Expert Doctor


Botox is a refined form of botulinum toxin used to smooth and lessen the appearance of wrinkles in certain areas of the face. When injected into a muscle near a wrinkle, neuromuscular blockers limit muscle contraction in the treated area. This interference allows the muscles to relax and permits the skin to smooth out and reduce unwanted wrinkles. Wrinkled areas that respond well to Botox include the forehead, above the nose and the corners of the eyes. These areas become wrinkled due to excessive muscle tightness and usage. The area of the forehead and nose can become wrinkled due to frowning while squinting is the main cause of pronounced crow's feet. As the skin gets older, and these repetitive muscle contractions occur, the skin becomes used to being creased in those areas. Botox relaxes the muscles so that the skin is not continually being pulled which gives the skin time to smooth out.

Am I A Good Candidate For Botox?

Patients who are good candidates for Botox include:

  • Patients with moderate to severe wrinkles on the face
  • Those in overall good health
  • Patients with realistic expectations
  • Patients with wrinkles located in an area that can be treated by Botox

Even though Botox is one of the most widely used cosmetic treatments currently available, there are some patients who are not good candidates for the treatment:

  • Patients with a skin infection where the injection will be made
  • Those who are allergic to ingredients in Botox
  • Patients who are pregnant or breastfeeding
  • Patients with nerve or muscle conditions such as ALS

Although Botox is generally administered to people in their 30s or older, it is not completely uncommon for physicians to treat someone in their 20s. Botox can be used to treat slight wrinkles or deep grooves. Many people do not wish to see fine lines so they seek out Botox at an early age. Patients interested in having Botox should consult with a board-certified doctor to see if Botox is the right choice to treat their wrinkles.

How is a Botox Treatment Performed?

Botox uses a fine needle to inject the solution into areas of the face such as the forehead, the crow’s feet at the sides of the eyes and the frown lines between the eyes. Botox temporarily paralyzes these muscles in order to prevent fine lines and wrinkles.

Before the injections are made, the doctor will thoroughly clean the area to be treated. The placement of the needle is determined by the depth and size of the area being treated and multiple injections might be necessary to effectively treat the muscle. The treatment is performed on an outpatient basis and is normally done in a doctor’s office. Overall, the procedure can be performed in a few minutes without sedation or anesthesia. Once injected, the Botox blocks the nerve signals that tell the muscle to contract and this prevents wrinkles from happening.


Other indications of Botox:

Botox does have other uses besides treating facial muscles:

Tight muscles - When a muscle in the neck or other areas has become so tight that movement is severely limited, larger doses of Botox can be administered to help loosen the muscle and gain some mobility. This has been used to help patients with MS or patients who have had a stroke.

Headache - Botox has also been known to relieve headaches in patients which are caused by muscle spasms or tension.

Hyperhidrosis - Botox is also useful with patients suffering from axillary hyperhidrosis. This is a condition where a patient suffers from excessive sweating from the armpits. In this case, Botox will block some of the signals which lead to secretion via sweaty armpits.

Alternative wrinkle treatments:

It should be noted that Botox is just one of the methods that can be used to treat wrinkles on the neck and face. Alternative treatments include:

  • Microdermabrasion
  • Brow lift
  • Chemical peels
  • Neck lift
  • Dermal fillers
  • Facelift

Botox is not intended for every part of the face. Keep in mind that Botox is only used for areas where muscle tightness and overuse has worn the skin down and created wrinkles. Therefore, some wrinkles and droopy skin cannot be remedied by Botox because these areas are not caused by a tightening of the muscle.

The nasolabial folds, which are the creases from the nose to each corner of the mouth, will not respond to Botox. These areas are due to overlapping folds of the tissue and they can be corrected with dermal fillers. Injecting fillers into these creases can cause the fold to become shallower and less noticeable. Dermal fillers can also be used to correct facial blemishes such as scars, indentations and irregular contours of the skin by pumping up that particular area and making it smooth again.

What is the Cost of Botox?

The cost of Botox depends on the number of vials used by the doctor, the area of the country where it is performed and how many areas of the face are being treated. In general, the cost is $200-$1000.

Recovery and Downtime

Botox is a simple procedure that involves very little pain during the injection. Therefore, the recovery time is quite minimal. A patient may experience some bruising from the injection but is able to resume work the same day. Patients should not do any heavy exercise the day of the procedure.


Typically, a patient can feel the results within a couple of days but may not see any results for a week or two. For example, a patient will be able to feel that the eyebrows are weak and cannot be lowered into a deep frown like they could before the injection. This is a good thing since the skin is no longer pulling with the muscle. As time goes on, the skin will begin to smooth out and the wrinkles will fade.

It is important to remember that Botox lasts approximately four to six months depending on the patient. Many patients prefer a repeat dosage sooner than others because they are not tolerant of seeing any wrinkles at all.

Limitations and Risks of Botox

The main limitation of Botox is that it does not give permanent results. For maintenance, a patient must continue to receive the injections as the results will wear off.

There are quite a few risks Botox patients should be aware of before having the treatment.  One of the biggest risks is droopy eyelid. Botox must be used in the correct areas and with the proper doses. If Botox is used in the wrong areas, it will not work and complications can arise. For example, when administering Botox to the eyelid, it is possible for a little bit to drip down and cause the eyelid to droop a bit. The droopiness is temporary but it will take a few months to resolve. In the meantime, a special eye drop can be used to stimulate the muscle in the eyelid and correct the droopiness for short periods of time.

There are also a number of general risks involved with Botox including:

  • Allergic reactions
  • Itching
  • Trouble breathing
  • Nausea
  • Rash
  • Bruising or bleeding at the injection site
  • Infection
  • Swelling
  • Dizziness
  • Dry mouth

Trust the Brand Name

Botox is a patented medication produced by Allergan and monitored by the FDA. However, there are cheaper brands of Botox sold online. These cheaper brands come from other countries and can be purchased by doctors in the United States in order to make a higher profit. It is important to note that these other brands may not be tested as thoroughly and could possibly cause adverse reactions. Patients need to make sure their doctor of choice is using Botox that is inspected and approved by the FDA. 

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Andres Taleisnik, MD in Orange, CA