Botox, Dysport, and other neuromodulators temporarily weaken the signal between the nerves and muscles of your face in areas that create wrinkling with facial expression. When performed conservatively as an individualized art, Botox can help you look more youthful and awake, but still completely natural. When done by someone inexperienced or heavy handed, Botox can create unnatural looks, heaviness, drooping, or other problems.

Botox, Dysport, and other neuromodulators like Xeomin are safe when used appropriately and conservatively by an experienced professional. This should ideally be a board-certified physician in the core four aesthetic specialties of dermatology, plastic surgery, oculoplastic surgery, or ENT/facial plastic surgery.

I am a conservative board-certified dermatologist who believes in balancing healthy self-image with reasonable anti-aging steps. I do not push my patients get Botox or Dysport too young. I think a board-certified dermatologist can most properly identify the timing between when lines may start to form, and when its time to start treatments to prevent the fine lines from etching into the skin and being more difficult to reverse.

When performed by an experienced core 4 aesthetic physician, Botox may be nearly painless. I use needles so small that sometimes my patients literally do not feel them at all. I do have some patients who prefer to come in early for a few minutes of numbing cream, but it is not necessary by any means.

Botox, Dysport, and Xeomin work by cleaving the muscle receptor that receives the nerve signal to contract. It takes time for this to happen. And then it takes 3 months (on average) for your muscles to regenerate new receptors. When the receptors are all regenerated, the Botox effect has worn off.

Botox, Dysport, and Xeomin do not make you look older after they wear off. However, you do look older than while your treatment was working (for the normal 2-4 months) because your lines will start to re-form when your muscles recover their normal strength and begin to crease your skin again. For this reason, it is valuable to get your treatments regularly so that you have constant improvement, instead of a back and forth improvement that does not get better over time. Finally, if the treatment you get is wrong, placed poorly, or excessive, you may actually look older while it is in effect, and younger when it finally wears off. In that case, please go next time to a board-certified dermatologist who can best assist with appropriate treatment judgment.

If it has been at least 4 or 5 hours since your Botox, Dysport, or Xeomin was placed, you can feel free to sleep normally.

Three common areas for Botox or Dysport treatments are the glabella (frown lines between the eyes, or the elevens), the crows feet (smile lines outside the eyes), and the forehead. However, I also treat patients around the lips, bunny lines of the nose, chin, jawline, and neck, depending on their needs.

The most important thing to know before getting Botox, Dysport, Xeomin, or other neuromodulator injection, is that it is important to see a respected, experienced, board-certified physician from one of the core four aesthetic specialties. Many non-physicians and weekend-trained physicians are performing Botox nowadays, and it is hard to know who has what understanding of how the skin works and what the facial surgical anatomy implies about how much Botox to place, where, and why. You should start by choosing a board-certified dermatologist/dermatologic surgeon, plastic surgeon, oculoplastic surgeon, or ENT/facial plastic surgeon.

Botox may be used to weaken the masseter muscles and cause a slimmer appearance (less square) of the jawline, but its not for everyone. See an experienced board-certified dermatologist or plastic surgeon who can refer you to the right person to evaluate TMJ action before Botox treatment is done.

On average, Botox tends to last 3 months, but may commonly last a few extra weeks. In rare individuals, it may last 5 to 6 months from the start, but this is unlikely.

Botox works by weakening muscles that pull together to crease the skin. This works great between the eyebrows, but can be a problem trying to use it around the mouth, since if you weaken the mouth muscles you may have trouble speaking or drinking fluids. It does not work for deep cheek folds, but does help for eye wrinkles known as crows feet.

Botox works by weakening muscles. There is a flat band of muscles that goes from your eyebrows up to your scalp. If that muscle is overtreated, you will not be able to lift your eyebrows, and if it is severely overtreated, it will not maintain its natural tension that keeps your brows in place, thus allowing them to droop or even just feel heavy. This is temporary and will wear off when the Botox does.

Botox can be a lifesaver for excessive sweating, but it may not be covered by insurance and must be repeated. It can be uncomfortable, but it is one of the most effective non-surgical ways to deal with a difficult problem.

Botox(R) brand neuromodulator is Abobotulinum Toxin A. This molecule starts working at about day 5 but full results are not seen until about the 10th day after treatment.

Botox Cosmetic is the same molecule as the Botox used for medical conditions such as muscle spasm, chronic migraine headache (more than 15 days per month), blepharospasm (eyelid muscle dysfunction), bladder dysfunction, muscle spasticity due to spinal cord injury, and many other neuromuscular conditions.

Botox wears off on average every 3 months. This is because “wearing off” means your own muscles have regenerated the receptors that are cleaved by Botox, so your nerve-to-muscle signals start working again. This is different for everyone, but by 6 months, all effect is generally long gone

Sure. Botox can be combined not only with other neuromodulators like Dysport, but also with fillers, lasers, chemical peels, and other treatments. Different physicians have different preferences on what they feel comfortable doing together on the same day due to skin surface disruption, swelling, and other factors.

Botox may reduce the formation of dynamic wrinkles (wrinkles created by making facial expressions) if used preventively, but there may be other side effects of very long term Botox usage especially at high doses. So be conservative.

Yes! Botox (or Dysport) will definitely work for you in the situation where you already see some lines at rest, but they aren't very deep yet. In fact, in some ways, you are the ideal candidate. People with no lines at all are probably jumping the gun and wasting money treating, unless they really, really, really want to prevent any lines at all. People with very deeply etched lines that won't disappear no matter how tight the skin is pulled will have a hard time ever truly losing all of the lines without a resurfacing procedure along with Botox (but Botox will still help). When you treat with Botox in your situation, the Botox will keep the muscles beneath the skin from repeatedly creasing it daily, allowing it to lie flat and get smoother over time.

In the right conservative hands, Botox can be a great subtle lip enhancer and help to minimize fine lines around the mouth, but if the creases are deep, it may take a combination of Botox, filler, and laser to smooth that pucker. Trying to do the whole trick with Botox alone may leave your mouth muscles so weak that you can't speak or eat properly! Plus, it's not reversible and has to wear off on its own. So.... see ONLY an experienced board-certified dermatologist or plastic surgeon for Botox in the mouth area. It's a more advanced treatment that you don't want done incorrectly.

Botox is used only to weaken muscles that pull underneath the skin and fold it to create wrinkles and lines of facial expression. It works well to soften crow's feet, the lines that form on the sides of your eyes when you smile. Botox is not helpful for the "smile lines" on the sides of your mouth that go from your nose to your mouth (nasolabial folds or melolabial folds). Those lines are only softened by injecting filler such as Restylane, Juvederm, or Perlane underneath to fill in the deep hollow. Very tiny amounts of Botox may be carefully used around the lip area to soften some lines on the lips themselves, but using too much there can make it impossible to speak or eat properly for up to 6 months! The safer way to get rid of lip wrinkes: Smile all the time.

There are two reasons not to exercise right after Botox or Dysport treatments. I allow my patients to exercise the morning of treatment before they come in (ideally not RIGHT before coming in), but not later the same day. They are allowed to resume exercise, for the most part except in special cases, the following day. Exercise increases circulation in the body, including the face, which is why your face flushes and gets red when you work out. This increased circulation is great for your skin, but it does increase the risk that the Botox will be taken away from the injection zone before it gets fully absorbed into the neuromuscular junction. We don't like this for two reasons: 1) it may leave less Botox where we want it, and possibly decrease the effect, and 2) we do not want to do anything that increases the risk that the Botox will act anywhere other than where it is intended. For this reason, I am strict about no exercise after treatment. I do make patients cancel their personal training sessions and Soul Cycle classes, even if they can't get a refund. Be warned!

Dysport and Xeomin both work the way Botox does, because they are all the same botulinum toxin A protein, wrapped in different carrier proteins. This is the only injectable treatment that will allow the muscles under the skin to relax so the wrinkles can soften over time. No cream can achieve the same result, and no filler like Restylane or Juvederm should be used in the forehead. The only other option for smoothing forehead wrinkles is a surgical brow lift, which involves a plastic surgeon or facial plastic surgeon using general anesthesia to lift, trim, and reattach the forehead surgically. This is a significant surgical procedure so I recommend having many consultations before proceeding.

Too much Botox can do more than "freeze your face" and prevent normal expressions. It could also potentially be dangerous, if it spreads out of the treatment area and begins to affect muscles that are not part of the intended target. Remember you can always try a little Botox and ADD MORE if you feel the effect is not strong enough. There is no harm in being conservative, except the hassle of having to go back to the board-certified dermatologist or plastic surgeon you have chosen to treat you.