What is BOTOX® Cosmetics?

BOTOX® is FDA approved and is a vacuum-dried purified botulinum toxin type A, which is produced from fermentation of Hall strain Clostridium botulinum type A. It is intended for intramuscular and intradermal use only. Botox is purified from the culture solution by dialysis and a series of acid precipitations to a complex consisting of the neurotoxin and several accessory proteins so that it is safe. It is administered via injection and often used for aesthetic purposes.

What is the difference between BOTOX® Cosmetic and Botox?

Both forms contain the same active ingredient in the same formulation, but they are labeled with different Indications and Usage. With that being said, it is important to note that adverse reactions observed with the use of BOTOX® Cosmetic also have the potential to be observed with the use of Botox.

Furthermore, BOTOX® Cosmetic and Botox are not interchangeable with other preparations of botulinum toxin products.

How does it work?

Botox is typically associated with anti-aging and wrinkles. It is actually a preventative measure against wrinkles and isn’t used to get rid of them. In reality, it “freezes” the muscles in your face so that more wrinkles aren’t created and current wrinkles aren’t deepened. Additionally, it can be used to treat chronic migraines, primary axillary hyperhidrosis (excessive underarm sweating).

How does it work?

Botox produces partial chemical denervation of the muscle, resulting in a reduction of muscle activity in the localized area that received the injection. This decreased muscle activity and contraction prevents your face from creating more wrinkles and deepening the ones you have. It is important to note that Botox is a preventative measure and will not “erase” wrinkles, but you should notice visible smoothing of the face, which in turn decreases the overall look of wrinkles, fine lines, and crows feet.

How long has this injection been around?

OnabotulinumtoxinA first received FDA approval for therapeutic use in 1989. It was then bought by Allergan and rebranded as Botox. Shortly after, clinical trials began to test how safe and effective it would be against moderate to severe wrinkles. In 2002, the FDA approved Botox for cosmetic use, making it the first treatment of its kind to gain approval for this purpose.

Who may benefit from this injection?

Botox is known for its aesthetic benefits such as preventing wrinkles, fine lines, crows feet, laugh lines, etc. In addition to its cosmetic benefits, it may also be used to treat chronic migraines (migraines that occur ≥15 days out of the month, lasting 4 hours a day or longer) and primary axillary hyperhidrosis that has not been resolved with other methods of treatment.

Do I have to be a certain age to get this injection? Is this injection only for older adults?

Botox isn’t dependent on age and there are many factors that may make a person a good candidate for this injection. Wrinkles and fine lines appear for a variety of reasons; age, environment, genetics, and so on. As a result, people may consider Botox earlier or later in their lives.

Is this considered surgery?

No, it’s an injection

Does this injection require any preparation?

Talk to your surgeon at Soma about any medications you are taking before receiving your Botox injection. No blood thinners beforehand as they may worsen bruising and bleeding. Aminoglycosides, Anticholinergics, Antibiotics , Muscle Relaxers, Other Botulinum Neurotoxin Products should not be taken before, during, or after the injection.

How long does the injection take?

The injection only takes about 10 minutes.

Will it hurt?

It is sometimes described as feeling like “a mosquito bite” or “a pinch,” but everyone’s pain threshold is different. A provider may provide you with an ice pack or topical anesthetic to numb the area and ease discomfort.

How will I feel after the injection?

Patients may notice a bit of discomfort following the injection, but it should resolve by the next day. There is minimal recovery, so a patient may return to their usual daily routine once they leave the provider’s office.


  • Keep your head level and don’t bend your head forward for two hours. You may resume exercise the next day.


  • Providers will not typically prescribe a medication for this injection
  • No blood thinners
  • No aminoglycosides
  • Speak with your doctor about continuing your medications

How long will the results of the injection last?

It ranges with each individual, but it could last up to four months. Factors affecting how long it lasts include a person’s activities, sun exposure, excessive exercise and increased metabolism

How long after my first injection do I have to wait until I get more Botox injections?

It varies, but you should allow at least 3 months between injections, some may even go longer. Consult your provider before scheduling your next round of BOTOX® Cosmetic.

What are the complications?

Complications may vary depending on the site of the injection. Complications include but are not limited to:

  • eyelid swelling
  • brow drooping in the forehead
  • dry mouth
  • discomfort or pain at the injection site
  • neck pain;
  • eye problems: double vision, blurred vision, decreased eyesight and dry eyes
  • tiredness; headache
  • allergic reactions
  • Problems swallowing, speaking, or breathing, due to weakening of associated muscle (this is serious and may be life threatening, contact your provider or doctor if you notice any of these symptoms)
  • Spread of toxin effects to areas away from the injection site

What are the complications?

Everyone heals differently and has unique requirements to aid them in their recovery. You can return to your normal daily routine as soon as you leave the providers office.

Listen to Your Provider
Follow your provider’s instructions, they will give you written instructions to refer to should you have questions, but if anything is alarming you, do not hesitate to contact your provider.

Listen to Your Body
Listen to your body – if something doesn’t feel right after the injection, discuss it with your provider right away.

Use Cold Compresses
You may experience a bit of discomfort after the injection, so an ice pack or cold compress can be used to help ease the discomfort and pain.

Get Plenty of Rest
This injection will not require you to take off from work, but rest is always a vital part of the recovery process.

Avoid Vigorous Exercise
Wait until the following day, a full 24 hours before resuming your normal exercise activities.

Avoid Aspirin & Blood thinners
Don’t be tempted to use aspirin as a painkiller. It thins the blood, and this can make bleeding and bruising more likely. For this reason, aspirin should be avoided for three days before and after the injection. Vitamin E supplements and Ibuprofen and Motrin should also be avoided for the same reason.

Other Medications to Avoid before and after the injection

  • Aminoglycosides
  • Anticholinergics
  • Antibiotics
  • Muscle Relaxers
  • Other Botulinum Neurotoxin Products

Be sure to let your provider know exactly what medications you are taking before receiving BOTOX® Cosmetic injections.

When will I see results? How long will they last?

You may notice visible results between 24 and 48 hours, with results lasting up to 4 months, although it varies on the individual.