Botox 101: Everything you wanted to know about Botox, right from a top plastic surgeon

Administered by the right provider, Botox can be a very beneficial tool to help with issues beyond aging.

In this article, I’m going to talk to Dr. Fred Aguilar, a board-certified Aesthetic Plastic Surgeon with over 40 years of experience in his field who received a lot of accolades over the years for his fantastic work.

We’ll try to cover the different face and body areas that can receive Botox treatments, many of which are often times very surprising to women. Most people think Botox is strictly for the forehead and the eyes, but we have discovered other uses for it which you will love finding out about!

botox guide - what it is and how it works

What is Botox, and how does it work?

First of all, let’s talk about what Botox is and what it isn’t.

Botox is a paralyzing agent, so it works to stop the movement of the muscles. The muscles that we’re paralyzing are the muscles that are responsible for causing the wrinkling. So, paralyzing those muscles means we no longer have wrinkling occurring, which is why it’s essential to start rather earlier than later.

Botox vs. fillers

Botox is not a filler. There’s sometimes the misconception that Botox fills wrinkles, but that’s not what it does.

“A lot of people come in, and they really need filler versus Botox. Or they’re confused about the fact that Botox is not a filler. It only paralyzes muscle. So frequently, we have patients that need Botox coupled with a filler to help eradicate the lines that have already been etched due to the extreme movement that they’ve had over the years.” Dr. Fred Aguilar explained.

Where are the most common areas to put Botox?

Botox smooths the forehead and the frown lines (or the so called 11s)

Botox use works great for forehead and glabella wrinkles, which is the frown lines or the number 11s that everybody talks about. It is a big, important area. And many women get those frown lines, those 11s, develop early on, especially if they’re a genetic trait that runs in the family.

botox for frown lines

They look frustrated all the time, even when they’re really not, and so, for many, the purpose of Botox was to eliminate that frustrated look and also to prevent the Shar-Pei thing from setting in the forehead. It’s a look of frustration, and sometimes people look angrier because of them, even when they’re not angry.

Smoothing that area out gives it a more youthful look and also eliminates the sensation that you’re worried or upset.

Also, if a shot is added right in the area where the nose meets the forehead, it stops that little bit of pulling downward that occurs in that area, the so-called lower part of the 11s.

botox for glabellar 11 lines

Botox can lift the eyebrows, fix brow asymmetries & help hooded eyes

One of the most significant issues with Botox is placement. What scares women away is that trademark Botox look of really raised, surprise eyebrows, and not every Botox job will turn out that way. It has to do with the placement of botulism toxin.

“One of the things that we have to help some women remember is that just because an eyebrow elevates doesn’t mean that that’s a more youthful look. In fact, I like a more horizontal eyebrow because it’s a more youthful eyebrow. If you look at an 18-year-old young lady, those eyebrows are pretty horizontal. And it’s a really great look, and also much more youthful. It’s the older women who’ve had overarching eyebrows that give away their age. And so, if we can get an eyebrow to look more horizontal, in reality, that’s a better look.“ Dr. Fred Aguilar explained.

botox for eyebrow lift and hooded eyes

To achieve that, the Botox is injected in an area that allows defining the arch of that eyebrow. So, suppose one wants to drop a specific area of their eyebrows. In that case, they need a little bit of Botox right there, but definitely not as much as in the center area because while we want the center area to be very still, we want the side to rise just a little bit and still have some movement.

The goal here is to get a good balance between keeping the eyebrow horizontal but still showing some movement – and that’s important for all women. You don’t want to be frozen, and you don’t want to look perpetually surprised.

Another benefit of the brow lift is that some women with hooded eyes will see a more uplifted rested, relaxed look. in their eyes, helping them with the hooded part of their eyes.

If you want more tips on how to deal with hooded eyes, check out our guide on makeup tips for downturned eyes.

Botox works well in the under eye area and prevents crow’s feet (smile lines)

Botox also works wonders around your eyes and it’s used to stop crow’s feet from developing.

It’s just going to be injected right where the crow’s feet tend to happen when you smile. So what that does is that when you do a big smile, it freezes the muscle and prevents that kind of squinty wrinkling that takes place on the outside, giving a subtle lift for the cheeks.

botox for crows feet and smile lines

Botox can help correct the neck’s drooping (acts on the platysma muscle)

The neck is one less known area where Botox treatments can be particularly useful, because as we age we start to develop a dropping of the muscles in the middle of the neck. By putting Botox in two or three little spots just around the neck curvature, it flattens those muscles and makes those hanging edges disappear, giving us a more youthful neck.

Especially if we’re in a good shape and we don’t have a lot of neck fat, as we start to age, we’ll start seeing the neckbands protrude more and more, especially when we turn to the side, giving us that “chicken neck” look which nobody likes. In fact, they’re just the edges of the platysma muscle and this is where a little Botox can work so well, by freezing it and effectively correcting the drooping and hanging effect. As with everything we recommended in this article, the most efficient way to use Botox is preventatively, so it’s best not to wait until the neck “hangs”, and to try to help that area out before it’s already affected by wrinkles.

botox for neck

If you worry about the neck might sounding like too much of an unusual are, or even unsafe, Dr. Fred Aguilar explains that if the Botox injections are done correctly, which means just superficially into the edge, there are absolutely no risks or side effects. However, if someone sticks a needle into a deeper part of the neck, there’s a real risk to paralyze a nerve. That’s why it’s critical to only go to someone that knows what they’re doing, and that’s usually a board-certified plastic surgeon, facial plastic surgeon, or dermatologist.

Botox treatments are by no definition new, risky, or experimental. They have actually been around for a long time, and they have a long history of medical usage that goes back to 1950 when Botox was used for people with uncontrollable eye blinking. And, over time, it proved to be a fantastic medicine that is now used in obstetrics, urology, or laryngology.

Botox treatments don’t take care of the sternocleidomastoid muscles, which is the very broad neck muscle on the edge of the base of our necks that creates a hollow in the neck. But, while some of us may see this as a deficiency, many others see it as something awesome and very esthetic – so it’s pretty much just a matter of perspective.

Botox for the jaw area (maseteers) and the jowls

The masseter is the muscle responsible for the way that we chew foods and the force that we apply. It is a fairly big muscle, so if it overgrows it can easily give a more square jaw in the back that is slightly bulging out as opposed to being nicely flared and smaller.

On top of that, because our forehead is a certain width when we smile and we have a strong masseter, it can make our lower jaw wider than the width of our forehead, even if we’re lean and we don’t have fat cheeks. Not to mention the jaw muscle soreness that many people experience in the morning.

botox for jowls and masseter

And herein lies another potential treatment for Botox. 

By injecting your masseter muscle in two or three places, we allow that muscle to be more relaxed, and hopefully, it will also help not grind your teeth at night. 

“Also, sometimes there are people who have a lot of wrinkles on their chin, and we can actually do a few drops of Botox in there to flatten the muscle and get the chin to look smoother.” Dr. Fred Aguilar explained.

So, as you’ve seen, Botox has multiple uses we tried to show you – it an also be used for a gummy smile, for eye bags, in the lip area, and even for excessive sweating or headaches. Prioritize what you’re trying to treat or keep in its current shape – you don’t have to do all the areas we went through, but know about the possibilities.

How much does Botox cost and how many units should you use?

Many people inquire about the cost. Dr. Fred Aguilar charges $10 per unit, and on average, 40-50 units are used depending on the area.

“I get a lot of patients that say ‘I want the Botox full strength’ and I think they’re confused because the Botox comes in a vial that’s totally empty of any fluid. So each doctor can decide how much they’re going to dilute that Botox. Some doctors dilute the solution less, making it more potent and allowing them to use fewer injections, while some places like spas or other places may dilute their Botox more, so they have to use more injections.” Dr. Fred Aguilar explained.

The more potent the mixture, the less the number of injections one needs. So, at the end of the day, what matters is the total number of Botox units you’re getting, not the number of shots, and that’s what you should consider when comparing prices and whatnot.

Does getting injected hurt?

Never done a Botox shot and still scared?

Botox injections won’t really hurt more than an ant or a bee sting, but they’re not completely painless. The doctor usually applies pressure after each shot so that there is no bleeding, and that also helps keeping any sting at bay. The testament to this is the fact that most people that get Botox actually go back to work right after the shots (as long as their work doesn’t include heavy lifting, exercising or lying on their back).

There’s no need for numbing cream. You can even apply a bag of frozen peas or ice packs if you’re really sensitive once you get home.

“We have a few patients that like to have the ice pack put on. We have maybe a handful that likes to come in 30 minutes and apply numbing medicine. But 80% of the people come in with no anesthesia and no ice, and they do just great. ” Dr. Fred Aguilar explains.

It’s no harder than a bikini wax. You just go in and bite the bullet.

Hopefully, if there’s going to be any bruise, it’s going to be a pinpoint slight bruise right where the needle went in, but it shouldn’t be terrible. Most of the times it’s easily covered with concealer. We invite you to check out a curated list with the best concealers for mature skin.

How long does it take for the Botox to take effect? 

Botox treatments are definitely not instantaneous.

It can work almost overnight for some people, but for most people, between 5 to 10 days is the full time that it takes for the Botox to kick in fully.

That’s why it’s recommended to wait about a week or two before coming back to your doctor and start correcting the things that didn’t work out perfectly from the first time, which might mean extra units in some areas.

The benefits of using Botox preventively

The earlier you use Botox, the better. 

One of the great benefits of starting Botox preventatively, before wrinkles have been etched into the skin, is that you can get an ideal response, meaning that when the Botox kicks in, the skin will look smooth and wrinkle-free. 

“Unfortunately, we get people in here who have already had the wrinkles embedded or etched into their skin. So the Botox will stop the movement, but it won’t make those wrinkles disappear – it will keep it from getting deeper, but if you want it to disappear, that’s when you have to move on to a filler.”

With anything that you do, as you’ve learned, the key is to research, ask a lot of questions, and also find a capable medical provider. 

If you want to watch the whole interview with Dr. Fred Aguilar, check out these two videos below.

Be bold and be blessed!

Coming soon, tune in for best anti aging products and our under eye filler 101 guide!