Doctor’s Review on Botox: Safety, Before and After, Preparation

July 21, 2023
botox injection in the area around the eye, demonstration on a woman

Botox before and after photos can amaze. Deep wrinkles on the forehead or around the eyes smooth out just in one session. However, achieving these astonishing and long-lasting botox results is not that simple. 

Botulinum toxin injections are more than just a simple esthetic procedure. It is a cooperation between professional doctors, patients’ attitudes, and recommendations after the treatment. 

We asked Dr. Tatiana Kobets to share insight about botulinum toxin injections. She is a cosmetologist with 20 years of experience and the owner of the cosmetological clinic “KeyMed”. During the interview, she shared her insights about the procedure and also tell some interesting stories from her practice. Keep reading, to find out everything.

Botox or botulinum toxin is a neurotoxin that blocks muscle activity. When injected into the specific muscle groups in the face and neck it prevents contraction. As a result, it removes mimic wrinkles. Read more about the procedure in the article about what botox is.

When is it time to start getting Botox injections?

There is no particular age for starting botulinum toxin injections. The average age for people to start getting botox injections is between the mid-20s and late 30s. This starting point is very individual and depends on many factors, like genetics, face structure, habits, stress, etc.

The main indication of the procedure is:
The formation of visible lines, folds, or wrinkles on the face even in a relaxed state.

“I think that there is no such thing as preventive botulinum toxin injections. If you have no wrinkles, the procedure is a waste of money. However, if you see wrinkles on the face, then it is time to schedule a meeting with a cosmetologist without postponing. I have regular clients who got botulinum toxin injections for 10-15 years and they have fewer wrinkles than people of the same age group.”

— said Dr. Kobets.
A key to a good result

A key to a good result: selecting a professional specialist 

This topic has recently gained high popularity because depending on the location the list of specialists who can make botulinum toxin injections is different. 

Injections from an unprofessional specialist lead to poor results. This creates a negative perception of the procedure in society. 

The main signs of good specialists are:

  • Completed higher education in medicine
  • The beauty center/cabinet should have a medical license
  • Certificates about completed courses from the manufacturer of the used medication
  • Price. Procedures from experienced specialists who used only licensed medication can’t cost lower than the average price. If the procedure is too cheap it should warn you.

Moreover, a good sign is when the doctor creates a medical card for every patient. It is used as a reminder about the previous procedures.

If you decide to change the specialist, you can request the card from the clinic, thus another doctor can understand places, doses, and used medications. It will help specialists to understand how to treat the face better.

In the licensed center, you might also sign an informational agreement that you are acquitted of the procedure, its contraindication, and treatment zones.

A key to a good result

Preparation for the botox injections

Luckily, the procedure has almost no special preparation steps. The only rule is that you should avoid drinking alcohol for 24-48 hours before the treatment.

There are also some tips on how to select a good period for injections to avoid negative effects.

While coming to the doctor, you need to define all areas to treat in one session. The main reason for this is that with time organisms can develop an immune reaction to botox. As a result, the effectiveness of the procedure will decrease. However, it won’t happen if treatment will be every 3-6 months as recommended. 

The good news is that there is that the menstrual cycle has no influence on the final results of botulinum toxin injections. So you shouldn’t plan the session on the exact day of the cycle. 

The only recommendation here is that you should avoid any type of injection procedure on 1-2 days of the menstruation. The reason for that there is a higher risk of bruises during this period. If you are afraid of hematoma, Dr. Kobets recommends appointing a session on 5-7 days of the cycle, because at this time the organism has higher regeneration potential. 

You also should feel well before attending the procedure. It is better to cancel the appointment if you:

  • Feel sick (no temperature, thou through, cough, sneezing)
  • Have exacerbation of chronicle diseases
  • Have inflammation process in the treatment site

Sometimes, when the wrinkles are too deep, the doctor can recommend smoothing your skin with other procedures like pilings and then applying botox to fix the results.

You should avoid all intensive cosmetology procedures in the treatment zone after botulinum toxin. Specialists recommend applying botox on top of other lifting and anti-aging procedures. Otherwise, it will reduce the length of the effect. Consult with specialists and plan procedures in advance!

“In most cases, I don’t recommend my patient’s botulinum toxin injections as the first procedure. The only exception is online consultations, however, I also prescribe special cosmetics to create comprehensive skin care at home”

— said Dr. Kobets.
Botox injections procedure

Botox injections procedure

Before this, you will discuss with the specialist some questions. You should be prepared to answer or inform the doctor about the followings:

  • Previous botulinum toxin injections and treatment areas (if there were any).
  • Vitamins or microelements you take daily. “For example, Magnesium, high doses of vitamin B complex reduces acting periods of botulinum toxin” ⁠⁠— comments Dr. Kobets.
  • You should talk about any medication you take daily or special regular procedures.
  • Planned surgery in the nearest future (2⁠⁠-3 months). General anesthesia prevents botox from acting. 
  • Whether you recovered from botulism or got a shot of vaccine against it.
  • Whether you have any injuries at the treatment site.

“One time I was going to inject botox into the patient’s forehead. Suddenly, he said that he had had an injury there. I took into account the muscle atrophy at this site. Otherwise, he would end up with a dropped eyebrow. “

— commented Dr. Kobets.

Botulinum toxin injections can give a little discomfort. Before the treatment, it is diluted with a 0.9% solution of sodium chloride. This solution is absolutely safe and causes a little pinching while injected.

The most painful zone for botox is around the mouth because its contour is very sensitive. “Most patients are afraid that areas near the eyes are painful. Not at all. Areas around the mouth and between eyebrows are more delicate” — said Dr. Kobets.

The injection time takes about 5-15 minutes depending on the zone. The number of injections also varies:

  • Frown lines — 3-5 injections
  • Forehead — 2-12 injections
  • Crow’s lines — 1-6 injections
There are many myths about botulinum toxin injections. Check the special section about misconceptions about Botox.

Botox before and after results

Be prepared that botulinum toxin starts acting within 7-10 days after the treatment, while wrinkles can disappear in 2-3 weeks. Plan the procedure beforehand for important events

“I noticed that the time for botulinum toxin to act varies. Even when I inject the same doses, to the same zone for the same patient. Sometimes it is 2 days, sometimes 12 days. I connect it to some electrolytes contained in the cells or to the rapid changes in weather when many people can suffer from headaches.”

⁠— comments Dr. Kobets.

There are also some recommendations to get long-lasting results. The main recommendation is to avoid intensive exercising for 24-48 hours and thermal procedures like a sauna for a week after the procedure. 

Botox before and after results
Botox before and after results
Botox before and after results
Botox before and after results

Side effects after the procedure

In most cases, side effects are limited to:

  • Bruising, swelling, or pain in the injection site.
  • Little change in mimic. For the first time, you might feel that the face looks frozen or has some uncomfortable feelings while expressing emotions. 
  • Short-term headache that resolves after a few days.

A severe side effect like asymmetry, dropping of the eyelid or eyebrow, or swelling of the eyelid is connected to the wrong execution of the procedure. Another reason is that person had a predisposition to this side effect. You should discuss it individually with a doctor. 

“When people come to the procedure they are very afraid of getting asymmetry. I understand them because photos of faces after bad procedures are frightening. However, I have been injecting botulinum toxin for 18 years, I can say that these effects are rare if a person gets treatment from a professional specialist who can make the procedure according to the anatomic features.”

— said Dr. Kobets.

How to fix bad botox results?

How to fix bad botox results?

Botox effects are hard to remove, however it is possible. If the patient is not satisfied with the results or gets asymmetrical results, it is possible to remove these effects faster. There are a couple of methods:

  • Massage will increase the blood from the area
  • Microcurrents
  • SMAS-lifting

The key to reducing the botox effect is consistency. For example, the above-listed procedures are recommended to perform several times per week for 2-3 weeks in a row to see improvement. 

You can also try to eat high doses of the B vitamin group, as it is proven to reduce the duration of botulinum toxin effects. 

“In my practice, I had a case when the mother of my patient got injections from another specialist. When she came to me afterward, I saw two dropped eyelids with almost closed eyes. The situation was even harder because she would go to the sea in two weeks. I injected her with special medication and also recommended using an at-home radio wave lifting device every day. Just in three weeks, she sent me a happy photo with opened eyes.”

— pointed out Dr. Kobets.


Botox is an effective and most popular treatment to remove and prevent mimic wrinkles on the face. There is no specific age to start botox injections, the main indication is the line formation on the face.

The botulinum toxin injections are safe and require no preparation. However, you should give much attention to the process of selecting the specialist. It should be a person with high medical education and complete professional courses for botulinum toxin injections from the manufacturer. 

Side effects after the procedure are limited to bruising in the sites of injections. Sometimes side effects like ptosis of the eyelid happen. It is possible to fix it with procedures that stimulate blood flow and muscle activity like microcurrent or massage. 


⌛ How long does Botox usually last?

The average length of the effect is between 3 and 6 months. After that time there is a period of about 1,5-3 months when muscles are not as active as before and this prevents wrinkles formation.

😢 Is botox injections painful?

It is rather a little uncomfortable than painful. Most patients describe injections as mosquito bites, so there is no need to apply anesthetics for most of the face areas. The zone around the mouth is the most sensitive, so here the doctor may propose to apply the local anesthetic gel.

😊 When can I see results after botox injections?

It takes up to 10 days to see the effect of the botox. The maximum effect in wrinkles reduction is achieved in the 2-3 weeks after the treatment.

😟 How do you fix Spock’s eyebrows after Botox?

Spock’s eyebrow is a common situation with forehead botox when the tail of the brow is raised unnaturally. This moment is very easy to fix by injecting a little botulinum toxin above the crease.

😏 How do you treat eyelid ptosis from Botox?

Instead of waiting 3-6 months before botox wear off, try to stimulate muscle activity and blood flow in the treated zone. Try procedures like massage, microcurrents, and radio wave lifting. It will help to reduce ptosis in a month.

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