Botulinum Toxin Injection (Botox)

What's Involved

Botox: Before

Injections of Botox, a purified product of the bacterium that causes botulism, was one of the single most popular cosmetic procedures in the United States in 2004, when doctors performed more than 2.8 million Botox injections. Unlike injectable fillers, which add volume to plump up wrinkles, Botox is injected into a muscle, blocking nerve signals that make the muscle contract. This weakens or paralyzes the muscle, causing the wrinkle to smooth out or disappear. The most popular sites for Botox injections are the forehead, frown lines, crow's feet, and vertical neck bands. Incidentally, Botox is only FDA approved for frown lines; other uses are considered "off label."

Botox: After

Pain Level/Recovery Time: The injections take only a few minutes and you can return to your regular routine right away. The effects may become apparent immediately, or they may take three to four days. Complete results typically are evident in a week. However, wrinkles may return within 120 days. Most patients return for repeat treatments every four to six months to maintain the effects. In addition, Botox may carry some side effects. These include bruising, redness, headache, flulike symptoms, drooping eyelids, and nausea.

Cost

$387 (national average for surgeon's fees).** Average surgeon's fee for Botox may vary by region:

For New England (CT, ME, MA, NH, RI, VT) and Middle Atlantic (NJ, NY, PA): $425 For East North Central (IL, IN, MI, OH, WI) and West North Central (IA, KS, MN, MO, NE, ND, SD): $356 For South Atlantic (DE, DC, FL, GA, MD, NC, SC, VA, WV): $368 For East South Central (AL, KY, MS, TN) and West South Central: (AR, LA, OK, TX): $372 For Mountain (AZ, CO, ID, MT, NV, NM, UT, WY) and Pacific (AK, CA, HI, OR, WA): $410

** Note: These averages for surgeon's fees are provided by the American Association for Aesthetic Plastic Surgery, Inc. These figures do not include fees for the facility or other miscellaneous costs related to the procedure. In addition, insurance companies do not cover the cost of Botox injections.

Is It Right for You?

While it is considered a nonsurgical procedure, Botox injections should be done by a qualified physician in an appropriate facility. They are a more convenient, less painful procedure than many other wrinkle-removing techniques, such as chemical peels, dermabrasion, laser resurfacing, and facelift. But, while the cost of Botox may seem relatively low by comparison, the cost of repeat treatments quickly adds up.

What Real Women Say

Karen, 43, Miami, Florida

Seven years ago, Karen started going for Botox injections -- long before they were all the rage. She had seen an ad in an alternative newspaper for a "new" wrinkle-removing technique and thought she'd give it a try. The 43-year-old mother of three doesn't have wrinkles. "Botox is more of a preventative," Karen says. She gets injections in the crow's feet around her eyes, in the line between her eyes, and in her forehead. First, the doctor applies some numbing cream on Karen's face for 20 minutes, followed by alcohol. Injections take about five minutes. Only once, she felt stiffness afterward. "You have a lot of puncture wounds," she says.

But Karen loves the results. "The eyebrows come up. It lifts your whole face up a bit," she says. After about three months, however, the effects wear off. "By four months, I'm climbing the walls," Karen says. "When I make certain expressions, my eyes crinkle up and my eyelids start drooping a bit." Time for more Botox. Karen pays $450 for each visit. "In Miami, that's really cheap," she adds, quoting $1,200 to $1,500 for other doctors. Would she recommend Botox? "Sure," she says. "I want my husband to do it."

To Learn More: Visit the Public Site section of the American Society for Aesthetic Plastic Surgery's Web site. Or call their toll-free referral line at 1-888-ASAPS-11.

Check out the Learn section of BeautySurg.com, the "cosmetic surgery supersite."

For physician referrals, call the American Society of Plastic Surgeons referral service at 1-888-4PLASTIC or visit them online. Click on "Learn About Procedures" to find out more.