Yeah, there are some really obvious downsides to getting Botox. You could end up seeming permanently surprised—or like you're auditioning for a new season of Real Housewives. (Sorry, not sorry.)
Still, Botox is not going away any time soon. “Its popularity has steadily increased since it was first approved by the FDA,” says Sejal Shah, M.D., founder of SmarterSkin Dermatology.
And honestly, sometimes it winds up looking ah-freakin-mazing. So, you've got to admit, it's kind of tempting.
That being said, there are a few things you should know before going under the needle, whether you're in your twenties, thirties, or forties.
What is Botox?
Botox is an FDA-approved drug that can be used to treat a wide variety of cosmetic issues, including fine lines and wrinkles and excessive sweating.
But how does it do that, exactly? “Neurotoxins such as Botox, Dysport, and Xeomin work by blocking the signal between nerves and muscles so the muscles treated do not contract, causing wrinkles to soften and relax,” says Shah. Basically, Botox temporarily paralyzes a group of muscles underneath the skin.
The average cost of a Botox treatment is $550, according to RealSelf.com—although that amount can vary depending on where you live.
Does Botox hurt?
Since it’s an injectable treatment, you may feel a little pinch as the needle is inserted into the skin. Topical numbing cream or ice can be used before the injection to reduce any discomfort. “The injections themselves aren't painful for most people, but some are more sensitive to them than others,” Shah says.
Results themselves appear a few days after the procedure, and last for around three to four months, according to RealSelf.com.
What are Botox side effects?
“The most common myth I hear is that Botox completely freezes you,” Shah says. (That scene with Tim Allen in Christmas With The Kranks comes to mind…)
But Shah says that side effect is just a myth, especially when you’re going with a good dermatologist who has done this sort of procedure before. “Botox treatments can be completely tailored and there is a range of results, from just reducing the muscle movement to completely stopping it,” she says.
In most cases, Shah says there can be some swelling, redness, or bruising after treatment. “The redness and swelling typically resolve in one to two days,” she says. But bruising can take longer—up to two weeks to go away.
Other possible side effects of Botox include dry mouth, neck pain, headaches, and eye problems like blurred or double vision, according to the drug manufacturer’s website.
There is also some risk that the paralysis could spread, leading to problems swallowing, breathing, or speaking. You should seek medical help ASAP if you’re experiencing these rare, more dangerous side effects.
Who makes a good Botox candidate?
“Botox is a completely cosmetic procedure, so if and when someone ‘needs’ it is a purely personal decision,” Shah says. “Some people are not bothered by developing fine lines and wrinkles. For those who are, I generally advise starting treatments just when they start to see the lines develop, or when the wrinkles linger even after the movement has stopped.”
Preventative Botox has been getting lots of buzz. “It can potentially have a preventive effect on dynamic wrinkles, which are caused by underlying muscle movement,” Shah explains. “That being said, muscle movement is only one factor that contributes to the development of wrinkles, so Botox may not be completely preventive.” (Some other wrinkle causes: sun exposure, smoking, and diet.)
If you want to tackle fine lines or wrinkles on the forehead, between the brows and around the eyes, Botox can be a good option, but the best way to determine if it's right for you is to have a consultation with a board-certified dermatologist.
What you should know about getting Botox in your 20s
“Most people in their twenties decide to try Botox simply because they want to enhance their appearance, such as relaxing the muscles in their forehead, or because they want to keep their skin looking fresh and young,” Shah says. “Starting earlier is better than later because as the lines get more and more embedded into the skin, Botox is not as effective in eliminating the lines.”
However, if you’re in your twenties and aren’t seeing those lines (lucky you!), Shah says you can hold off—since the benefits of “preventive” Botox aren’t quite proven.
What you should know about getting Botox in your 30s
“I see a lot of patients who come in from sun damage, or who have creases in their foreheads, more lines around the sides of their mouths, crow's feet, and wrinkles on the side of their nose,” Shah says. “At this age, a dermatologist can inject Botox in the right places to help train a person’s face to no longer fall into that habit, which can help decrease the odds that they’ll develop permanent wrinkles in those spots later on.”
How often you need touch-ups really depends on where you are getting the Botox, but typically every three to four months is a good range at this age.
What you should know about getting Botox in your 40s
“Many of my patients come in because they have waited until they see considerable lines and wrinkles, or just want to look more awake,” Shah says. “At this age, many people are more concerned about their crow's feet and upper eyelids, which start to droop.”
Shah says that it’s harder to treat wrinkles with just Botox as they get more and more ingrained into the face. “Some people may need just a few injections, but some may require more treatments, such as laser treatments or a series of smaller procedures, which are going to cost more. Whereas if they came in five years earlier, I may have just been able to use Botox to get the same effect,” she says.
Celia Shatzman (she/her) is a Brooklyn-based writer and editor who has penned stories on topics ranging from beauty to fashion, travel, celebrities, health, entertainment, finance and more. A graduate of the Medill School of Journalism at Northwestern University, she is a beauty and style contributor at Forbes and her work has appeared in New York, Cosmopolitan, WWD, ELLE, Conde Nast Traveler, Afar, Travel + Leisure, Women’s Health, Marie Claire, Byrdie, Refinery29 and NYLON, among others.
