Jordana Herschthal, MD

I get this question a lot and each case, and therefore solution, is somewhat unique. Botox relaxes the muscle it is injected into, preventing the muscle from contracting. When the muscle normally contracts, you get expression lines. Your under eye issue is due to herniation of the fat pad and skin laxity. You would really be a candidate for a blepharoplasty to remove the fat pad and then laser resurfacing to tighten the skin. These procedures can typically be done at the same time under local anesthesia. Good luck!

Great question. This is extremely variable depending on where you live, who is injecting (degrees and specialty), and what is being injected (currently 3 FDA approved versions of botox on the US market). Practices will either charge by unit ($ amount per actual unit of Botox) or by area (forehead, glabella, crows feet, etc). At our practice (we are both Board-certified Dermatologist MD's), we charge by area and include a complimentary 2 week touch-up. My average number of units used for all 3 areas is about 50. Good Botox isn't cheap, and cheap Botox isn't good :)

Every patient responds to Botox differently, but most patients start to see results around day 3. It can take up to 14 days for the final result to appear, so I always have my patients return in 2 weeks for a 'touch-up.' While many patients will get Botox treatments every 3-4 months, I have a few who come in every 6 weeks for smaller amounts of Botox. These are patients who wish to have minimal movement at all times. Results typically begin to wear off around 6 weeks and the muscle returns to full movement at 3-4 months. You will not have the peak effect for the full 3-4 months. You can receive Botox as long as you keep responding to treatments and it is giving you a desirable clinical result. Some of my patients need less treatments and less Botox over time. Bottom line: everyone is unique and treatments should be tailored accordingly!