Botox Before & Afters

Botulinum toxin products like Botox, Dysport and Xeomin work by blocking nerve signals that tell your muscles to contract. Without these nerve signals, which tell your facial muscles to move, the repeated facial movements which cause wrinkles to form are diminished -- and the result is a complexion with far fewer lines and creases.

Botox is most commonly used in the forehead and around the eyes, but there are several other common injection sites including the nose, neck and the areas around the lips and chin.

Unlike plastic surgery, the effects of Botox are non-permanent. If you're on the fence about going for an invasive cosmetic surgery procedure, getting Botox is often an easier decision to make than surgery. While individual results may vary, Botox typically lasts anywhere from 3 to 6 months.


Botox in the Forehead

The FDA approved Botox for use treating forehead lines in the Fall of 2017. Multiple injections of 5 to 25 units are made into the "frontalis muscle" every 1.5 - 2 cm. These injections need to be done cautiously by an experienced injector in order to prevent the dreaded "droopy eyelid" or eyelid ptosis.


Botox for Treating Frown Lines

While commonly confused with "forehead lines", frown lines are the lines that appear in the glabella and between the eyebrows. These lines are produced with the corrugator supercilii and procerus muscles. Typically 5 injections of 20 to 25 units are enough to reduce the formation of frown lines. This procedure requires an experienced injector as there is a risk of brow ptosis should the botulinum toxin reach past the middle of the brow.


Botox Around the Eyes ("Crow's Feet")

Crow's feet lines are one of the most obvious signs of aging, and are one of the most popular injection sites for Botox. To treat crow's feet, the orbicularis oculi and procerus muscles are injected with 5 to 15 units. As with forehead injections, Botox injections for crow's feet need to be done with care to avoid eyelid ptosis.


Botox Brow Lift

The brow can be "lifted" by injecting Botox above the outer area of the brow. This procedure requires an excellent understanding of the underlying facial anatomy of the forehead as it carries a risk of actually lowering the brow if performed incorrectly. By precisely injecting Botox into the muscles that depress the brow, the brow will relax into a raised position.


Botox for a Downturned Smile

To correct a downturned smile, Botox can be injected near the corners of the lips. This technique raises the corners of mouth to reverse a downturned smile and reduces the appearance of marionette lines.


Botox Around the Mouth ("Smoker's Lines")

Lines around the lips are known as "perioral lines", or more commonly as "smoker's lines". Injecting 5 units of Botox into each line just above the lip margin can help reduce the formation of these fine creases.


Botox Gone Wrong

Botox injections may have a temporary effect, lasting anywhere from 3 to 6 months, but that doesn't mean bad things can't happen. Two potential pitfalls resulting from Botox treatment gone wrong are "ptosis" and "asymmetry".

Ptosis may be the result of a poorly chosen injection site, but is more frequently due to migration of the botulinum toxin under the surface of the skin. In eyelid ptosis the botulinum toxin drifts down to the levator palpebra muscle which supports the opening and closing of the eyelid.

Once the eyelid elevator muscles have been immobilized, the eyelid will droop noticeably. While lopidine eyedrops (and some additional strategically placed Botox) may help the problem to some extent, in many cases there's little you can do but wait. When Botox does go wrong, that 3 to 6 months can feel like a very long time.

Asymmetry may happen when injecting Botox into the upper face. If the amount of botulinum toxin is not balanced between either side of the face, one side of the face may rise higher than the other. In other cases, the eyebrows will arch unevenly.

Remember to consult with a board-certified dermatologist or plastic surgeon for the best medical care and great results.


While serious side effects to Botox are rare, be sure to contact your physician immediately if you experience muscle spasms, difficulty breathing or other serious side effects. A minor amount of bruising and swelling is normal following Botox treatment.


» Should you get Botox before you get wrinkles? Dermatologists are divided on the practice of "Prejuvenation". Many patients in their 20's and 30's consider Botox to be a preventative measure against future wrinkles. Is preventative Botox for you? Read about Botox Prejuvenation here.


Botox isn't the only non-invasive option for regaining a youthful look. Be sure to read our guides on dermal fillers, chemical peels and Coolsculpting for other non-surgical options.

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In this patient, in order to achieve overall facial rejuvenation, a combination of different injectable facial fillers and Botox were used. A total of 4 syringes (4mL) of Juvederm Voluma were used to augment the cheeks a...