Find the best surgeon near you with our new surgery professional search.

Join our Facial Plastic Surgery Discussion Forum to begin talking to real patients now!

See pictures of real people before and after a facial plastic surgery.

The Cosmetic Benefits of Botox

Botulinum toxins are made by the bacterium, Clostridium botulinum, the same bacterium that causes the deadly food poisoning known as botulism. There are several botulinum toxins, of which only A and B have been approved for medical use in the United States. Botulinum toxin A is Botox. Two other botulinum toxin A products should be on the U.S. market within the next year or two. Myobloc, which is botulinum toxin B, is already approved for certain muscle problems. But Botox is the first and best-known of these products and the only one approved for cosmetic use.

Originally, Botox was approved by the U.S. Food and Drug Administration for the treatment of a condition called blepharospasm, which is spasms of the muscles of the eyelids, and strabismus, or crossed eyes caused by one or more eye muscle being pulled too tight. It is now also approved for the treatment of cervical dystonia, where the muscles of the neck have tightened causing severe pain and pulling the head into an abnormal position. It is also used to treat hyperhydrosis, which extreme sweating under the arms.

Botox is also used off-label (which means that it does not have FDA approval for that use) in treating other disorders involving muscle spasms (dystonia) and some forms of migraine headaches. Once a drug is approved by the FDA, a physician can use it in any way he or she sees fit. However, the manufacturer is not allowed to publicize or advertise any off-label use. Off-label, Botox has also been helpful for people with serious muscle contractions and muscle imbalances caused by cerebral palsy.

Don’t be put off by the connection between Botox and botulism poisoning. Botox has been used for many years with an excellent safety record when it is administered by a qualified cosmetic physician.

What Is Botox Cosmetic Used For?

Botox Cosmetic was approved in 2002 to improve the look of fine lines and superficial wrinkles caused from every day facial expressions like smiling, frowning, or squinting. A tiny injection of Botox into the facial muscle causing the line or wrinkle stops the muscle from moving and prevents the wrinkling.

Officially, Botox is approved for cosmetic use only in the area between the eyebrows (called the glabella) and on the forehead. However, once a drug is approved, physicians are allowed to use it elsewhere, and they do. This is why Botox was widely used to treat wrinkles before 2002.

Botox injections may not remove a long-standing wrinkle completely, although it might lessen it. It can only keep you from furrowing your brow or squinting. However, if your wrinkles are superficial, it can smooth them considerably.

How Does Botox Work?

Normally, when your body wants a muscle to move, your brain sends electrical messages to the muscles telling them to contract. The electrical message is transmitted to the muscle by a substance called acetylcholine. Botox blocks the release of acetylcholine so that the muscle does not receive the message to contract. Essentially, this means that the muscle has been stopped from moving and is paralyzed. And it won’t move until the Botox starts wearing off in a few months.

Many people do not realize that they go through every day with a furrowed brow or vertical lines between their eyebrows. They end up looking tired and worried or angry. Botox can help smooth out their forehead, not only eliminating the lines and wrinkles, but making them look more rested and relaxed and even happier.

Botox may also help you put off the need for having plastic surgery for several years. It can be used in conjunction with injectable fillers such as Restylane and Sculptra to further assist in rejuvenating your appearance. 

There are a lot of jokes about Botoxed people with rigid faces and no way to show emotion. A cosmetic physician who is experienced with Botox and the correct placement and number of injections will leave you looking refreshed, not stiff.

What to Expect at Your Botox Appointment

The most common areas to be treated with Botox are the forehead, the area between your eyebrows at the top of your nose (the glabella), and the outer eye area. Botox is injected with a very fine needle into the muscle or muscles that are causing the wrinkle or furrow. Usually, you get several injections in each muscle. It may take about 30 minutes or so to complete the whole treatment. 

Patients report very little pain or discomfort associated with Botox injections because of the tiny size of the needle, but you will feel at least some discomfort from the injection. You might feel a bit of stinging or a feeling of great pressure. 

In The Weeks After Your Botox Treatment

After your treatment, it can take between a few hours and a few days to see the effects of Botox. In the first hours and day, you should try to move the treated muscles as little as you can.

The maximum benefit is reached in 1 to 2 weeks and you will not see any improvement beyond then. The effects last about 3 months with a single treatment session of Botox Cosmetic. You will see a smoothing of your skin and the improvement of fine lines and superficial wrinkles in the area of your treatment.  When the effects start wearing off, you will notice a very gradual fading of the effects.  At this point you can schedule another treatment. Botox  Cosmetic has proven itself again and again in eliminating superficial lines and wrinkles. Patients report that during a course of treatment their lines seem to disappear and the skin regains its former smoothness.

Botox Side Effects: Risks, Complications, and Contraindications

Although treatment with Botox is very safe, there are risks and possible complications. A major risk is that either too much is used or the injections are placed incorrectly and the wrong muscles are paralyzed or too many muscles are paralyzed. You could possibly end up with a drooping eyelid or eyebrow, double vision, an inability to move one or both eyes properly, or the inability to move other muscles in your face. However local injections of antibiotics have been shown to reduce paralysis in some patients. In any event, Botox wears off in a few weeks.

Botox can cause temporary headaches. There is also the possibility of bruising at the injection sites. 

Treatment with Botox can usually be repeated indefinitely, whenever you need it.  However, if you are pregnant or taking certain medications, you should not receive Botox treatments.  The effects of Botox may be increased if it is used while you are taking certain antibiotics or other drugs that interfere with neuromuscular chemicals. This means that injections that had worked well in the past might paralyze a greater area than intended. Be sure to disclose all pre-existing medical conditions and all medications you are currently to the physician before having any treatment with Botox.

Botox Cost 

The average price for Botox is between $175 and $500 for treating one area (about 20 to 25 units for the glabella), between $275 and $600 for two areas, and between $375 and $800 for three areas. The usual charge is between $10 and $15 per unit used.  Prices vary a great deal depending on the region and the surgeon.