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Read this before you get Botox

A plastic surgeon offers her expertise on the cosmetic procedure.

A person with long blond hair sitting on a doctor's office table and looking into a handheld mirror. Credit: Getty Images / praetorianphoto

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The world is obsessed with any product or procedure that claims to have anti-aging effects, and any conversation about tapping into the fountain of youth is bound to bring up one term: Botox. If you’ve already tried dousing your skin topically with dermatologist-recommended ingredients or concealing with the latest and greatest makeup items to unsatisfying results, you may be curious about this longer-lasting, all-but-guaranteed solution to smoother skin. To learn who might consider Botox—and who should stay clear of it—we spoke with Dr. Alexander Zuriarrain, double board-certified plastic surgeon with Zuri Plastic Surgery.

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What is Botox?

A closeup on a person's forehead with a doctor pinching the skin and injecting a needle into it.
Credit: Getty Images / FG Trade

Botox freezes small facial muscles to prevent wrinkles from forming.

Botox is an example of a neurotoxin treatment developed by pharmaceutical company Allergan that “works by blocking nerve impulses to the muscles, causing them to relax,” according to the American Board of Cosmetic Surgery. Technically, Botox (and its name) is derived from a toxin that's also responsible for a serious foodborne illness called botulism. The aim of the treatment is to temporarily paralyze tiny facial muscles to reduce or soften facial expressions that lead to fine lines and wrinkles in the skin of the face and neck.

Other brands of neurotoxin treatments consist of different wrinkle-treating toxins and a doctor can help you choose the one that’s right for you. For example, “some patients are allergic to specific strains of the botulinum toxin and can benefit from using a different brand,” says Zuriarrain. “Other patients develop resistance to the continual use of the same botulinum toxin, which requires changing to a different type of toxin.” You’ll need an in-depth consultation with your doctor to determine if either of these scenarios is the case for you.

Botox is not a filler. “Fillers are used to enhance volume in areas that are deficient,” says Zuriarrain. “Fillers are made of different components and, nowadays, use hyaluronic acid as their main ingredient.”

Who might Botox work for?

Botox is a preventative measure and there is no average age to get started. Those with increased sun exposure or animated facial expressions causing lines may seek treatments as young as their 20s. Regardless of age, Botox can be successful for those looking to reduce the appearance of wrinkles or fine lines around the forehead, crow’s feet, or area between the eyebrows. “The toxin can guarantee relaxation of the forehead musculature as well as the muscles surrounding the eye to decrease the formation of permanent lines and wrinkles associated with aging,” says Zuriarrain.

On the other hand, Zuriarrain says to stay away from Botox if you are pregnant or nursing, or if you have a pre-existing neuromuscular condition such as Lambert-Eaton myasthenic syndrome. If you have an egg allergy, you may be allergic to certain types of toxins and should check with your doctor first. You should also check with your doctor if you take medications such as aminoglycosides, penicillamine, quinine, or calcium channel blockers, as these may increase the power of Botox, Zuriarrain says.

How long does Botox last?

A person wearing a towel on their head, looking into a mirror, and touching their forehead.
Credit: Getty Images / fizkes

Botox is best for tackling wrinkles and fine lines in the forehead area.

You should see results from Botox within two to four days of the procedure and results should last between three and six months. Zuriarrain explains the wide range of the results’ longevity: “This is highly variable depending on prior use of the toxin, age of the patient, and overall health status. Some patients metabolize the toxin in a much more rapid fashion than others.” To maintain your results, most people seek treatments every six months.

To take care of your skin post-procedure and set yourself up for the best results, Zuriarrain recommends avoiding participating in vigorous activity or compressing the injected areas, as both of these could cause the Botox to migrate. To limit bruising or bleeding after the procedure, avoid alcohol, blood-thinning medications, or hot tubs or saunas for at least two days.

Does getting Botox hurt?

No need to worry about getting a painful treatment twice a year. “Botox is a very quick and, for the most part, pain-free experience if done in the right hands,” Zuriarrain says. “There are multiple modalities that help to make the session much more comfortable, such as the use of a vibrating wand as well as numbing creams [to] apply to the face prior to injection.” Zuriarrain recommends seeing a board-certified plastic surgeon for the best results.

How much does Botox cost?

The cost of a single treatment of Botox depends on multiple factors, including where you receive the procedure and how many units you require. “It can range from $18 to $30 per unit,” Zuriarrain says. “Most patients require a minimum of 50 units to produce the desired effect.” Without needing to do the mental math, it may cost upwards of $900 per session.

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