One research review showed that Botox is one of the most popular cosmetic procedures in the United States. Primarily used to treat signs of skin aging, like wrinkles and fine lines, professionally administered Botox has a reputation for being safe and effective.

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Until recently, the procedure was done mainly on older adults looking to ease skin wear and tear. According to the American Society of Plastic Surgeons, nowadays, more and more people in their 20s and 30s use Botox to keep their skin looking fresh and youthful by preventing some effects of aging altogether.

“When muscles don’t contract as much, it takes longer — if at all — for wrinkles to form,” explains Dr. Derek Steinbacher, a Yale Medicine plastic surgeon.

Static vs. dynamic wrinkles

Before you get the ‘tox, you might want to know the diff between these two wrinkle types:

Static wrinkles refer to lines and crinkles that form as a result of gravity and elasticity and are often considered permanent.

Dynamic wrinkles form as a result of repeated facial expressions. They are known to be temporary, coming and going.

Botox will help minimize the appearance of both, but if you like your expression lines, you should discuss this with your doctor/injector so that they know what you’re looking for and can adjust accordingly.

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But before you go scheduling your appointment, there’s a lot to know. Below, find details about the cost, how to set expectations, and safety risks to be aware of.

Squinting, frowning, smiling, scowling — our facial muscles are in motion 24/7. Over time, these repetitive contractions start to form wrinkles and fine lines on your skin.

Preventive Botox is believed to work against this natural process by blocking the nerve signals that tell your facial muscles to move. This effect lasts an average of 3 to 6 months, according to a research review.

“The leading theory is that keeping consistent with your treatments will keep expression lines from showing up later on,” says dermatologist Dr. Angelo Landriscina.

“This depends on your individual skin and the recommendation of your doctor,” says Landriscina. But the general recommendation is every 3 to 6 months.

He explains that people with shallower expression lines may see some benefit after the toxin wears off, and may choose to go less frequently. For example, Landriscina, who is 31, says he gets treatments every 6 months.

And as for the common myth that once you start getting Botox, you have to continue or your wrinkles will get worse? Totally untrue, according Dr. Kathleen Cook Suozzi, the director of aesthetic dermatology at Yale Medicine.

“I reassure patients that the notion that ‘once you start you cannot stop,’ or that ‘wrinkles will come back stronger with discontinued use,’ is a myth,” she says.

“It’s more important to consider the unique condition of your individual skin than to set an arbitrary age to start treatment,” says Landriscina.

“I base my recommendations on whether the patient is developing [expression] lines rather than basing it on their age. If you’re starting to develop expression lines at 20, you’re a good candidate. If you’re 50 and don’t have any expression lines, you probably don’t need it,” he says.

Also keep in mind, Botox is only FDA approved for people between the ages of 18 and 65.

In short, yes. Quite a bit. Landriscina says it can range anywhere from $150 to $1600 per session. Since Botox is for cosmetic purposes, it’s not covered by insurance. Meaning you have to pay out of pocket.

The cost can vary greatly between locations and brand. “Some providers charge by area treated while others charge a flat per-unit price,” says Landriscina. “Also, more experienced injectors may be more expensive.”

Remember, if you’re getting treatments every 3 to 6 months, the bill can really start to add up.

Botox is an FDA approved treatment and when administered by a qualified, skilled provider, it isn’t all that risky. But there’s a chance you’ll experience some side effects, such as:

  • double vision
  • fatigue
  • swelling
  • headache
  • nausea

Although unlikely, some people are allergic to the Botox chemical, which can lead to serious side effects, according to the FDA. If you experience difficulty breathing, swallowing, or talking, call 911 immediately.

To avoid side effects, always work with a licensed professional

When Botox is administered improperly, it can change the look of your face in ways you weren’t expecting. The first thing to know is this is rare (if you’re working with a pro). And secondly, it won’t last. “Since the action of botulinum toxins is temporary, any side effects you may encounter are also temporary,” says Landriscina.

One unlikely side effect is that Botox can reveal or create facial asymmetry, either through uneven injections, or by changing the way your muscles move. Similarly, too much Botox can lead to an unwanted skin appearance.

“Overtreatment can lead to a ‘frozen’ appearance which can actually make patients appear older,” Dr. Sara Perkins, a Yale Medicine dermatologist says.

“Both of these scenarios can be avoided with a good eye and proper technique. It’s for this reason that I always recommend having your cosmetic work done by a dermatologist or plastic surgeon,” says Landriscina.

Avoid Botox altogether if…

  • you’re pregnant or breastfeeding
  • you have a neuromuscular condition
  • you have a skin infection or another condition affecting the injection area
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Here are some quick facts Landriscina says to keep in mind if you’re booking your first appointment.

When you go in

  • The treatment takes 10 minutes at most.
  • It’s not very painful and you can request topical numbing cream to be applied before the procedure.
  • There might be tiny bruises from the injections, but nothing major.

After you go home

  • Lie flat on your back for a few hours after treatment to prevent migration.
  • Avoid exercise or alcohol for the rest of the day as these can increase your chances of bruising.
  • Your face could feel a bit weird, or full at first, and you might be more aware of the feeling of your facial expressions immediately after treatment.
  • You might notice a difference within a few days of treatment, but give it about 2 weeks to see the full effects. If you’re getting Botox for a big event, get it a full month beforehand for best results.
  • You can get back to your regular skin care routine immediately, though avoid skin care devices, especially vibrating ones, as they could cause the Botox to migrate.