Maybe you raise an eyebrow any time someone admits to getting Botox [1] (which would make physical sense, since skipping the injectable neurotoxin means it's probably pretty easy for you to move your forehead). But the treatment is not just for the Real Housewives anymore. In fact, 7,056,255 Botox procedures [2] were performed in 2016 alone — and I was one of them.
Like most people about to jab their skin with a fancy-sounding toxin that effectively paralyses the facial muscles [3] for months at a time, I was terrified to make my first appointment. Will I look like a Stepford wife? What if I want to actually feign surprise at my surprise birthday party? Two years later, though, and I've all but converted to the church that is botulinum toxin type A. Here's everything I wish I knew back then — the good, bad, and frozen (forehead) included.
No, Botox Doesn't Hurt (For the Most Part)
My pain tolerance falls somewhere between a newborn baby's and Batman's exoskeleton suit, and I'd rank Botox at about a 3. You'll feel a slight prick at the injection sight, but it's hardly anything you'll need Demerol for. As with most times you're getting poked with a needle, the worst part is mostly the anticipation of it all. That said, if you're especially sensitive to pain, ask your dermatologist to apply a topical anesthetic cream 20 minutes before to numb the area. You won't feel a thing.
You Won't See Results Right Away
You wouldn't be a modern human living in the 21st century if you didn't want instant gratification when getting Botox injections. Unfortunately, though, this is an instance where you're just going to have to wait anywhere from four to seven days to see results.
You Shouldn't Get Botox at Night
Serendipitously, after my very first Botox appointment, I had scheduled a massage for a few hours later, which I then had to promptly cancel after being advised to keep my head elevated for four hours after treatment. There's been little research on why or whether Botox will actually shift via any sort of gravity while laying down, but I've since retired my Dracula instincts and will only schedule morning appointments, to be safe.
You'll Want to Come to the Appointment Prepared
No need to bring a First Aid kit or every item in your 10-step skincare routine [4], but you may want to toss face powder or concealer in your bag if you plan on going somewhere after the appointment. To make sure the derm has the best view of your forehead (or whichever area they are injecting), the nurse will take off any makeup near the area with an alcohol wipe. I keep It Cosmetics's Bye Bye Redness Correcting Cream [5] ($32) close at all times so I can squash any redness as soon as it comes.
You May Get a Headache Afterward
Annoying but true: a common side effect immediately after getting Botox is that you could develop a mild headache. In most cases, Advil does the trick, but the Journal of the American Academy of Dermatology has reported that about one percent of patients experience severe head pain [6]. (If that's the case, maybe lay off the 'tox for a bit — after you call your doctor, that is.)
Don't Get Injections Too Close to Your Eyebrows
Winking at every waking person around you should be optional, but if a needle gets too close to the upper part of either eyebrow, you may be stuck with the look for a few days or weeks. This happens when the toxin that's been injected in your skin migrates near the muscle above your eye (called the levator palpebrae [7]), which can cause the lid to droop. It's not all that uncommon, either — even I've fallen victim to eyebrows that look more asymmetrical than Buzz Lightyear's.
It Won't Get Rid of ALL of Your Wrinkles — and That's OK
My mom was 54 when she went in for her first round of Botox, so she already had a few deep-set wrinkles that tend to be harder to treat. And because most derms aim to make you look as natural as possible, they'll never inject you with too much juice, meaning you'll have fewer lines, but they won't completely vanish.
It Requires Zero Downtime
It's called a "lunchtime treatment" for a reason — the entire thing takes 10 to 15 minutes, tops. Even with the minimal redness at the injection sight (you have your concealer, right?), nobody will suspect a thing.
It's Not Cheap
Much like a real estate agent might tell you, the price of Botox is all about location, location, location. In general, you are either charged by unit (i.e., how much of the actual Botox fluid you require) or by the specific area being treated, which varies depending on where you live. Each unit can set you back anywhere from £7 to £15, which the American Society For Aesthetic Plastic Surgery reports averages around £290 per session [8].