A healthy living blog from Marshfield Clinic Health System

Considering Botox for lines and wrinkles? What you should know

As we age, things like wrinkles and laugh lines may become more noticeable. While developing lines and wrinkles on your face usually can’t be prevented, there is a minimally-invasive treatment available: Botox.

Botox, short for Botulinum toxin, is an injection used to help reduce the appearance of facial lines and wrinkles. The injections use a toxin that temporarily paralyzes or weakens certain muscles in the face and helps the skin look visibly smoother.

Repeated muscle contractions from frowning, squinting or raising your eyebrows can cause the skin to furrow and fold. This gradually results in the formation of wrinkles and lines. Botox, when used for cosmetic purposes, targets the horizontal wrinkles on the forehead, the 11 lines (or two vertical lines) between eyebrows and crow’s feet (or smile lines) that form lateral to the eyes.

Most people are candidates for Botox. But, people with neuromuscular disorders, and people with a Botox allergy are advised against getting the injections.

Middle-aged woman smiling in summer

Botox is an injection used to help reduce the appearance of facial lines and wrinkles.

What to expect when getting Botox

Patients interested in Botox will meet with the provider for a consultation. If Botox is deemed an appropriate solution, the treatment is scheduled.

Botox treatments require minimal downtime. Patients can return to their daily routine immediately after leaving the provider’s office.

“We use a topical anesthetic agent on the face and let it sit. We’ll then do a series of injections with the Botox to the targeted muscles. The entire treatment takes about 15 minutes,” said Dr. Michael Harl, plastic surgeon with Marshfield Clinic Health System.

Patients typically notice results as soon as 24 to 48 hours, but won’t see the peak effect for about two weeks.

“Patients usually can expect results to last between three to four months. We typically ask patients to come back before the results have completely worn off, so we can start overlapping treatment,” Dr. Harl said.

As a new patient, it takes time to find the appropriate dosage of Botox to get the result they want. But, as patients receive more treatment, the less Botox they’ll need.

“Patients train themselves not to make those facial expressions that produce those wrinkles and lines. Muscles also progressively weaken over time, so less Botox is needed to help them relax,” he said.

If patients frequently receive Botox to correct lines and wrinkles on the face, the body will start to fill in the creases naturally with collagen. This creates an element of permanence to the treatment.

The risks associated with Botox are minimal, but side effects can happen

Botox injections are fairly safe when performed by an experienced doctor or provider. Although it’s rare, the toxin in the injection can migrate to somewhere on your face you don’t want it to have an effect. This could cause the drooping of an eyelid or an eyebrow.

Patients also may have an asymmetric response where one side of the face has more of an effect than the other.

“These side effects are temporary, and we can treat an uneven response by injecting more toxin to balance the results out,” Dr. Harl said.

Following treatment, you also may cause swelling or bruising at the injection site.

Seek out the appropriate medical professionals for Botox

“I caution that there are a lot of people and providers who do Botox who don’t have specific training for it,” Dr. Harl said. It’s important to seek out providers who specialize in your condition and have experience with these treatments.

It’s also recommended patients see a plastic surgeon or a spa where a plastic surgeon oversees the practice.

“The benefit of coming to a plastic surgeon is that we do have a lot of other treatments we can offer,” he said. “A skilled and properly-certified provider can advise you on benefits and risks of the procedure. They also can best determine what treatment suits your needs.”


Botox also can be used for more than cosmetic reasons on the face. Learn more about the health benefits it offers beyond lines and wrinkles.

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