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BOTOX® Cosmetic

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BOTOX® Cosmetic for the treatment of facial wrinkles is the most commonly requested non-surgical procedure performed at Richmond Aesthetic Surgery and Dermlounge medical spa. Made of onabotulinumtoxinA, BOTOX® Cosmetic is one of the most popular non-surgical cosmetic treatments performed each year, and for good reason. Our team has helped numerous men and women achieve a more youthful, natural-looking result with virtually no downtime and minimal side effects.

While we offer a variety of wrinkle relaxers and dermal fillers, BOTOX® Cosmetic continues to be a patient favorite due to its ability to provide an incredibly natural-looking rejuvenation in a quick, in-office visit.

What Is BOTOX® Cosmetic?

BOTOX® Cosmetic is a neurotoxin injectable made of onabotulinumtoxinA that is FDA-approved to smooth frown lines, crow’s feet, and forehead lines. It is one of the most widely performed non-surgical cosmetic treatments in the world, valued for its ability to deliver natural-looking rejuvenation with minimal downtime.

Wrinkles can be divided into two categories based on their underlying cause. Static wrinkles are caused by the effects of age, gravity, and loss of facial bone and volume; these are best treated with soft tissue fillers such as JUVÉDERM® to re-volumize and lift. Dynamic wrinkles, on the other hand, are caused by the repetitive action of the muscles used for facial expression. Over time, these movements cause the overlying skin to form creases that eventually become etched in, visible even when the face is at rest. BOTOX® Cosmetic is specifically designed to address this second category.

*Individual Results May Vary

How Do BOTOX® Injections Work?

When injected into a muscle, BOTOX® Cosmetic inhibits the release of acetylcholine, the neurotransmitter responsible for triggering muscle contraction. The treated muscle becomes temporarily weakened, which allows the overlying skin to remodel over time so that lines smooth out and, in some cases, completely resolve.

Placement is everything. Injecting even a few millimeters away from the intended muscle group, or by a practitioner who infrequently performs injections, can cause unwanted paralysis and poor cosmetic outcomes. When administered properly by a skilled, experienced injector, the result is a natural look that enhances a patient’s existing features without altering them.

What BOTOX® Cosmetic Treats

BOTOX® Cosmetic is most commonly used for dynamic wrinkles of the upper face, including:

It is also effective in several areas of the lower face and neck, including vertical lip lines, prominent chin cobblestoning, and the depressor muscles along the jaw that contribute to jowling and downturned mouth corners. More advanced injectors also treat the masseter muscles of the lower jaw — either to slim and contour the lower face for cosmetic purposes, or as a therapeutic treatment for bruxism (teeth grinding), where reducing muscle activity helps relieve jaw pain, headaches, and tooth damage — as well as prominent platysmal bands of the neck.

Am I a Candidate for BOTOX® Cosmetic?

Individuals with wrinkles that appear during facial expressions are excellent candidates for BOTOX® Cosmetic. While it was once most commonly sought by women over 40, it is now widely performed in both men and women beginning in their late twenties. In addition to treating existing lines, BOTOX® Cosmetic is an effective preventative tool. According to the American Society of Plastic Surgeons, neuromodulator injections among patients ages 20–29 rose 71% between 2019 and 2022.1

The best way to determine whether BOTOX® Cosmetic is right for you is through a personalized consultation with one of our experienced providers. During this visit, your face will be examined both at rest and during muscle animation to assess the strength of muscle contractions, skin quality, and the most appropriate treatment approach for your goals.

What Does the BOTOX® Cosmetic Treatment Involve?

Your BOTOX® Cosmetic experience begins with a personal consultation with one of our experienced providers, who will assess your areas of concern and develop an individualized treatment plan. In some cases, treatment can begin during this same appointment.

Before injections, an ice pack is applied to help numb the skin and minimize discomfort. Our team uses small 31-gauge insulin needles and the most concentrated dilution of BOTOX® Cosmetic with 1cc of bacteriostatic saline, a combination that significantly reduces discomfort, bruising, and redness compared to standard needle sizes and saline formulations used at many other practices. Most patients report feeling little to no discomfort. Your provider will strategically place several small injections into the targeted muscle groups, with most patients benefiting from approximately three to five injections per area.

The treatment itself takes less than 10 minutes, and a full appointment, including consultation, averages about 30 minutes. You will be asked to return for a follow-up two weeks later to evaluate your results. If any minor touch-ups are needed, they can be performed at that time.

Are There Side Effects to BOTOX® Cosmetic?

Side effects from BOTOX® Cosmetic are typically mild and injection-related. Slight redness at the injection site is common immediately after treatment but usually fades within 30 minutes. Minor bruising may occur and typically resolves within two to three days, though it can last up to a week.

Rare but more serious side effects can include eyelid or eyebrow drooping, flu-like symptoms, hypersensitivity or allergic reaction, and blurred vision. Your provider will review all potential side effects during your consultation so you can make a fully informed decision.

When Will I See My BOTOX® Cosmetic Results?

Some improvement is typically visible within the first week, with BOTOX® Cosmetic generally taking one to two weeks to fully set in as the treated muscles gradually relax. The full extent of results is usually noticeable at four to eight weeks after treatment.

Results last an average of three to six months, at which point a follow-up session can be scheduled to maintain your outcome. Patients with very deep forehead creases or frown lines may also benefit from a dermal filler such as JUVÉDERM® and/or skin resurfacing to optimize their results.

How Much Does BOTOX® Cosmetic Cost?

The cost of BOTOX® Cosmetic at Richmond Aesthetic Surgery is $14 per unit. The number of units needed varies by treatment area and individual anatomy; for example, the glabella area between the eyebrows typically requires an average of 22 units for female patients (range of 19–30 units), making the average cost for that area approximately $308. Overall treatment costs generally range from $250 to $1,000 depending on the extent of your needs.

During your consultation, our team will assess your muscle groups and provide a personalized cost estimate. Financing is available for those who prefer to split costs into smaller monthly payments, and VIP Program members can take advantage of discounts on BOTOX® Cosmetic treatments.

Other Uses for BOTOX® Injections

Beyond facial rejuvenation, BOTOX® Cosmetic has a number of therapeutic and cosmetic applications that make it one of the most versatile injectable treatments available.

Hyperhidrosis (Excessive Sweating)

BOTOX® Cosmetic is a highly effective treatment for hyperhidrosis, or excessive underarm sweating. The procedure takes less than 15 minutes and consists of approximately 15–20 small intradermal injections with a fine needle. Results are typically seen within days of treatment and last an average of six months, with many patients experiencing complete resolution of underarm sweating. Most patients require only ice prior to treatment; a topical anesthetic is available upon request.

Teeth Grinding (Bruxism)

Teeth grinding, or bruxism, can cause jaw pain, tooth damage, and headaches, and traditional solutions like mouthguards don’t work for everyone. BOTOX® injections into the masseter muscle, the large muscle responsible for chewing, have shown promising results in reducing the symptoms of bruxism. By temporarily reducing the muscle’s activity, BOTOX® injections help alleviate the pressure and grinding that leads to tooth damage and jaw discomfort, with most patients noticing significant improvement within days to weeks after treatment.

Schedule Your BOTOX® Cosmetic Consultation

To learn whether BOTOX® Cosmetic is right for you, or to explore other non-surgical options such as dermal fillers or laser treatments, contact Richmond Aesthetic Surgery and Dermlounge today to schedule your consultation.

Medical Resources

1Media Hub: Baby botox: why younger and younger women are turning to preventative injections
2BOTOX Cosmetic: The one & only BOTOX® Cosmetic