Good Botox looks quiet. No frozen brows, no arched “surprised” look, no drooping eyelids. Just smoother movement and softer lines that don’t shout, “I had something done.” Getting there starts long before the needle touches skin and continues for a few hours afterward. The day of treatment is about good preparation, the right numbing approach, accurate dosing and injection placement, and disciplined aftercare. When those pieces line up, Botox results are natural, predictable, and long lasting.
I’ve guided thousands of patients through Botox cosmetic treatment for forehead lines, frown lines, and crow’s feet. I’ve also treated masseter muscles for jaw clenching and facial slimming, reduced underarm sweating with hyperhidrosis Botox treatment, and used medical Botox for migraines or eyelid twitching. The protocol changes depending on the goal, but the core rhythm of the appointment is similar. Here is what to expect and how to set yourself up for the best possible Botox results.
A quick refresher: what Botox is and where it shines
Botox is a purified neuromodulator that temporarily relaxes targeted muscles. Relaxing an overactive muscle reduces the skin folding that creates wrinkles. On the face, that means softening dynamic lines in the glabella (the “11s” between the brows), horizontal forehead lines, and the fan lines at the outer eye, known as crow’s feet. It also refines smaller areas like bunny lines along the top of the nose, chin dimpling, downturned mouth corners, and the vertical bands of the neck.
For non-cosmetic uses, therapeutic Botox calms muscle hyperactivity and some nerve-mediated conditions. Masseter Botox can slim a square jawline and reduce teeth grinding or TMJ-related jaw pain. Injecting underarms for excessive sweating can keep shirts dry for months. For migraines Botox treatment, precise patterns across the scalp and neck can reduce headache frequency and intensity for eligible patients.
People talk about “Botox versus fillers,” which is a helpful distinction. Botox and fillers do different jobs. Botox relaxes muscle movement to prevent and soften lines. Hyaluronic acid fillers replace volume and structure to lift, contour, or fill static wrinkles. When results look off, it is often because the wrong tool was chosen for the problem. A non-surgical brow lift Botox can subtly elevate the tail of the brow by relaxing the depressor muscles. If the brow is heavy due to volume loss, a filler or a different approach may be the better choice. The art lies in matching the tool to the goal.
How long Botox takes to work, and how long it lasts
The onset is not instant. Most people start to notice change at day 2 to 4, with full effect around day 10 to 14. This matters for planning. If you want to look smoother for an event, schedule your Botox appointment at least two weeks before.
Duration depends on the area, dose, and individual metabolism. Typical cosmetic areas hold for 3 to 4 months. Crow’s feet can wear off a bit sooner. Masseter Botox and underarm sweating treatments can last 4 to 6 months, sometimes longer. If you’re evaluating Botox before and after photos online, check the time stamp. Photos taken at week two are the most honest version of the result.
What good preparation looks like
Preparation starts about a week before. You can still get Botox injections without perfect prep, but dialing this in pays off with less bruising, a smoother experience, and cleaner results.
I ask patients to avoid aspirin, ibuprofen, naproxen, fish oil, high-dose vitamin E, ginkgo, and St. John’s wort for 5 to 7 days if medically safe to do so. These thin the blood and raise the chance of a bruise. If your physician has you on a blood thinner, do not stop it for cosmetic Botox without medical clearance. A bruise heals. A stroke is not worth a smoother forehead.
Hold vigorous exercise and alcohol the night before. Both increase blood flow and can push more bleeding at the injection sites. Arrive with clean skin. Skip heavy moisturizers, sunscreen with zinc or titanium, and makeup to reduce the risk of contamination.
Hydrate and eat lightly. An empty stomach and dehydration can make some people woozy. If you are anxious about needles, say so during your Botox consultation. We can slow down, use vibration distraction, add cooling, and plan numbing more deliberately. First time Botox patients tend to relax once they understand the steps and feel how quick the process is.
Consultation and mapping: the five-minute difference between OK and great
The Botox consultation is not a sales script or a quick “what do you want to do today.” It is a problem-solving conversation. I ask you to animate your face: frown, lift your brows, squint, smile big. I’m looking at how your muscles recruit and where your lines form. Two patients can both say “I want Botox for forehead lines,” but the path to natural looking Botox for each is different. Some people pull their brows upward with their frontalis constantly, often to open heavy lids. If we over-relax that muscle without adjusting the depressors below, the brows feel heavy and drop. Others pull strongly inward and down at the glabella, which makes a brow lift Botox especially satisfying.
I map the injection sites with a cosmetic pencil, adjusting for asymmetries. A right-dominant frontalis may need a unit or two more on the right side. The goal is balance, not symmetry by force. For masseter Botox or jawline Botox, I palpate the muscle while you clench to find the densest portions. For hyperhidrosis Botox treatment under the arms, I sometimes do a starch-iodine test to highlight sweat distribution, then grid the area.
Dosing is more than a menu. You will see ranges because faces vary. Common ballparks: 10 to 20 units for the glabella, 6 to 20 units for More help the forehead depending on the width and strength of the muscle, and 6 to 12 units total for crow’s feet. Preventative Botox or baby Botox uses smaller doses spread more widely to soften movement without fully blocking it. For masseter Botox, 20 to 40 units per side is common for a first treatment, adjusted to your chewing strength and facial shape. Hyperhidrosis in the underarms can range from 50 to 100 units per side.
If you have a history of eyelid droop, eyebrow asymmetry, prior eye surgery, neuromuscular disorders, or medications like aminoglycosides, disclose that now. These details guide safer placement and realistic expectations.
Numbing options, and when I recommend each
Most cosmetic Botox injections are quick and feel like a series of pinches with a tiny insulin needle. Numbing isn’t always necessary for areas like the forehead and glabella. Crow’s feet can be more tender. Underarm sweating treatments and lip-related injections, like a lip flip Botox for a gummy smile or slight lip eversion, can sting more.
Topical anesthetic creams with lidocaine or prilocaine take 20 to 30 minutes to work and reduce the sharpness well. Ice and vibration devices help more than people expect. For underarms or palms, a quick pass with a chilled roller and a spray of vapocoolant can make a big difference. Dental nerve blocks are rarely needed for Botox, but they are an option if we are treating a very sensitive perioral region.
If you are needle-sensitive and want numbing cream, arrive a bit early so we can apply it without rushing. Some clinics will send a small prescription tube home so you can apply before you come in. Ask during your Botox consultation.
The injection sequence: what actually happens
Treatment areas are cleaned with alcohol or chlorhexidine and then dried. I often apply ice briefly to each Botox injection site to constrict tiny vessels and lower sting. We double-check the map and ask you to animate again. I use a fresh 30 or 32 gauge needle and a dose-calibrated syringe for precision.
The needle enters at a shallow angle, and product is placed into the superficial muscle or intradermally for micro Botox approaches that target fine lines and pores. You may feel a brief sting and a pressure bubble under the skin. For crow’s feet, I position the injections slightly lateral to avoid diffusion into the lower lid. For forehead lines, I stay at least a couple of centimeters above the brow to reduce the risk of brow ptosis. For the glabella, angles are careful around the medial brow and the procerus to avoid injecting too low.
Each area takes only minutes. Even a combined plan for frown lines, forehead, and crow’s feet typically wraps in 10 to 15 minutes. Masseter treatments add a few more. Underarms take longer due to the number of points but still fit within a typical lunch break.
You can expect tiny raised blebs like mosquito bites over each site that flatten within 20 to 60 minutes. Pinkness fades quickly. Occasionally a small bruise appears in one or two spots, more likely if a vessel was nicked or if you took a blood thinner.
What you pay for, and what “deals” often mean
Patients search “botox near me for wrinkles,” “affordable Botox,” and “Botox deals” for understandable reasons. Pricing can be per unit or per area. Per unit pricing makes the math transparent. Regional averages vary, but you may see $10 to $20 per unit in many markets, with experienced injectors often in the mid to upper range. Per area pricing can be fair if the clinic discloses typical unit counts and customizes dosages. A low headline price sometimes hides heavy dilution, rushed mapping, or inappropriate one-size-fits-all dosing.
If you visit the best Botox clinic in your city, you are paying for sterile technique, conservative artistry, a willingness to say no to inappropriate requests, and consistent Botox maintenance plans that keep you looking like yourself. Ask your injector what product they use. Botox Cosmetic, Dysport, Xeomin, and Daxxify are common neuromodulators with similar targets. Dysport vs Botox debates often focus on diffusion and onset. Xeomin vs Botox discussions highlight that Xeomin lacks accessory proteins, which may matter for a small subset of patients. Daxxify may last longer in some individuals. The key is to work with someone fluent in these differences who can explain why a given choice fits your goals.
Memberships or Botox package deals can be worthwhile if you maintain results routinely. Most cosmetic patients return every 3 to 4 months. If you prefer the softest steady-state, a touch up at two weeks can refine any small asymmetry, followed by maintenance at three months.
Immediate aftercare and the first day’s rules
Most undesired Botox side effects that are preventable relate to diffusion in the first hours. The protein needs time to bind at the neuromuscular junction. Simple precautions keep it where you want it.
Here is the short checklist I ask every patient to follow after a Botox appointment:
- Keep your head upright for four hours. No lying down, bending face-down to tie shoes, or napping on the couch. Avoid rubbing, massaging, or putting pressure on treated areas for the day. Skip facials, masks, or tight hats pressing the forehead. Hold vigorous exercise, saunas, hot yoga, or long hot showers for 24 hours. Avoid alcohol the night of treatment to reduce bruising and flushing. If you need to apply skincare, wait at least four hours and use a gentle touch, patting rather than rubbing.
A light workout the next morning is usually fine. You can wash your face that evening with cool water and a gentle cleanser. Makeup can go on after several hours if you need it, but minimal pressure is better. If you do bruise, topical arnica or a color-correcting concealer covers it well. Bruises clear in a few days.
The first two weeks: what to watch and how to time your check-in
By day 3 to 4, you should feel a soft change as the treated muscles resist moving. The full read comes at day 10 to 14. If you’re planning a Botox touch up, schedule the follow-up inside that window. Small tweaks work best. Adding a couple of units above a slightly more active brow or adjusting one crow’s foot line brings the face into balance.
If movement feels too frozen for your taste, tell your injector. Your next personalized Botox plan can adjust the dose down or soften a zone to give you more expression, especially if you prefer subtle Botox results. If lines remain deeper than you hope, that can mean volume loss or etched-in creases that Botox alone can’t erase. That is where fillers or skin remodeling come into the conversation.
Mild headaches can occur the day of treatment or the next day. Over-the-counter acetaminophen typically handles it. Small bumps or tingling settle quickly. If you notice eyelid heaviness or brow droop, contact your clinic. Properly placed Botox rarely causes this, but anatomy varies. Most mild ptosis resolves as the product settles, and eyedrops like apraclonidine can lift the lid temporarily. This is also why the upright, no-rubbing rules matter.
Choosing where and whom to trust
The best Botox doctor for you listens to your goals and narrates their choices. You should hear why they’re placing fewer units near the lateral brow tail to avoid an overarched look, or why they’re spacing injections higher on your forehead because your brow position depends on frontalis engagement. You should also hear a clear plan for how many units of Botox for forehead lines they recommend and how they’ll adjust at your two-week check.
Ask to see a range of Botox patient reviews, including conservative outcomes and before-and-after examples taken at similar time points. Beware only one type of face or only maximal smoothing. Natural looking Botox is a spectrum. Younger patients doing preventative Botox may want 10 to 12 units across the forehead to train patterns early. A 55-year-old with deep etched lines may need a staged plan with Botox and resurfacing to reach their goal.
If you are deciding between same day Botox at a walk-in spa and a medical practice, weigh convenience against expertise and safety. Medical Botox and therapeutic injections for migraines or hyperhidrosis should be done in a medical setting with clear documentation, dosing, and follow-up. Cosmetic treatments benefit from the same rigor.
Special cases: men, athletes, and oilier or thicker skin
Men often need higher doses due to stronger muscle mass, which is where the “brotox for men” nickname came from. Heavier frontalis muscles can require 12 to 20 units to achieve the same smoothing that 8 to 12 units would deliver in a smaller muscle. The goal remains natural movement. Stronger dosing should be balanced with higher placement and careful brow preservation.
Very active athletes sometimes metabolize neuromodulators faster. Expect closer to 3 months for duration. If you are training for an event, place your treatment two weeks before race day and avoid hard sessions the day of.
Patients with oily skin or larger pores sometimes ask about micro Botox for pore reduction. Superficial microdroplet techniques can improve texture and sebum control temporarily, especially on the T-zone. The effect is nuanced and must be done conservatively to avoid flattening expression.
Safety, side effects, and realistic risk
Is Botox safe? In qualified hands, yes. It has a long track record across both cosmetic and medical indications. Common temporary effects include mild bruising, pinpoint bleeding, tenderness, and a dull headache. Less common effects include eyelid or brow ptosis, asymmetry, smile changes if perioral muscles are affected, or dry eye sensations with heavy crow’s feet dosing in dry climates. Allergic reactions are rare. If you have a neuromuscular disorder, are pregnant or breastfeeding, or have an active skin infection, hold off. Share your medical history. There are also alternatives like Xeomin or Dysport if you have specific concerns.
If you ever see symptoms of a spreading toxin effect like generalized weakness, swallowing issues, or breathing difficulty, seek medical care immediately. This is exceedingly rare at cosmetic doses and proper injection technique, but it is part of informed consent.
How much Botox costs, and what drives the number
How much does Botox cost depends on units used, injector expertise, and regional market. You might pay $240 to $480 for a glabella treatment at $12 per unit with 20 to 40 units, or $150 to $360 for crow’s feet at 12 to 30 units. A full upper face plan with forehead, frown lines, and crow’s feet can run $500 to $1,200 depending on needs and geography. Masseter treatments range widely, often $600 to $1,200 depending on dosage per side. Hyperhidrosis in the underarms is more unit-heavy and may cost $1,000 to $1,800. Some plans are eligible for Burlington botox insurance when medical, such as migraines or severe hyperhidrosis, but documentation is key and coverage varies.
Memberships can smooth costs if you are on a regular schedule. If a clinic quotes a per area price that seems too good to be true, ask about units, product brand, dilution, and follow-up policy. A transparent answer should line up with what you learned during mapping.
Maintenance: how often to get Botox and how to keep it natural
Most patients return every 3 to 4 months for cosmetic areas. If you prefer a softer, continuous look, schedule before you feel the full return of movement. If you want to stretch appointments, wait until the lines just start to come back, then book. Over time, consistent Botox can train muscles to be less expressive even off treatment, which sometimes reduces needed units.
Baby Botox or a subtle plan is a valid choice, especially for first time Botox. The approach uses fewer units with a wider spread to keep movement while reducing the harsher lines. This often works well on a smaller forehead or in patients whose jobs require a lot of expression. Conversely, if you are seeing little change, your dose might simply be too low for your muscle strength. The fix is not more frequent visits, it is a more accurate dose.
When Botox is not the only answer
Botox is not the right solution for every line. Static creases at rest from volume loss or sun damage need a different tool. That might be a hyaluronic acid filler, a biostimulator, microneedling RF, laser resurfacing, or a skincare upgrade with retinoids and proper sun protection. Neck laxity and sagging skin respond poorly to neuromodulators alone. A neck botox plan can soften platysmal bands, but it will not tighten loose skin. Brow heaviness from upper eyelid skin excess may need surgical evaluation if your vision is affected or if you want a true lift beyond what a non surgical brow lift Botox can offer.
For lip shape, a lip flip Botox can gently evert the upper lip, showing more pink without adding volume. It is subtle and wears off quickly, about 6 to 8 weeks, due to the tiny doses involved. If you want visible volume or contour, a filler is the more effective route.
What not to do after Botox, and what to do instead
Some advice online is either too rigid or too loose. The practical middle ground looks like this: do not rub the treated area, avoid laying face down or pressing your face, skip intense heat and exercise for a day, and keep alcohol modest. If you forget and take a hot shower that night, do not panic. Just avoid compounding the risk with a sauna or a hard workout. Be gentle with your skincare. Focus on hydration, SPF, and non-irritating formulas for a few days. If your skin runs oily, you can resume actives like retinoids after 24 to 48 hours if your skin tolerates them well.
If an area feels uneven at day 10 to 14, reach out. Most clinics welcome a brief check and a small adjustment. Trying to “massage it out” almost never helps and can worsen distribution.
A practical step-by-step for your treatment day
If you like a simple game plan, here is the flow that works for most people:
- Eat a light meal and hydrate. Arrive with clean skin and no heavy products. Review your goals with your injector, animate the face, and agree on the personalized Botox plan. Confirm units and areas. Decide on numbing: none, ice and vibration, or topical cream. If cream, expect a short wait. Cleanse, map, and inject. Expect 10 to 20 minutes for most treatments, with small raised dots that fade quickly. Follow the four-hour upright rule, keep hands off the face, skip alcohol and hard workouts that day, and book your two-week check-in before you leave.
Final notes on realistic expectations
Botox is minimally invasive and has minimal downtime, but it remains a medical treatment with skill-dependent outcomes. Your face today is a stack of habits, genetics, sun history, and sleep. A personalized Botox plan meets you where you are. It can relax a frown that makes you look stern when you feel calm. It can stop your makeup from settling into forehead lines. It can ease jaw clenching that leaves your masseters sore by evening. It is not an eraser for every crease, and it is not meant to make you look like someone else.
If you are on the fence, start small. Treat the glabella alone or try baby Botox in the forehead, then reassess at two weeks. Ask questions. A good injector will explain trade-offs, suggest when fillers or skin treatments would help, and say no when a request risks a poor look. The best Botox is customized, conservative at first, and refined over time as you learn what you love in the mirror.
When you walk out of the clinic, you should feel composed, not transformed. The changes build quietly over the next few days. That is the point. Subtle, steady, and skillful.