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The Treatment

The administration of BOTOX® Cosmetic involves:

  • No anesthesia is required. Discomfort is usually minimal and brief.

  • Your practitioner will administer a few tiny injections of BOTOX® Cosmetic directly into the muscles that cause those moderate-to-severe lines.
    The most popular areas to be treated are the frown lines between the brows, forehead lines and crows feet.

  • It takes approximately 10 minutes for the entire treatment.

After the Treatment

  • No downtime is needed – you’re ready to get on with your day!

  • Your practitioner will give you specific aftercare instructions.

  • Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.

Frequently asked questions


What are expression lines?

Expression lines, or dynamic wrinkles, are creases in the skin caused by contractions of the underlying facial muscles every time you smile, laugh, or frown. The more emotion you show, the deeper these lines and creases are likely to be.

What is Botox?

Botox is a purified protein produced by the clostridium botulinum bacteria. Although Botox is a toxin, there are no systemic side effects. This is because, for the treatment described, it is used in extremely small amounts and does not spread throughout the body.

How does Botox work?

Botox is used in a procedure known as Cosmetic Denervation to relax the overactive facial muscles responsible for prominent expression lines such as worry lines, frown lines, and crow’s feet. Botox dramatically improves the appearance of these lines by blocking the nerve impulses to these overactive muscles, making them unable to contract. As the muscles relax, the lines disappear. Desirable facial expressions remain unaffected. Botox does not affect sensory nerves, so there is no numbness in the area of the injection.

How is Cosmetic Denervation performed?

This technique involves injecting a very small amount of Botox through a tiny needle precisely into the overactive facial muscles responsible for expression lines. Because the needle is very fine and only a small amount of liquid is injected, the discomfort associated with treatment is minimal. Many patients compare this sensation to a mosquito bite. Patients can resume normal activities immediately following treatment.


Are there any side effects?

The most common side effect of treatment is a small bruise at any or all of the injection sites. The degree of bruising varies from individual to individual, but is rarely of any significance. Any bruising is easily covered with makeup until it resolves, usually in a few days. Patients occasionally complain of a mild headache lasting for several hours after treatment. Uncommonly, the Botox can migrate to nearby muscles. In these cases there can be a temporary drooping of an eyelid or mild asymmetry of facial expression. The risk of this depends upon the areas being treated. Because the effects of Botox are completely reversible, any side effects are temporary. Allergic reactions are rare.

What results can I expect?

If deep expression lines make you look older than you feel, Cosmetic Denervation with Botox can smooth these out and give you a more youthful and pleasant appearance. Initially, the results of Botox treatment last an average of 3-4 months. With repeated treatments, we find that many patients are able to go longer and longer between treatment sessions to maintain the effect. This seems to be due to a gradual weakening of the overactive muscles.

What are the limitations of Botox?

Cosmetic Denervation with Botox cannot improve wrinkles due primarily to aging and sun-damaged skin since they are unrelated to facial movement. Botox will not improve sagging skin, nor will it replace the need for a face lift, brow lift, or blepharoplasty. Botox is most useful for treating frown lines, worry lines, and crow’s feet. The treatment of lines around the mouth are best treated with filler such as Juvéderm®.

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