“Does Botox Hurt?” and 19 Other Botox FAQs Answered by Doctors

Botox Treatment

You look in the mirror and notice those lines appearing around the corners of your eyes. You lean a little closer and clearly see your forehead doesn’t look as smooth as it once did. It’s crossed your mind a few times that maybe it’s time to consider Botox injections, but you’ve heard a number of stories that have you feeling nervous about taking the plunge.

That’s exactly why we’ve brought in four experts to answer your questions about Botox treatments. By the time you’re finished reading this, all your Botox worries will be resolved.

doctors who perform botox
Drs. Zamora, Steiger, Torkian, and Speigel

Is Botox safe?

Botox is an FDA approved medication that is considered very safe. It has been used for more than 20 years in the cosmetic treatment of facial wrinkles and has now been approved in more than 78 countries.

How does Botox work?

According to Denver-based oculo-facial plastic surgeon Dr. Jack Zamora, “Botox is a neuromodulator that gets injected into the muscle, causing it to temporarily relax. The relaxed muscle can no longer contract and therefore cannot create a wrinkle.”

Does Botox help with lines around the eyes?

Although Botox is used for various purposes, facial plastic surgeon Dr. Jacob D. Steiger of Boca Raton says, “Botox is most commonly used to treat the glabella (frown lines between the eyebrows), forehead creases, and the crow’s feet (fine lines at the corner of the eyes).”

 Pictures taken before and 7 days after Botox treatments for frown lines. Credits: Botox Cosmetic

How long before I see results from my Botox treatment?

“When injected, the proteins bind and enter into the nerve endings within 30 minutes,” says Beverly Hills facial plastic and reconstructive surgeon Dr. Behrooz A. Torkian. “The blockade of the nerve-muscle communication begins at about 3-7 days,” he adds. Therefore, this is when you can expect to see the results of your treatment.

How long does a Botox treatment last?

According to Dr. Torkian, “One treatment may last 3-4 months, but may not result in a significant improvement of the wrinkles for the long term. One or two years of consistent Botox in the same area will result in long term reversal of some wrinkles and optimize the improvements you may be looking for.”

Dr. Steiger adds, “It is recommended to repeat Botox injections every 4 months for maintenance. As you continue to use Botox, deeper wrinkles will continue to soften as dermal remodeling takes place.”

Will Botox make me look fake?

Dr. Onir Spiegel, an expert injector from Chestnut Hill, Boston, suggests there is a chance you can look fake after Botox treatment and warns that people should seek out highly qualified injectors.

“You see, Botox is like paint. If you give one person paint they’ll create you a masterpiece, while another may just make a huge mess. In the right hands, Botox will result in a natural beautiful appearance. With a less experienced person you could look unnatural,” says Dr. Spiegel.

Are there side effects with Botox?

“There are no serious side effects associated with the use of Botox with the doses that are employed for cosmetic purposes. Side effects can occur if Botox migrates from the injection sites. For this reason, it is wise to avoid massaging the area for 12 hours after the injection,” says Dr. Steiger.

Botox is a medication and like any medication, it can have adverse risks in some people. However, serious side effects are extremely rare, especially when administered by an expert injector. In a recent independent review of 35 clinical trials that included 8,787 participants in total, only minor side effects were found to occur in approximately 3% of people, all of which spontaneously resolved themselves.

The American Society of Aesthetic Plastic Surgery suggests the most common side effects from Botox are temporary muscle weakness, along with redness, irritation and swelling at the injection site.

Will I require anesthetic to have Botox?

No anesthetic is required for Botox treatments. It is a simple quick procedure that can even be performed during your work lunch break.

Does Botox hurt?

“Patients are often apprehensive about the prospect of feeling pain during the injection,” says Dr. Steiger. But he assures that choosing a highly qualified injector is the key, stating, “I use special techniques and equipment to minimize or eliminate the pain. When this is done, most patients are surprised at how little they felt.”

How much does Botox cost?

Botox is sold by the unit at an average rate of $10-20 per unit. When planning a Botox treatment, expect to pay anywhere between $175-800.

What’s the best age to start using Botox?

“I recommend starting Botox when patients notice active wrinkles (those that occur with facial animation) that are becoming constant and visible when the patient is not animating the face. For example, lines in the crow’s feet area that are beginning to be noticeable even when the patient is not smiling,” says Dr. Torkian.

Is 24 too young to start Botox treatments?

You may have heard that Botox can be used as a preventative treatment starting from an early age. According to Dr. Zamora, this is true. “We recommend patients start their Botox treatments earlier in life rather than later. Our patients are able to avoid lines, creases and furrows by starting Botox before wrinkles have developed,” he says.

Can men get Botox?

Dr. Zamora suggests, “Botox is the ideal anti-aging treatment for both men and women.”

Since 1997, the number of men having both surgical and non-surgical treatments like Botox has increased by 325%, according to the American Society of Aesthetic Plastic Surgery. Out of a total of 3,828,526 Botox procedures performed in the United States in 2015, 10.3% of those were men.

Pictures taken before and 7 days after Botox treatments for frown lines. Credits: Botox Cosmetic

Can I go to work after my Botox treatment?

“Overall it’s no problem to go to work, take your medications, or do most activities. Just a few hours after the treatment, you’ll be ready for anything,” says Dr. Spiegel.

Can I exercise after my Botox treatment?

As Dr. Steiger suggested above, side effects can occur if Botox migrates from the injection sites, which is why some post treatment activity precautions are recommended.

Dr. Zamora suggests you should, “avoid any strenuous exercise, wearing a helmet or laying down for four hours post treatment.”

Will my friends know I had Botox?

Dr. Zamora suggests, “it is possible to look frozen or overdone with Botox but that is the result of the injector’s technique. When done well, everyone will notice you looking better, but no one will know what you have done.”

Dr. Torkian adds, “there will be a period when the muscles are a bit more “frozen.” Generally this is 2 weeks after injection. After about 4 weeks, the Botox treatment should reach a “sweet spot” when injections look their best and most natural.”

What happens with the wrinkles when the Botox wears off?

Botox is a temporary treatment that typically lasts between 3-4 months. All the experts agree that once you stop having Botox treatments the muscles will slowly regain their ability to contract and the wrinkles will return.

However, the good news is, “you will always have fewer wrinkles than if you never did the treatment because for several months your body wasn’t producing new wrinkles or deepening existing ones,” says Dr. Spiegel.

Is it too late to start having Botox at 60?

It’s never too late to improve your appearance!

“Botox can prevent further creasing in severe lines, but additional services such as laser treatments and dermal fillers will be needed to smooth and fill deep wrinkles,” says Dr. Zamora.

Is there anyone that should not have Botox treatments?

Dr. Steiger warns that “pregnant women and patients with degenerative neuromuscular diseases should not be treated with Botox.”

What is the most important thing you’d tell people to consider before getting Botox for the first time?

“I recommend anyone getting into Botox treatment consider that they should maintain commitment to continuation of treatment over the long term. Permanent wrinkles that can be improved with Botox improve over time. One treatment may last 3-4 months, but may not result in a significant improvement of the wrinkles for the long term. One or two years of consistent Botox in the same area will result in long term reversal of some wrinkles and optimize the improvements you may be looking for,” says Dr. Torkian.

Dr. Spiegel adds, “Botox is a bit of a miracle medication. It helps you look better, helps headaches, reduces sweating, and even helps other people to think you look more competent and friendly. Don’t be afraid! All you’ve got to lose are the wrinkles!”

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