Dr. Baumann Recommends Botox. Here’s Why.

Botox Cosmetic and its competitors Dysport and Xeomin are nonsurgical wrinkle treatments that have been used on millions of people.  I treat about 100 people a week with these treatments.  I have noticed that many people have the same questions so I will answer the most commonly asked questions about Botox and the other botulinum toxins. I will use the abbreviation BTX to stand for all of the FDA approved botulinum toxin Type A products.

1. How Long Will My Botox Results Last?

BTX has been shown to yield very effective results that can last anywhere from three to six months. Most people need Botox injections 3 times a year. How long it lasts will depend on a few things:

1. Which product is used.  

Botox, Dysport and Xeomin all last between 3- 6 months in most people.

2. When was the BTX mixed?  

In my opinion the BTX should be mixed by the doctor fresh every day. This is why you want to go to a doctor who does a lot of BTX injections everyday so that the mixture is made several times a day.  Some doctors will keep it for up to 6 weeks. I believe that it loses its strength over time.

3. How much saline was added to dilute the BTX.

Doctors all dilute their BTX differently. Some doctors, in order to give you a  cheaper price, dilute their BTX with more saline resulting in less units given per treatment area.  There is no correct way to dilute the BTX.  How this is done depends on the artistry of the doctor.  However, the important part is how many units are injected into each area.

4. How many units are injected into the muscle.

The number units that are injected of BTX will affect how long it lasts-up to a point. After a certain dose, a higher number of units results in more side effects but not an increase in longevity.  The amount of units used in a particular area depends upon the muscle mass of that area.  For example, men usually require a higher dose of BTX than women. The number of units of botulinum toxin you will need depends upon the type of BTX used and the muscle mass of the area to be treated.

2. Does Botox Prevent Future Wrinkles from Forming?

Not only can Botox have immediate anti-wrinkle effects, but research has shown that this injectable could also help to prevent future lines and wrinkles from forming. A 2006 study published in the Archives of Facial Plastic Surgery involving a set of identical twin sisters found that regular Botox treatments over the span of 13 years actually prevented the development of facial wrinkles in the treated twin.  The untreated twin developed more wrinkles in the 13 years.  The twins were examined again 19 years later and the same results were seen.

There are, of course, some other factors that can contribute to aging including sun exposure, smoking and diet, however, if you are considering BTX, the research shows that it could be better to opt for treatment sooner rather than later, before you develop wrinkles that are deeply set.

3. Is Botox Going To Make Me Look or Feel “Frozen”?

One of the most frequent questions I get from first-time Botox patients is, “Will I look “fake” or frozen or expressionless?” The goal of BTX injections is to make you look normal and rested.  However, injecting BTX is an art as well as a science. The doctor must know the facial anatomy, where they nerves and vessels are, what directions the muscles pull in, and how relaxing certain muscles will affect your facial expressions. The stereotypically “frozen” or “overdone” look that some people have come to associate with BTX injections really comes down to two main issues: using too much product and/or improper injection techniques. So when you select a physician choose one with extensive experience administering Botox.  If you choose a good doctor who knows how many units to inject in each muscle, you should not look frozen.

4. Does Botox Build Up In My Body or Cause Harm Long Term?

BTX works by breaking a protein called SNAP 25 that is required for muscles to contract.  The BTX clears the body in about Think of it like this- SNAP 25 is a key to a lock on a door that allows muscles to contract.  When the key is broken, the door cannot be opened and the muscle remains relaxed.  The muscle remains relaxed until the body can make more of the SNAP-25 protein and this usually takes 3- 6 months. It is important to understand that the BTX does not stay in the body for 3- 6 months and does not build up in the body tissues.

Where To Get Cheap Botox Injections?

I hope that you never ask this question. If BTX injections are cheap you have to consider why this would be.  Either they are using illegal or counterfeit BTX, they are over diluting it or something is amiss.  When non-FDA approved versions of BTX are used or legal BTX is misused, many dangerous problems occur.  Please find other ways to save money!  BTX is not something to buy at bargain basement prices.

When my Botox wears off will I look worse?

No, your wrinkles will not be worse.  In fact, they might be better.  Studies have shown that after 3 treatment cycles of Botox, frown lines remain improved even after the Botox has worn off.

The Bottom Line

Botulinum toxin may have the unfortunate name of “toxin” but it has been safely used to treat wrinkles, sweating, crossed eyes, migraines and spasticity for 2 decades.  Long term safety trials have demonstrated no long term side effects and huge patient satisfaction rates when used properly. There are many people out there using counterfeit Botox products. Do your homework and choose your doctor wisely.  Stay tuned for blogs on the differences between the various brands of botulinum toxins.


Dr. Leslie Baumann, M.D. and her team at Baumann Cosmetic Dermatology believe in proof, not promises. World-recognized for both cosmetic and general dermatology, our treatment strategies rely exclusively on evidence-based, scientifically verified products and procedures that promote skin health and a natural appearance. We combine effective medical procedures with individualized instruction on proper skincare, nutrition, supplementation and lifestyle in order to maximize the health of the skin and body as a whole while minimizing the effects of aging. For more, visit Dr. Baumann’s blog for daily updates Monday through Friday, or inquire about an appointment through

September 12, 2016 Botox