Skin Care / Injectables / Botox

Botox for Beginners

Written by
Juli Albright
Juli is our patient advocate and community connection. She balances work, life and family with grace.
Juli is our patient advocate and community connection. She balances work, life and family with grace.

Botox for Beginners

A little about the author...

So a little about me I was raised in a family that eschewed anything unnatural. My mother had an organic garden, raised goats, and considered a daily shower an adequate skin care regimen. Except for the occasional concealer or blush, skin care products and make-up were non existent. Like most girls, my skin care journey started with teenage acne. My mother and two older sisters never had acne, so their advice was to scrub my face hard with Dove soap and stop eating chocolate...Skin care has certainly evolved since those days, and I am grateful that my daughter will have more effective regimens for her skin.

Why did I get Botox?

During residency, my husband Dr. Albright worked with two female plastic surgery residents who were so beautiful. Their foreheads were smooth, and it accentuated their face and brows. One time they happened to mention my husband injected them with Botox (Botulinum Toxin). This was my first exposure to Botox. After I had my second child, I noticed wrinkles on my forehead were starting to stay even when my face was a rest. Botox was so easy and worked so well! Although it is not cheap, it also was not as expensive as I thought. Since Botox weakens your facial muscles over time, it prevents wrinkles from progressing.

When should you get it?

Used for spot treatments, forehead lines which don't disappear when the face is at rest, to create a smooth forehead look, or for general wrinkles.

The answer like most things in life is it depends….Don’t you hate that answer?   Seriously though, I have tried to create a few rules of thumb.  Of course this is based on my non-medical experience and reflects my own personal opinion:

  1. Spot Treatment Botox- You are constantly bothered by a line or wrinkle in your face or neck.  I have a friend who spent the last two years trying every wrinkle cream and also Amazon night strips to hold the skin taut at night.  Needless to say, nothing worked.  To me, it was not extremely obvious, but to her, it was all she saw on her face.  She was worried that she would develop deep furrows between her brows like her mother.  The great thing about Botox is it temporarily paralyzes the muscles where it is injected.  It will also weaken that muscle to prevent a wrinkle or line appearing or deepening in the future.  After one treatment with Botox (very small amount so thus not expensive) she was hooked.  
  1. Forehead Lines / Crows Feet- By late 30s most people are affected by forehead lines / creases which don’t disappear immediately when you stop raising your eyebrows.  For me it was after my second kid at age 32.  I noticed my forehead lines seemed to linger longer and become deeper.  One round of botox, and I was hooked. After that I was starting to develop crows feet which did not seem to be fixed with skin care products. Botox treatments easily fixed them as well.
  1. General Wrinkles - When I started botox I was 32, and I could not believe the results. At only 32, I had spent a fair amount of money on skin care promising great results in one area or another. Some delivered and some didn’t, but for the money and results, botox injected by a qualified medical professional can’t be beat. Usually Botox will be ~$250 for your forehead which lasts up to six months (really closer to 3-5 months) but weakens those muscles so you will have less severe wrinkles in the future. You can easily spend $100+ on a cream promising wrinkle prevention / mitigation which hardly does anything in the best case scenario and lasts three months. So what I am trying to say is, for me, botox is really more economical! [Husband rolls eyes]...

Does Botox hurt?

So my first time, I was completely unprepared for the actual injections themselves. In my mind, Botox would be injected in a couple of places, and that would be it. My husband did my forehead and glabella, about ~10 injection sites. By the fifth shot, I was starting to hyperventilate. I was just too anxious and started breathing too rapidly. I made it through without passing out (thankfully), but the nurse had to bring me juice and cold packs. Once I was made aware of the importance of regulating my breathing, I have not had another experience like that again.

Botox has 5 - 20 Injection Sites

Although some advocate applying a numbing cream (topical anesthetic) for your first time, I have found this is not necessary after the first treatment. Topical anesthetics can require more than 30 minutes before they take affect. Not worth the wait.

The botox needle is very small. Each injection is accompanied by a slight sting which quickly fades. The number and amount of Botox to be injected depends on the area to be treated among other factors. The area between your brows (glabella) will be ~5 injections and the forehead plus glabella may be ~10 injections. A good injector should rub or hold the injection site to quickly dissipate the pain (similar to eyebrow waxing), while being careful not to displace the Botox toward the eyelids. After the first time, I think you quickly get used to the sensation. The most common side effect is a mild headache. I felt a little funny after the first time, but did not have any issues after the second time. A little bruising and bleeding around the injection site is also normal.

Who is getting Botox?

Last year over 1.5 million people had injections in the United States. After getting Botox, it is fairly easier to spot other people who have been treated, as their forehead or glabella do not move like normal facial expressions. Look around and you will quickly be able to tell too! Women who are pregnant or breastfeeding should not receive botox injections.

Where to go for Botox?

Alamo Plastic Surgery offers botox in San Antonio. In general, however, I would look for a board certified plastic surgeon or dermatologists with good online reviews ( I prefer a physician to inject my Botox. Although Botox should wear off in 3-6 months, lopsided eyebrows are not particularly attractive! Which brings up another important point, make sure you know what your injector's revision or 'touch up' policy is.

Exercise / General Care after Botox?

Do not exercise or wear hats for 24 hours after Botox!

It is important to remember botox is administered in liquid forms in the areas you want to paralyze. Until the Botox binds to the nerves, the liquid can shift with movement. Therefore do not work out for 24 hours after receiving botox. I know this can be hard for everyone with a routine, but it is not worth messing it up. I do sometimes go early in the day and then still work out the next morning, but I make sure not to do any handstands! Also do not wear any hats or sweat bands for a couple of days until you see the Botox taking affect. I thought it felt a little weird to apply mascara or eyeliner at first, but after a couple of weeks I was used to it.

Frequency of Botox injections?

Botox is effective for 3 - 6 months for most people. I like to go every 6 months, but I have a good friend that says she metabolizes botox very quickly so she goes every three months.


Hope this was helpful!

Written by
Juli Albright

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