Botox for the first time: before and after — a complete guide

Having botox (botulinum toxin) injections for the first time is an anxious step for many people. With the right information, however, this is a procedure that is over in 15 minutes, carries minimal risk and is reversible.

What does botox do?

Botulinum toxin temporarily weakens the muscle — because the muscle does not contract, the dynamic wrinkles on the face (from smiling, from raising the eyebrows) are smoothed out.

Why botox for the first time?

The ideal age: 25-35 (preventive) Target zones (for beginners):

• Forehead lines (the frontalis muscle)
• Frown lines between the brows (the glabella — the "11 sign")
• Lines around the eyes (crow's feet)

What should you ask at the consultation?

1. 1Which brand? Allergan Botox / Dysport / Xeomin — it must be certified
2. 2How many units is the dose? For a first time, 30-50 units is generally enough
3. 3Has an allergy test for the excipients been done? (rare, but it happens)
4. 4Are before-and-after photos shown? They should be the clinic's own patients

The steps of the procedure

1. 1Consultation (15 min): as you move your face, the surgeon assesses how each muscle works
2. 2Marking: the injection points are marked with a pencil
3. 3Cold compress (2 min): numbs the area slightly
4. 4Injection (5 min): a fine needle (30G), spread across 2-6 zones
5. 5Light massage: so the product spreads evenly

How painful is it?

1-3/10 — the sensation of "a needle prick". Most patients need no anaesthesia. A topical cream (lidocaine) can be applied 15 minutes beforehand.

What happens afterwards?

• 0-3 hours: small red dots (usually covered with make-up)
• 24 hours: no visible change
• 3-7 days: the result gradually begins
• 14 days: the full result is visible

What NOT to do within 24 hours

• Lying down — stay upright for 4 hours
• Pressing on or massaging your face
• Sauna, exercise, hot showers (blood circulation)
• Alcohol (risk of bruising)
• Flying straight away (pressure change)
• A hairdryer or hot tools close to your face

How long does the result last?

• The first time: 3-4 months
• With regular use (1 every 4 months): 4-5 months (the muscle "gets used to it")
• If you stop after the 18th month: the muscle fully regains its function

Side effects

Typical (in 5-10% of patients):

• A headache for 24-48 hours
• Small bruises (5-7 days)
• A mild feeling of tightness

Rare (1-2%):

• Ptosis (a drooping eyelid) — lasts 6-8 weeks, then passes
• Asymmetry (corrected with a touch-up 2 weeks later)

Very rare (<0.1%):

• An allergic reaction
• Breathing problems (only at a very high dose)

About the price

The price depends on the number of zones treated (1, 2 or 3). The exact amount can only be found out at a consultation.

Our recommendation

For a first time, choose a conservative dose (so your face is not left too frozen). At a review consultation 2 weeks later you can add more if needed — taking it away is not possible.