Your Botox Questions, Answered

What you need to know before getting botox

Modern beauty is broader and more encompassing than ever before. Science, technology, and evolving standards have taken us far beyond mascara, lipstick, and cold cream. Now, we have microcurrent toning devices, LED face masks, and dropper bottle after dropper bottle of molecularly perfect serums. Approaches that were previously reserved for only the rich and famous have become mainstream—though you often still need a lot of money—and outcomes are better than ever. 

Case in point: Botox. Since the botulinum toxin type A neuromodulator was first approved for aesthetic use by the U.S. Food and Drug Administration (FDA) in 2002, it’s gone from the unnerving substance behind the uncannily frozen faces of celebrities to the casual go-to of everyone and their moms. 

Chances are that someone you know has had Botox—maybe even yourself! There are Botox parties, and you can walk right into countless medspas for quick injections. It’s now even available at Nordstrom, with a Kate Somerville clinic opened this month inside the retailer’s new NYC flagship store. What was previously hush-hush is now proudly Instagrammed. The hesitation and stigma around Botox and other non-invasive treatments are dropping day by day. The American Society of Plastic Surgeons reported a stunning 7.4 million botulinum toxin type A injections in 2018 alone!

If the increasing ubiquity of Botox has you curious, here’s the top five things you should know before going under the needle.

1. Is Botox the only neuromodulator for reducing wrinkles?

Botox was the first botulinum toxin type A injectable approved for cosmetic use, but now the name brand is often used as a catch-all term for a handful of neuromodulators that perform similarly but vary slightly in their formulations. Depending on your skin goals (reducing forehead wrinkles, frown lines between the brows, crow’s feet, etc.) and your provider’s preferences, you may instead be treated with Dysport, Xeomin, or Jeuveau.

2. What are the other uses for Botox besides treating wrinkles?

The muscle relaxing abilities of this class of neuromodulator can benefit more than your skin. Botox is FDA-approved to treat both migraines and hyperhidrosis (excessive sweating). Off-label, meaning without FDA approval but proven effective in clinical use, it’s used therapeutically to relieve symptoms of TMJ and reduce the painful muscle spasms of vaginismus. Cosmetically, Botox can correct a gummy smile, make lips look fuller with a treatment called a “lip flip,” and narrow the jawline.

3. Who should administer Botox? 

It’s very easy to find Botox and deals on Groupon can be appealing, but the treatment should only be performed by an experienced and qualified provider. Who’s allowed to perform injections varies from state to state, but a medical professional (doctor, nurse, or physician assistant) should be the one administering your Botox. A provider with deep knowledge of facial anatomy—particularly the muscles, nerves, and blood vessels beneath the surface of your skin—will best be able to inject you safely and with the best results. Going to the office of a board-certified plastic surgeon or dermatologist also helps ensure that you’re receiving legitimate Botox (or another brand’s neuromodulator) directly from the manufacturer—yes, black market Botox is a thing and it’s dangerous!

4. Does preventative Botox work? And when should you start preventative Botox? 

Even in our Kylie Jenner bestowed world, there’s a knee-jerk reaction to someone under the age of 30 getting Botox. But when injected before you have significant wrinkles, Botox can prevent them from forming (check these botox twin study photos). Plastic surgeons and derms frequently compare skin to a piece of paper: Once you fold it and a crease forms, you can’t fully smooth back out the crease. Sometimes called “baby Botox,” early injections are intended to avoid the initial folding that leads to creases.  

5. How Long Does Botox Last? 

Botox usually lasts between 3-4 months, depending on the individual and number of units used. In general, stronger muscles means less longevity when it comes to botox, so if the muscle is particularly strong you can expect it to last closer to 2-3 months. And just because you get botox once doesn't mean you have to keep doing it (there's no risk of getting "addicted"). 

You might also be wondering, how long before botox results? After injection, it usually takes around 5 days to start seeing the full effects. 

6. I have an expressive face - Can I get Botox and still look like "myself?" 

When you're going in for your botox appointment, make sure your practitioner evaluates the way you move your face versus just evaluating it at rest. The way your expressions change post botox depends on how many units are injected, and where. Getting it right is a combination of art and science! And the good news is that even if you don't love the result, the effects are temporary. 

7. What is The Difference Between Botox vs. Fillers? How do you know which one to get?

The short answer is if the root cause of the issue at hand is related to the muscle (like muscle movement), then botox makes more sense than filler because it treats the muscle. Dermal fillers work differently as they are designed to treat volume loss. If you're unsure about which to get, it's better to go in for a consult and have the practitioner create a personalize treatment plan so you can optimize for the result you're looking for.  

8. Botox safety: what are the risks and side effects of getting Botox?

Botox is generally regarded as a safe treatment, and side effects are rare especially if you're going to an experienced physician.

While side effects from botox are rare, the most commonly reported side effects include pain, swelling or bruising at the injection site, headaches, or tearing. You may also experience droopy eyelids or a crooked smile as a result of improper injection. And while very rare, botox injections can result in more serious side effects like muscle weakness, vision problems and trouble speaking, swallowing, or even breathing problems (1). Again, these side effects are extremely rare but they do exist. So, it's incredibly important that you go to a qualified physician for the injection. Additionally, doctors advise pregnant and nursing women 

9. How open should I be about getting Botox?

Injectables, lasers, peels, and all these other in-office skin treatments are becoming more and more widespread, but there’s still the impetus to lie about having them done. “I make sure to sleep eight hours every night and drink a lot of water” continues to be a common refrain from people with beautiful skin. But denying the reality of how beauty is achieved sets up false standards and unrealistic expectations. Skincare products and treatments aren’t magic potions and spells for otherworldly beauty. They’re the results of science that can benefit us all when we’re honest about it.

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