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All you need to know about Botox

Do you have frown lines or ‘scary lines’ that make you look angry, older, or worried all the time, even when you are not?

That’s when Botox comes in as a solution without the downtime and without going under the knife.

What is botulinum toxin type A, best known as Botox?

Botox is a neurotoxin derived from Clostridium botulinum, an organism found in the natural environment where it is largely inactive and non-toxic.

In large amounts, this toxin can cause a form of muscle paralysis known as botulism, which is usually associated with food poisoning.

However, small, diluted (weakened) amounts can be injected directly into specific muscles, causing controlled relaxation of the muscles.

Botox injections work by relaxing or paralyzing certain muscles or by blocking certain nerves, depending on the treatment.

What is Botox used for?

Botulinum toxin is used to reduce fine lines and wrinkles by paralyzing the underlying muscles.​ According to statistics, in 2018 there were 7,4 million Botox procedures just in the United States.

And while it is the most popular non-surgical cosmetic treatment, Botox is also a solution for other conditions too, including stopping excessive sweating and migraines.

Is Botox FDA approved?

The FDA approved its usage in the late 1980s when it was discovered that it stopped uncontrolled blinking and misaligned eyes.

Cosmetic physicians have been using it for years to successfully treat wrinkles and facial creases that make you look worried or angry.


Botox is currently approved for:

  • Glabellar lines (frown lines between the eyebrows)

  • Canthal lines (crow’s feet)

  • Blepharospasm (eye squints)

  • Idiopathic rotational cervical dystonia (severe neck and shoulder muscle spasms)

  • Chronic migraine

  • Severe primary axillary hyperhidrosis (excessive sweating)

  • Strabismus (misaligned eyes)

  • Overactive bladder

  • Hemifacial spasm

  • Post-stroke upper limb spasticity

  • Detrusor (bladder wall muscle) overactivity – causing urinary incontinence

What are the benefits of Botox?

Botox’s benefits include a more youthful and pleasant appearance without surgical intervention or significant time lost in the recovery period.

The fact is, getting wrinkles removed from your face has a profound effect on the way you look to other people.

People who use Botox experience an increase in social confidence because of its unique ability to relax muscles, treat facial wrinkles, and other medical conditions.

Who is an ideal candidate for Botox?

Your doctor may suggest that you are a good fit for Botox if:

  • You have moderate to severe facial wrinkles.

  • These wrinkles are located in the approved areas that Botox can treat

  • You are in generally good health.

  • And if you have realistic expectations.

Who may not be a good candidate for Botox are people with a skin infection at the desired site of treatment, are pregnant or breast-feeding, have a muscle or nerve condition such as ALS (amyotrophic lateral sclerosis) or myasthenia gravis, or if you have a severe illness or infection.

Botox use has increased 80% since 2000, to 7,4 million to 2018.

What are the risks of Botox?

Botulinum toxin injections are generally well tolerated, however, here are some of the potential side effects:

  • Mild pain, swelling, numbness, reddening of the skin, bleeding or bruising at the injection site.

  • Flu-like symptoms

  • Headache

  • Upset stomach

  • Temporary drooping eyelids

  • Fluid buildup

  • Numbness

  • Mild nausea

  • Blurred vision

  • Dry mouth

  • Neck weakness

  • Brachial plexopathy – a condition affecting the nerves on either side of the neck and chest

Around 1% of people receiving injections of botulinum toxin type A develop antibodies to the toxin that make subsequent

treatments ineffective.

What are the steps of a Botox procedure?

There are 43 muscles in your face. It is key that the medical specialist who performs the injections understands and pinpoints the correct spots to optimize your treatment.

A very thin needle is used to inject small amounts of botulinum toxin into specific muscles.

By carefully choosing these specific muscles, your healthcare provider weakens only the wrinkle-producing muscles, preserving your natural facial expressions. It takes around 10 minutes, it doesn’t require anesthesia and carries only minor discomfort.

Though it may seem like a simple procedure to you, it’s actually both an art and science that only an experienced healthcare professional should do.

How many Botox units do I need?

One of the most popular questions about Botox relates to how much Botox someone needs. You are not alone, especially if you’re new to this cosmetic treatment.

Botox is measured in units, an arbitrary unit of measurement derived by animal studies that correlate to a fixed number of botulinum molecules.

Units measure the biologic strength of the Botox; it’s a scale to standardize the ability of Botox to relax the nerve.

Units are unique to Botox and are determined by Allergan. Other neurotoxins and dermal fillers are measured differently.

Each vial of Botox contains 100 units, which can be split into individual blocks for treating various areas.

The ideal units of Botox for you can only be determined through a consultation with a board-certified cosmetic physician and depends on the quantity, length, and depth of your lines because every patient is unique in terms of facial characteristics and desired result.

Some of the most well-known characteristics include:

  • Gender: Men usually have larger facial muscles compared to women and thus they generally need more Botox.

  • Facial muscle strength from repetitive actions like frowning, smiling or squinting. Individuals who are more prone to these repetitions will require more Botox.

  • Wrinkle Severity: The more severe or deep the wrinkle, the more Botox will be needed for proper treatment.

Units also vary depending on your face shape, size, and your metabolism.

Most Botox providers use these guidelines as a starting point and customize a treatment plan for each patient, given the patient’s current condition and desired results we have mentioned.

Here are the recommended units of Botox needed to treat common areas:

  • Crow’s feet: 5-15 Botox units per side

  • Dimpled chin: 2-6 Botox units

  • Frown or Glabellar Lines: 15-25 Botox units

  • Eyebrows: 2-5 Botox units per side

  • Forehead lines: 10-30 Botox unites

  • Gummy smile: 2-4 Botox units

  • Marionette lines: 2-8 Botox units

  • Nasalis “Bunny” lines: 5-10 Botox units

  • Neckbands: 25-50 Botox units

  • Pout boost: 2-4 Botox units

  • Upper lip lines: 4-8 Botox units

  • Smile lift: 3-6 Botox units

Glabellar lines and crow’s feet are FDA approved. The rest are considered off-label uses.

Keep in mind that undertreating an area may not leave a satisfying result and could end up costing you more money if a fix is needed.


An experienced and board-certified physician will determine the right amount of Botox needed to deliver the results you are looking for.

Is Botox safe?

Botox injections have been used safely and effectively for over 20 years.

Although botulinum toxin is life-threatening, small doses — such as those used in the application of Botox — are considered safe.

Botox is considered safe overall.

You should always go to a board-certified aesthetic or cosmetic doctor. Taking this as your first step drastically reduces possible side effects and guarantees that your treatment aligns with proper quality standards

What is the recovery time for Botox?

There is no recovery or downtime with Botox injections and almost all patients can resume normal activities right after treatment.

As a precaution measure, do not rub or massage the treated areas after the treatment, to prevent the toxin from spreading to a different area of your face, causing temporary facial weakness or dropping.

How long does Botox take to work?

Botox injections are fully noticed one to three days after treatment.

How long does Botox lasts?

The effects from Botox usually last three to six months or longer.

As muscle action gradually returns, the lines and wrinkles begin to reappear. To maintain the effect, you’ll need regular follow-up injections.

However, the lines and wrinkles often appear less severe over time because the muscles are shrinking.

Is Botox covered by insurance?

Botox is not covered by insurance when used for cosmetic purposes.

How much does Botox cost?

Botox is priced per unit.

On average, each unit costs about $10 to $15. If you receive up to 20 units in your forehead, you could be looking at a total of about $200 to $300 for the treatment of horizontal forehead lines.


In the Dominican Republic, Botox's cost is less and holds the same quality treatment.

Find a Doctor in the DR

Aesthetic and Anti-Aging MD


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