In 2002, Botox received approval from the U.S. Food and Drug Administration (FDA) for cosmetic use; in the nearly 20 years since, the injectable has become a household name, with a 95% Worth It Rating on RealSelf. Millions of people in the United States get Botox every year, to fight lines and wrinkles—it’s quick, effective, and relatively painless. But if you’re considering the treatment for the first time, there are some things you may not know. We sought out the experts to uncover nine things to know before your first Botox appointment.
1. Choose an injector wisely
It’s all too common to find spas and dental offices offering Botox treatment, but don’t go for the most convenient or cheapest option. “Avoid anything that sounds too good to be true—Groupon deals are not [the way] you should be getting injectables,” says Westport, Connecticut, board-certified dermatologist Dr. Deanne Mraz Robinson. “I’m not a fan of ‘Botox parties over cocktails—the environment should be clean and in a medical setting.” While Botox injections are relatively simple, the treatment still needs to be done by a trained and experienced medical professional. If the injections are too deep, too low, or in the wrong spot, you could have negative side effects, like a droopy eyelid.
So how do you find a highly qualified injector with proven results? Research. Start by reading reviews of doctors in your area. When you meet for a consultation, ask to see before and after pictures. “Go to a trusted injector, such as a board-certified dermatologist, to ensure the person you are seeing knows the anatomy and proper placement,” says New York City board-certified dermatologist Dr. Marisa Garshick.
2. Know how your doctor charges
The price of Botox can vary dramatically from practice to practice. Some providers charge per unit of Botox, while others charge per treatment area. (Most Botox providers who charge per unit charge between $10 and $20 per unit.) The location and experience of your provider will also impact the cost. The average Botox treatment costs $550.
3. Botox treatment is quick and easy
At your appointment, your provider will ask you about your areas of concern and analyze your face as you make different expressions—like raising your brows, furrowing your brows, and smiling. Most patients don’t need numbing cream, but if you’re anxious about the pain, ask if you can arrive early and have it applied (the cream typically takes about 20 minutes to kick in). Your provider will then make a few injections in the treatment areas, and you will be on your way.
“Botox is injected with a very fine gauge needle, so the discomfort is minimal and well tolerated,” says Dr. Robinson. “That said, some areas can be more uncomfortable—for example, around the lips. I often use a vibrator, which distracts the body’s nervous system from the pain and can be really effective at improving patient comfort.”
4. Botox side effects are usually minimal
Many patients report minimal pain during and after Botox. “Temporary bruising and swelling tend to be the most common side effects,” says Dr. Garshick. The reaction is similar to getting a shot at your general practitioner. You may also notice small bumps at the injection sites, but they usually go away after a few hours. Most people find they can go from their Botox appointment to the office or a social event.
5. Botox results aren’t instantaneous
When done correctly in both the injection amount and technique, Botox should give you a more youthful look. “Results can begin showing up within a few days and fully settle within two weeks,” says Dr. Robinson. “As Botox settles in gradually, it also wears off gradually—so most patients are ready for another treatment about three months later.”
The factors that impact how long Botox lasts include “your metabolism, your facial movement, and the skill and accuracy of injector for ideal placement,” says Dr. Robinson. It also depends on the areas treated and how many units were injected.
6. There’s no way to reverse Botox
If you have a complication from Botox or aren’t happy with your results, the only option is to wait it out. “While Botox cannot be undone, the effects do wear off over the course of three to four months on average—with some effects dissipating even within the first month,” says Dr. Garshick. However, certain interventions can help depending on the concern. “If there are changes specifically related to the eyelids, there are certain eye drops that can work to help strengthen the muscle around the eye, to help reduce any eyelid droop, if needed,” she says.
7. Botox may do more than smooth your wrinkles
Botox is known for smoothing wrinkles, but it could also have some effects you didn’t expect or necessarily want. “While injecting Botox into one muscle targets that specific muscle, some of our facial muscles work together to achieve a desired expression—so if you relax one, it may impact how a different muscle appears,” says Dr. Garshick. “This is when it becomes important to see a trusted injector who knows how the different muscles interact, to ensure that everything continues to appear natural and balanced.”
On the plus side, Botox can be beneficial for treating other issues, such as muscle spasms and heavy sweating. “It is also used to help treat migraines and can also help with TMJ by relaxing the masseter muscle,” says Dr. Garshick. It can even be used to do a lip flip. “Through relaxing the facial muscles around the mouth, it can give the appearance of a fuller and plumper lip,” she explains.
8. Botox can work as a preventive treatment
Although you may not have wrinkles yet, that doesn’t mean you shouldn’t consider Botox. Starting treatment before wrinkles start forming can limit their development and reduce the treatments needed later. “It works to relax muscle movement, which weakens the muscle and subsequently prevents wrinkles,” says Dr. Garshick. “To put it another way, with certain repeated facial expressions, the muscle gets bigger, and the bigger the muscle, the deeper the potential expression line—so when you do Botox, it prevents the muscle from getting bigger and, as a result, prevents the line from getting deeper.”
9. Start small at first
It’s not the moment to go all-out. “When it comes to Botox, you can always add more—especially if you’re getting it for the first time,” says Dr. Garshick. Since the injection can’t be undone, it’s always a better bet to be more conservative if you’re not sure what look you want, assess the results, and then take it from there.
