The Ultimate (Beginner’s) Guide to Botox

Botox works by blocking a receptor in a nerve, which prevents the muscle that’s being treated from contracting. Translation: It paralyzes the muscle that is activated when you make expressions (like squinting or smiling). That said, it’s most commonly used (and FDA approved) to treat forehead lines and crow’s feet. It's also approved to combat underarm sweat and chronic migraines. There are some "off-label uses" (like using Botox to treat the area under your eyes). This is a very delicate spot and you should go to a board-certified dermatologist or plastic surgeon who understands the anatomy of the muscle in that area, as you need to inject very superficially and in small amounts. Which brings us to the next point...

There is a big difference between Botox and fillers. Botox is actually the brand name of the drug itself (botulinum toxin). Botulinum toxin is used to relax the underlying facial muscles that cause lines and wrinkles. Other brands that are also used include Dysport and Xeomin, but Botox is the most popular—hence, why people refer to the whole class of drug as "botox." Fillers are used to fill in lines and areas of your face that have sunken in. There are different types of fillers like hyaluronic acid fillers (common brand names include Restylane, Juvederm and Belotero) and calcium fillers (like Radiesse). Your derm will help determine which type to use depending on the area you’re filling and how deep the lines are in that spot. So to sum up: Botox is best used to smooth or soften the appearance of dynamic (aka expressive) lines and wrinkles; fillers are used to add volume back to areas of your face that have sunken in over time. Knowing this distinction is important to get the best results.

Ready to proceed? Make sure that whomever you’re considering for your first (and any subsequent) treatment is board-certified and matches the aesthetic of what you want. More than likely they’ve performed similar treatments on themselves so you can gauge how they might approach your face. And if they're not aligned with what you want, find someone who is. Another tip for starting the vetting process: Personal recommendations are always a safe bet—or you could check a site like realself.com (which is basically Yelp for cosmetic treatments).

One of the biggest surprises about Botox is that the effects are not immediate. In fact, it can take up to a month before you see full results so wait at least two weeks before you march back into the derm’s office for more. Once you’ve been treated, how long do results typically last? That depends, but it's usually between three to four months (and up to six months for more, shall we say, experienced folks). First-time users may see their results fade faster because it takes some time for your facial muscles to get conditioned to the Botox. The flip side is that over time, you’ll need fewer treatments because the muscles have been trained to relax for longer periods.

How much does Botox cost? Pricing is usually determined by the number of vials required for each area of your face and can run you anywhere between $500 to $2,000 a treatment. And while it’s always tempting to book a spa deal for a fraction of the cost, this is one instance where we’d err on the side of caution. Again, you want someone who is properly trained in administering Botox.

The one thing you should never do immediately after getting Botox? Exercise of any form in the first 24 hours following your appointment. Any motion that requires you to put your head below your heart (i.e., downward dog) can move the Botox from its intended area. Ditto for any cardio (which again, runs the risk of moving the injected proteins before they’ve had time to fully absorb).

And if you’re still not ready (or perhaps never will be) for Botox, there are many other options—from retinol to lasers—that can help. Or you know, just embrace the whole aging process. Do whatever makes you feel most empowered. We're just here to give you some guidance.