Botox has been blowing up in popularity over the last few years especially in younger aged people. We are seeing tons of patients in their twenties and thirties, different from the typical demographic of older than 40 which we used to see. This is because botox is actually a great preventative treatment for wrinkles!

I know I’ve said it before, but I’ll say it again, the younger you start Botox the better!! Because it is most successful as a preventative treatment. What age exactly?! Well, it’s different for everyone. When you start to see those faint lines and wrinkles when your brows, forehead, around the eyes etc. are not expressing, ie. “at rest” – its TIME!  If you start when you first notice those little lines we can stop those little wrinkles from ever forming!

In this blog I’m covering what Botox actually does and what to expect during and after your treatment!

What is Botox/Dysport?

Botox & Dysport are actually names for the brand of product. The medicinal ingredient is called botulinum toxin which is found in both Botox and Dysport. These are just the two brands that people are most familiar with. Botulinum Toxin is used to prevent and treat fine lines and wrinkles on the face. It does this by semi-permanently relaxing the muscles.

For example when you frown your eyebrows pull together causing a crease of skin. When you raise your eyebrows you might notice wrinkles appearing across your forehead. Botox relaxes these muscles. When the muscles are relaxed the lines can’t form and subsequently wrinkles cannot form.

We most commonly use these products on the forehead and around the eyes, however there are other areas where it is effective such as the upper lip lines, the masseter/jaw muscle, the platysmal bands of the neck, and the underarms and palms for sweating (hyperhidrosis); to name a few.

What is the difference between Botox and Dysport?

I use both Botox and Dysport in my practice, they are made of the same main ingredients just made by different manufacturers. You can switch back and forth between the two products. The number of units is 2.5:1 for Dysport vs. Botox (meaning 50 units of dysport = 20 units of botox), but don’t let that confuse you because the actual volume being used is exactly the same. The price also comes out to be the same. They are just reconstituted differently because they are made by different companies. There is another neuromodulator out there, Xeomin, which is also good and very similar to Botox. I do use this from time to time but it is not as popular in my practice.

What to Expect During Your Appointment

A Botox appointment normally takes no longer than 30 minutes with the total injection time being less than five minutes. Your practitioner with ask you what you are interested in targeting and discuss with you the best option. He/She will ask you to move your face into different expressions so that they can watch your muscles move and determine which injection sites are best. They may also have you take a before photo!

Once you’ve decided on the appropriate amount of treatment the practitioner will have to remove any makeup over the injections sites with a sterilizing wipe or cloth. They will then pinch small area of your skin to raise it up and make a quick injection. Each injection takes only 1-3 seconds and most patients feel little to no pain.

The amount of injections you will receive depends on what area of your body you are targeting. Forehead/eye treatments can range between 10-20 units of Botox but don’t confuse that with the number of injections. For example, regardless of the number of units to be used each area typically requires around 4-5 needle pokes.

Immediately after your injections there may be small raised bumps at the injection sites.  I call them little “bug bites.” These bumps are just the product waiting to be absorbed and they will go away within less than 10 minutes.  I tell my patients they will look like nothing happened by the time they make it back to their car. Almost all clients continue on with their day as normal. You can re-apply your makeup but be careful not to rub the area too hard.

What To Expect After Your Botox Appointment?

As I mentioned immediately after the appointment there will be no pain, you can go back to work, re-apply your make-up and even work out. You won’t notice any immediate changes with Botox or Dysport because these products have a slow, gradual onset and take up to two full weeks to take full effect, but you can definitely start to see improvement after just a couple of days. If you still have unwanted movement after two weeks, then it is appropriate to tweak the botox at your follow up appointment. I will not retreat any Botox within that first 2 weeks because we run the risk of dropping the brow and making your eyes heavy if we add more before the first round is fully kicked in.

On average, the treatments last about 3-4 months. For your very first treatment I always say you will probably need to re-treat within 3 months because your muscles are still very strong. Once you get in the routine of treating regularly, you will most likely be able to use less units and go longer in between treatments. By keeping up with regular treatment intervals Botox will become more cost effective over the long haul!

By the 3-4 month make you will start to notice that some movement is coming back. The treatment doesn’t just stop working all at once, the movement will slowly return in different areas. Most people notice that when the glabella (area between the eyebrows) starts to move again, their brows are no longer as lifted as when it was relaxed. I encourage all of my patients to wait at least 3 months before coming in for their next treatment. If you treat too often you are training your muscles to need botox more often and you can also build up resistance to the product! And that’s like your worst nightmare, right!?

Will these deep creases between my brows or on my forehead be completely gone?

Eventually, YES! If you look in the mirror and you see wrinkles when your face is rested, those are called “static” lines. Those lines are created by dynamic muscle movements or expressions over a long period of time. They took a long time to get there so you cannot expect them to be completely erased with just one treatment. With that being said, I generally see up to 80% improvement with just the very first treatment alone. After a few treatments back to back those lines will eventually fade all the way away. I love when I see a patient after a year of regular treatment who started out with super deep wrinkles and they tell me, “You were right! I can’t believe it… I never thought it was possible to get rid of these wrinkles and they are completely gone!”

It is a work in progress, and with Botox wrinkles do get better over time.  Stick with the plan!

Finding an Injector

Do your research, find an experienced and qualified injector that you like, and stick with them!  Finding “your” injector is just like finding the perfect hair stylist, therapist, or personal trainer. Set up a consult with them and go over a treatment plan. You can most likely get treated the day of your consultation if you feel confident! If after the first appointment everything isn’t perfect I would not recommend switching. It can take a little trial and error for you injector to learn your musculature and the way you respond to certain products. With a little fine tuning and tweaking he or she will be able to come up with the perfect recipe for you! If you hop around from place to place it makes it difficult for the next provider to understand what has been done and how it has worked, etc. Your best bet is to stick with one provider. Be patient, and when you find that person who “gets” you and your needs – hold on to them tight!  

How much does it cost?

On average most treatments requires 10-20 units, so around $250 per area. The exception would be the treatments for excessive sweating aka hyperhidrosis which require up to 100 units. Most clinics have a flat rate for these treatments to help lower the price!

Just because your best friend got 20 units, it does not mean you need 20 units! Listen to your injector. They will assess your face and come up with a plan that is most appropriate for you. They will determine what you need based on your skin, your unique musculature and the goal of the treatment.

Rewards Programs

These programs are offered by the manufacturers of Botox and Dysport. I recommend that all of my patients sign up for these reward programs. In a nutshell, it is like frequent flyer miles for your injections. Each time you get a treatment you will receive reward points which turn into coupons. For example, each treatment typically results in a $20 reward for the next treatment in 3-4 months. It is a great way to save money over time. The companies do not give out your information or harass you. Aspire gives you $20 for signing up, and both programs have special promotions throughout the year where they will give you even better incentives. Be sure to remember the email and password you sign up with because that it how you will access your coupons in the future.




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Racquel Frisella

Board Certified Nurse Practitioner & Aesthetic Specialist based in Saint Louis, Missouri

I work as a cosmetic injector and skincare specialist with 12 years of experience in the Aesthetic Industry. I see patients both in-office at Racquel Aesthetics for treatments as well as online for customized, complimentary skincare plans. I focus heavily on preventative and corrective injections, treatments, and skincare.  My career is my passion and I love to help people feel like the very best version of themselves. I am a wife and a mother of 3 beautiful children under the age of 3. I love all things beauty, fashion, and fitness. I am creating this site as a place to share my expertise on beauty, anti-aging, and skin while also giving a glimpse into my lifestyle as a mom, wife and lover of fitness!  


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