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Although BOTOX® Cosmetic is not a filler, it is often used with dermal filler procedures. BOTOX® Cosmetic is a simple, nonsurgical treatment that can temporarily smooth moderate to severe frown lines between the brows in people from 18 to 65 years of age.

BOTOX® works by relaxing the facial muscles. It is a purified protein produced by the clostridium botulinum bacterium, and has been approved by the FDA since 2002 for treatment of glabellar lines – commonly known as frown lines – between the eyes and above the nose. Treatments typically take 5 – 10 minutes.  Although results may vary, after one 10-minute treatment—a few tiny injections— within days there's a noticeable improvement in moderate to severe frown lines between the brows, which can last up to 4 months.


Since the needle is so tiny and the procedure so quick, healthcare professionals do not usually numb the area being treated. However, in sensitive areas, such as around the lips, some medical practitioners may apply local anesthesia just prior to the treatment.

Mark M Hamilton MD Botox Glabella Before After PictureIn 2007, almost 4.6 million procedures were performed with FDA-approved BOTOX® Cosmetic, ranking BOTOX® as the leading cosmetic medical procedure in the United States. While women received over 90% of the procedures performed with BOTOX®, a growing number of men are receiving BOTOX® each year.  In fact, nearly twice as many men now receive BOTOX® injections as did 5 years ago.1

Many plastic surgeons, dermatologists and other healthcare professionals who use BOTOX® employ it for a wider spectrum of facial lines and wrinkles that includes forehead lines, bunny lines (across the top of the nose), marionette lines (below the corners of the mouth), smile lines and smoker’s lines.

BOTOX® is now also used as an effective treatment for hyperhydrosis (excess sweating), and other disorders. Ask your healthcare professional about the variety of treatments now available with BOTOX®.

It is advisable to select a healthcare professional who has performed at least hundreds of BOTOX® procedures because techniques are often refined over time for more natural, appealing looks. Inexperienced practitioners will be more likely to leave you with a “frozen” look, or to drop a brow, or to leave you with more uneven and unnatural looking results.  We have determined a number of medical practitioners nationally who have extensive experience with BOTOX® cosmetic medical procedures.  To see a list of experienced healthcare professionals in your area, or to receive a special discount on your next BOTOX® procedure, Locate a Specialist.


Post-marketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity or other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms. In unapproved uses, including spasticity in children and adults, and in approved indications, cases of spread of effect have occurred at doses comparable to those used to treat cervical dystonia and at lower doses.

No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX®/BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines) or 100 Units (for severe primary axillary hyperhidrosis) have been reported.

BOTOX® Cosmetic is contraindicated in the presence of infection at the injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to the components in the formulation. Risks resulting from administration at higher dosages other than those approved by the FDA are unknown. Individuals with pre-existing neuromuscular disorders should only receive BOTOX® Cosmetic with caution. Co-Administration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission should only be performed with caution as the effect of the toxin may be potentiated. BOTOX® is not recommended for use during pregnancy.

For additional information, please refer to the BOTOX® Package Insert and Medication Guide.   Consult your physician to determine if BOTOX® is right for you.

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*This web site is designed to educate individuals about dermal filler and botulinum toxin procedure options being used by various physicians in the U.S. and abroad.  The information is not intended to be medical advice or endorsement of any particular procedure or product. Consult your physician for medical advice. Companies who manufacturer FDA-approved dermal fillers and botulinum toxins typically do not seek FDA approval for all procedures and facial areas. Many of the procedures  discussed on this site are "off-label", yet widely used by plastic surgeons, dermatologists and other physicians in the U.S. and abroad. Dermal Filler News is not affiliated with any medical device manufacturer.