Botox Treatments

COSMETIC BOTOX TREATMENTS are one of the most popular,low risk cosmetic procedures done in the United States, Europe and around the world.  The goal is to "relax" facial expression muscles which over time  leave  residual dynamic wrinkles. Frown lines,  forehead horizontal lines and Crows feet lines fall into these categories. These  three mentioned are the most popular, but there are  many other potential sites that  your doctor may decide to treat.


Frown Lines, Forehead lines and Crows Feet.  Frown lines are caused by the contraction of a group of the three  muscles, The middle Procerus muscles and  two "helper" muscles on each side... the Corrugators... above each eyebrow. Forehead lines are caused by the  large Frontalis muscles and the Crows feet are casued by the circular muscle around the eye, the Orbicularis Oculi.

FROWN LINES                                CROWS FEET LINES                   FOREHEAD LINES

There are advanced locations where Cosmetic Botox  has  been used such as:  for  gummy smiles,  vertical lines around the mouth, Bulging of the lower eyelid upon smiling "Jelly Rolls",  softening enlarged  side-jaw (masseter muscle)chewing muscle,   relaxing and softening the muscles that pull down on the corners of Down-turned Mouth "Mad Mouth". There are non-Cosmetic "Therapeutic" Botox treatments used by neurologists for migraines and other spastic muscle syndromes.

PRIOR TO INJECTION . If it is your first  botox treatments, relax, itsok to be nervous. It is a fairly simple, quick and fairly painless procedure. A little  discomfort, but most  patients usually  say its less painful than having blood drawn.

  • Tell your doctor about any illness or any medications you may be taking. These may affect treatment with Botox.
  • To avoid bruising,  do  not take aspirin, Ibuprofen-like  anti-inflammatories, Vitamin E,  Fish oil and Anti-oxidants for a week prior to Botox treatment. If you are on prescription Blood Thinners DO NOT STOP TAKING THEM.
  • Tell your Doctor if you are pregnant or breast feeding.
  • Tell your Doctor if you have had problems with Botox in the past  or problems such as prior inflammation, skin disease/condition or  surgery and scarring in the area to be treated.

DURING INJECTION. It is a fairly short procedure which usually takes between   five and  fifteen minutes depending on how many areas are treated. Some doctors pre-treat the the area with ice or cooling metal "roller".....others  gently pinch the area that is being treated to minimize the injection sensation, .....rarely does any patient  need  to use topical  anesthetic creams or to pre-medicate themselves with  valium, xanax or other anti-anxiety medications. Once the  treatment is done , you usually see minor redness at the site of the injections that may last  one to three hours. Most patients say that  appearance  is that of  mosquito or ant-bites. A cool compress will reduce the  marks faster if  necessary (lunch date or have to go back to work). After this  the  Doctor will usually remind you that the effects of the Botox take about 4 to 5 days   to be noticed and in some  patient s up to 14 days. The Doctor will also remind you about after treatment instructions....

AFTER TREATMENT INSTRUCTIONS to limit complications, it is recommended :

  • Not to rub or massage the treated areas for 24 to 48 hours after treatment.
  • This includes no scrubbing or rubbing when face washing, or rubbing when taking makeup off. onlly cleanse gently and "Dab" rather than scrub when washing face.
  • Not to apply makeup for four hours after botox treatment
  • To avoid  bending down or laying down to rest for at least four hours after the botox treatment.
  • Also, no strenous exercise, such as aerobics, spin class, running, jogging or other gym classes. No hot saunas are recommended.


  • Initially if after two weeks have passed and you have not noticed adequate relaxation and stillness of the treated muscle areas, you should call the doctor for follow-up appointment and possible " touch-up" treatment . Not everyone will respond to the same amount of Botox in the same manner and  some may need more than others.
  • If you want to continue to get Botox   regularly  to establish a preventative  schedule , than initially you want to wait for  "return of muscle movement". As soon as you begin to see early signs of the treated muscles movement returning, you want to go ahead and schedule your appointment for Botox retreatment. At first, this may  be at the 2 and1/2  to  4 month range.  Later it may be in the 4 to 8 month range!
  • A-la-Cart the term we use for those  patients who only want Botox treatments  prior to special occasions . Before weddings , class re-unions, Holidays or vacations. Although these patients won't get long term , preventative effect of wrinkle reduction and prevention like those on the regular, preventative schedule....they are still happy with the  occasional improvement  for their special occasions

WHEN TO CALL  THE DOCTOR/SIDE EFFECTS. There h as never been serious injury or mortality from Cosmetic Botox treatments.   Most   side  effects are limited to discomfort and swelling at the injection site...redness, bruising, swelling or stinging. Rarely , side  effects can include drooping of the eye lid,  muscle weakness or facial pain. Most  patients experience little or no side effects other than  the mosquito or ant bite appearance for a few hours.