Curious about Botox

Can someone please tell me as much as they can about Botox? I am interested in having this done.


F, 45, Colorado

Hi TurboMom,

Botox is a brand of neurotoxin made by Allergan, one of the largest pharmaceutical companies in the world. Neurotoxins are a family of medications that inhibit the action of muscle when injected into specific areas. One of the most common and consistently treated areas is the face. Specifically, dynamic wrinkles (the wrinkles of the face produced with expression) are ideal to treat before they create indentations that exist at rest. However, if you have wrinkles at rest it's not too late to address them - many patients have success of smoothing out resting wrinkles after several sessions over time with neurotoxins. In addition, improving skin quality (moisture, nutrients, reduction of environmental stressors, etc.) is a necessity for achieving optimal results. 

Neurotoxins for wrinkles treat various areas:

  • Glabellar lines (the 11’s or 1’s that form when moving the brows together in an angry face)
  • Crows feet
  • Forehead lines

Loss of volume is a common complaint, but many patients incorrectly assume that they need Botox for correcting this - it’s a simple misunderstanding of what the differences are between neurotoxins and fillers, and what they are used for in cosmetic treatment. Dermal fillers do just as they describe - fill areas of volume loss (i.e. lips, cheeks, undereye hollows, etc.). So when you point to your undereyes and say you need Botox to fix your “sleep deprived” look, you’re correct you would need a cosmetic treatment, but inaccurate in what will actually fix that issue. 

I recommend you present your concerns to a board certified dermatologist, and from that discussion will learn what treatment would be most appropriate. Once the appropriate treatment is determined, they will review the benefits, risks, and any other details you should know (or want to know). 


Best of luck to you,

Jeanine Downie, MD

Hi TurboMom, 

Here's everything I know about Botox, straight from a paper I wrote for grad school.

Botox is the most popular cosmetic treatment on the market. According to the American Society of Plastic Surgery, there were nearly 6.7 million Botox injections performed in 2015, up 1% from the year before.

Botulinum toxin type A, more commonly known by its trade name Botox, is a protein complex produced by Clostridium Botulinum, a diverse group of pathogenic bacteria. Botox works by blocking the release of the neurotransmitter acetylcholine, which signals muscles to contract. In small doses, Botox is able to smooth out fine lines and wrinkles by interfering with the contraction of the underlying muscles which cause those skin imperfections.

Botox was first used in 1977 to treat strabismus, a dysfunction of the muscles that control eye movement. The Food and Drug Administration subsequently approved Botox for the treatment of strabismus in 1989. As Botox’s use continued, doctors noticed that patients treated with it developed fewer wrinkles in the overlying skin above the area that was treated. Intrigued, doctors because using Botox for aesthetic reasons in 1996 and in 2002 it was eventually approved for cosmetic uses.

Botox can be used to prevent crow’s-feet, vertical frown lines, horizontal forehead lands and in some cases neck bands.  Botox can also be used to lift the sides of your mouth and smooth out creases in your chin or around your mouth, that are caused aging.  

When injected by a certified medical provider, Botox can leave you with a very natural, freshened look. Since Botox only impacts the movement of your muscles and not your sensory nerves, you will still have sensation where you were injected, you just won’t be able to move them.

When receiving a Botox injection, you may feel slight discomfort (as you would from any injection). To mitigate this, the doctor may use a topical anesthetic on the area that is to be injected approximately 10 minutes before you receive your Botox injection.

While every drug has side effects, Botox’s are usually minor and short-lived. 1-5% of people who are injected may experience mild drooping of their eyelid or eyebrow, slight redness at the injection area and/or minor bruising.

Depending on your location, what you’re having injected and the person providing the treatment (nurse, PA, doctor, etc.), the treatment is usually around $350-700 and lasts 3.5-4 months.

You should also know that Botox (unlike its competitors Dysport and Xeomin) arrived dehydrated and the medical provider must reconstitute it in solution before injecting you. It’s possible the solution could be over or under diluted depending on the experience of the provider.

So, what’s the best age to start using Botox? Well, there is no perfect age. Botox can be used safely and effectively at any age, although most people won’t do not start using it until they’re in their late 20s or 30s.