BOTOX Cosmetic is one of the most popular aesthetic treatments performed worldwide because it’s a quick, simple way to maintain a refreshed, younger-looking appearance. Women and men choose BOTOX to smooth out wrinkles and relax lines that have become etched into their skin over time. Essential Dermatology’s board-certified dermatologist Dr. Michael Krathen performs BOTOX injections at his medical spa in Natick, serving Wellesley, Framingham, Wayland, and Weston, MA, and other surrounding cities.

How Does BOTOX Work?

BOTOX is an FDA-approved neuromodulator made from botulinum toxin-A. It temporarily suspends the muscle contractions that form lines and wrinkles made by facial expressions, called “dynamic wrinkles.” The results are smoother skin and a more youthful, refreshed appearance.

BOTOX Treatment Areas 

BOTOX treats many different signs of aging in the face and neck, such as:

  • Vertical frown lines between the eyebrows (glabellar lines)
  • Crow’s feet at the corners of the eyes
  • Horizontal forehead furrows
  • Lines around the lips (perioral lines)
  • Platysmal bands on the neck

BOTOX Lip Flip

We can use BOTOX to make the upper lip look fuller without adding volume. This treatment is called a “lip flip” because it relaxes the muscles of the upper lip, allowing it to relax and turn (flip) upward slightly, exposing more of the red vermillion. It can be a good option on its own for people who want a subtle enhancement. We can combine the lip flip with lip filler injections to add volume to the lips and define their borders.

What Is Preventative BOTOX?

BOTOX can also be used proactively in younger patients to prevent dynamic wrinkles from forming in the first place. This treatment, often called “baby BOTOX,” uses smaller doses than for existing wrinkles.

Your BOTOX Cosmetic Treatment Plan

BOTOX results last a few months, so your treatment plan will likely include regular maintenance injections to keep your look fresh. Many people find that they can space their maintenance treatments out longer once they’ve consistently used BOTOX over time.

What Is a Liquid Facelift?

A liquid facelift combines BOTOX and dermal fillers to address multiple signs of facial aging. It can be an excellent option for those who are starting to see early signs of aging or those who want to improve the appearance of fine lines, wrinkles, and volume loss in the face. Although the results aren’t as dramatic as a surgical facelift, it’s a great alternative if you aren’t ready or willing to undergo surgery.

The results of a liquid facelift typically last between 6 months to 2 years. Touch-up treatments can help maintain your results.

Combining Treatments

Other nonsurgical treatments may also be part of your treatment plan to address skin issues that typically accompany the appearance of expression lines. For concerns such as rough skin texture, sun damage, brown spots, and redness, BOTOX works exceptionally well when combined with other treatments such as:

BOTOX Compared to Other Neuromodulator Injections

BOTOX and similar neuromodulators such as XEOMIN®, Dysport®, and Jeuveau® effectively reduce the appearance of expression lines and wrinkles. Each lasts about 3 to 4 months. Because their formulas differ, however, they vary how quickly they produce results and best uses. For example, Dysport diffuses more easily than BOTOX, so it’s not a great choice for small, precise treatment areas.

BOTOX was the first neuromodulator to be approved by the FDA for cosmetic use and has the longest track record. For many, it is still the gold standard for wrinkle-smoothing neuromodulators.

Are Dermal Fillers Better Than BOTOX?

BOTOX and dermal fillers are injectable treatments that have different benefits and work in different ways; neither is better than the other. Concerns caused by volume loss, such as smile lines (nasolabial folds) and hollows around the eyes, are often better treated with injectable dermal fillers that restore lost fullness to the face. Dr. Krathen often combines BOTOX and filler treatments for a more noticeable rejuvenation. You can see a comparison of the type of wrinkles each product treats in the table below:

BOTOX CosmeticDermal Fillers
Type of WrinklesDynamicStatic
EffectsSmooths fine lines & wrinkles; Relaxes facial musclesFills creases & folds; Adds volume
Results Appear7 to 10 daysImmediate
Results Last3 to 4 months6 to 12 months for most fillers

What To Expect at Your BOTOX Appointment

It typically takes only about 15 minutes to receive a BOTOX treatment in our office. The treatment consists of a few quick injections using a tiny needle. Most people do not find these painful, describing merely a brief, pinching sensation. Dr. Krathen will ask you to form different facial expressions to determine precisely which muscles to inject. That way, you’ll enjoy attractive results while maintaining plenty of natural, expressive movement in your face.

What Is BOTOX Recovery Like?

Directly following your BOTOX treatment, you should avoid touching or massaging the area. To minimize bruising and prevent BOTOX from migrating away from the treatment area, you should not lie down for at least 4 hours after your treatment.

Other than that, you are free to return to work and other daily activities right away. You may notice some slight swelling or bruising around your injection sites, but this typically fades quickly. Avoiding alcohol and blood-thinning supplements before your appointment will help keep this to a minimum.

What To Avoid After Your BOTOX Appointment

After getting BOTOX injections, you should refrain from certain activities to ensure the best results and prevent complications. Here are some things to keep in mind:

  • Don’t touch or rub the treated area for at least 4 hours after the injections.
  • Do not lie down or bend over for the first few hours after the treatment.
  • Postpone vigorous exercise for at least 24 hours.
  • Don’t drink alcohol for at least 24 hours.
  • Avoid taking blood-thinning medications, such as aspirin, ibuprofen, or naproxen, for at least 24 hours before and after the treatment.
  • Avoid heat exposure, such as saunas, hot tubs, or sunbathing, for at least 24 hours after the treatment.
  • Postpone facials or other facial treatments for at least 24 hours after the injections.

When Will I See My BOTOX Results?

BOTOX results are not immediate but emerge gradually over the course of about 7 to 10 days. Once treated facial muscles stop functioning, the overlying skin smooths out and wrinkles fade. It may take up to 2 weeks for the BOTOX to take full effect and produce the best results.

How Long Does BOTOX Last the First Time?

The results from BOTOX injections last about 3 to 4 months depending on the area treated. Repeat treatments at Essential Dermatology will maintain your look for as long as you’d like. Dr. Krathen will recommend a treatment schedule that works best for you and your unique cosmetic goals.


BOTOX has a long track record for safety when administered by a skilled, knowledgeable injector.

Many men and women begin BOTOX when they start to see expression lines form. For some, this can be when they’re in their 30s, while others begin BOTOX in their 40s or 50s. Some younger people also use the neuromodulator in smaller doses to delay the formation of dynamic wrinkles.

BOTOX is generally considered safe, but you may experience some discomfort, bruising, or swelling at the injection site after your treatment. Those are normal side effects that will resolve on their own. Some people who have used BOTOX for a prolonged period of time might experience muscle atrophy, so it’s important to use a board-certified dermatologist, plastic surgeon, or highly qualified injector who can monitor your BOTOX use.

You may notice expression lines beginning to form again as your BOTOX wears off, but they won’t be worse than when you began BOTOX injections.

Many people find that BOTOX is an excellent, cost-effective option for smoothing wrinkles, with more than 4 million BOTOX injections performed each year in the U.S. Those who have had BOTOX give it a 96% “worth it” rating on

The quality of your results is directly affected by the skill of your injector. Choosing an experienced, knowledgeable injector who knows the right dosage for you and can precisely target the injection location helps ensure you enjoy natural-looking results.

The number of units needed varies by patient, depending on your facial muscles, the severity of your wrinkles, and your desired results. Your injector can help you determine the number of units you’ll need to achieve your desired outcome.

While the amount of toxin used in cosmetic treatments is considered safe for most healthy adults, it is not known whether it can cross the placenta or be excreted in breast milk, potentially affecting the development of a fetus or nursing infant. If you are pregnant or breastfeeding, it is best to wait to have a BOTOX treatment.

Schedule a Consultation 

Dr. Krathen will work personally with you to find the best skin treatments that provide you with youthful, glowing skin. To get started, call our office at (508) 545-9713 or request a consultation by filling out our online form. To book an appointment, schedule your visit as a new patient using our online scheduler or as an existing patient using the Mass General Brigham Patient Gateway.

Meet Dr. Michael Krathen

Dr. Michael Krathen is a board-certified dermatologist with more than a decade of medical training and experience. A specialist in both medical and cosmetic dermatology, he uses expertise, collaboration, and compassion to help people of all ages discover their healthiest and most radiant skin.

Credentials You Can Trust

American Academy of Dermatology
American Society for Dermatologic Surgery
New England Dermatological Society
Alpha Omega Alpha
Massachusetts Academy of Dermatology
Dr. Michael Krathen