimpling or "orange peel" texture. In the before photo, the chin appears bumpy or uneven. After treatment, the chin looks smoother and more even.
Botox for Double Chin
For the area under the chin, usually, 20–30 units are used to tighten and smooth the area. In the before photo, extra fullness is visible under the chin. After treatment, the chin area appears more contoured and refined.
DAO Botox
DAO stands for “Depressor Angularis Oris,” which is the muscle that pulls down on the corners of the mouth) Botox uses around 4-6 units per side to lift the mouth corners. This is the treatment of choice for “Resting Bitch Face” (RBF).
Neck Botox
For smoothing neck bands, 25–50 units are commonly used. In the before photo, vertical bands are visible along the neck. After treatment, these bands are softened, resulting in a smoother neck appearance.
Trap Botox
Trap Botox refers to the trapezius, the muscle in the back of the neck. This area typically requires 25–50 units to reduce visible muscle. In the before photo, the neck appears thicker. After treatment, the neck appears more elongated and “swan-like.”
Botox Procedures Basics
Here's a simple overview of the Botox procedure:
Consult: You'll meet with a healthcare provider to discuss your goals and areas of concern.
Preparation: The provider cleans and marks the treatment area.
Injection: The provider injects small amounts of Botox into specific facial muscles. This feels like a pinch - not too bad!
Aftercare: You can resume normal activities but avoid rubbing the treated area or lying down for a few hours.
Results: Results appear in 7 - 10 days. Effects last around 3-4 months for most areas.
We’ve made it easy! This FREE handout covers everything you need to know, from benefits and risks to precautions and aftercare tips, ensuring you’re fully prepared for your treatment.
Results of Botox
The effects of Botox typically become noticeable within 3 to 7 days after treatment. You may start to notice smoother skin and a reduction in wrinkles and fine lines. The full effects can last anywhere from 3 to 6 months, depending on the area treated and your body’s response to the toxin. Over time, the effects will wear off, and the muscles will begin to return to normal, causing wrinkles to reappear.
Many people choose to schedule follow-up appointments to maintain their results. Regular treatments can help prevent new wrinkles from forming, as Botox can also relax muscles that might otherwise cause further skin aging.
Safety and Side Effects
Botox is generally considered safe when administered by a trained professional. However, as with any treatment, there can be side effects. The most common side effects are mild and include:
Redness or Swelling: Some patients experience slight redness or swelling at the injection sites. This typically resolves within a few hours.
Bruising: Since Botox is injected with a needle, there is a small chance of bruising.
Headache: Some people report mild headaches after Botox treatment, but these are usually temporary.
Drooping Eyelids: In rare cases, Botox can cause temporary drooping of the eyelids. This is typically a result of the injection being too close to the eyelid muscles and can be avoided with proper technique.
Serious side effects are rare but can include difficulty swallowing or breathing. If you experience any unusual symptoms after Botox treatment, it’s important to contact your doctor right away.
How Long Does Botox Last?
Botox results typically last 3 to 6 months, but this can vary depending on the individual and the area treated. Some people may find that the effects last longer with repeated treatments, while others may need touch-ups more often. Your dermatologist can help you determine a treatment schedule that works best for you.
Dysport vs Botox
We’ve been talking a lot about Botox — Botox this and Botox that — but are there other options besides Botox? Yes, there are! Botox isn’t the only neuromodulator available for reducing wrinkles and fine lines. Other popular alternatives include Dysport, Jeuveau, Xeomin, and Daxxify. While they all work similarly by relaxing the muscles that cause wrinkles, each has unique characteristics that might make one better suited for certain people or areas. Here is a summary of the differences between these brands:
Dysport vs. Botox: Dysport is known for spreading more easily, which can be helpful for treating larger areas like the forehead. It may also show results a bit faster than Botox, typically within 2–3 days. However, Botox might be a better option for smaller areas where more precision is needed, as it doesn’t spread as much as Dysport.
Xeomin vs. Botox: Xeomin is unique because it doesn’t contain any additives—just pure botulinum toxin. This can be beneficial for people who may have built up a resistance to Botox or those who prefer a "cleaner" formulation. Xeomin and Botox have similar effects and durations, usually lasting 3–4 months.
Jeuveau vs. Botox: Jeuveau is sometimes called “Newtox” because it’s newer to the market. It’s very similar to Botox in its formulation and effect, though it’s marketed mainly toward cosmetic use rather than medical applications. People who try Jeuveau often notice results comparable to Botox, but some report it may be slightly more affordable.
Daxxify vs. Botox: Daxxify is the latest neuromodulator to hit the market, and it boasts a longer-lasting effect. While Botox generally lasts 3–4 months, Daxxify claims to last up to 6 months or more. This can be a great option for people looking for fewer treatments over the year, though it may be priced higher due to its extended duration.
Each of these alternatives has its pros and cons, and the choice between them often comes down to personal preference, treatment goals, and how each product interacts with your unique skin and muscles. Consulting with a professional can help you decide which option best fits your needs.
“My Botox Doesn’t Work Anymore”
Botox resistance is rare, affecting about 1.5% of people. It happens when the body makes antibodies against Botox, making it less effective over time. This is more likely if someone gets high doses or frequent treatments. People with resistance may notice that Botox doesn’t last as long or doesn’t work at all.
To treat this, doctors may switch to a different treatment called Xeomin. Xeomin is a good choice because it doesn’t have proteins, so it’s less likely to cause the body to build antibodies.
To reduce the risk of resistance, it’s best to use the smallest dose that works and have fewer treatments. Newer treatments like Jeuveau and Daxxify have smaller proteins, which makes them less likely to trigger the immune system.
Botox FAQ
Can I drink alcohol a day after Botox injections?
It’s best to wait at least 24 hours before drinking alcohol after getting Botox. Alcohol can increase the risk of bruising and may interfere with how the Botox works. To get the best results, try to avoid alcohol for a full day after your injections.
How long after Botox can you lay down?
It’s recommended to wait about 4 hours before lying down after getting Botox. This helps prevent the Botox from moving to other areas and ensures it stays where it was injected.
How often should you get Botox?
Most people get Botox every 3 to 4 months. Over time, the effects might last longer, and some may only need it every 6 months. Talk to your provider to find the best schedule for you.
How many units of Botox for forehead?
The number of Botox units needed for the forehead can vary, but it’s usually between 10 to 20 units. Your provider will decide the right amount based on your muscle strength and desired results.
How long does Botox last?
Botox typically lasts 3 to 4 months. Some people might notice the effects lasting longer, up to 6 months, while others may need to return sooner.