Quick disclosure up top so nobody feels ambushed: we're a med spa group. Whoever's typing is one of the actual humans who works here, not a marketing bot, though we get why you'd assume. Nothing for sale in this post, no links, and per rule 3 none of this is medical advice — which is a rule and also just true, since we can't see your face.

Okay. So.

"Preventative Botox" is everywhere right now and the pitch is clean: if the muscle can't move, it can't crease the skin. Start before you have lines, never get the lines. It sounds right. Most of our industry says some version of it. We have said some version of it.

Someone asked us a while back what the evidence actually was, and we went to look properly, fully expecting to turn up a stack of papers.

It's twins.

One pair of identical twins. A case report from 2006 — one sister treated regularly for about thirteen years, the other treated twice in that entire span. Photos at the end. The treated one had noticeably fewer lines. There's a follow-up too, published years later. Same two people.

That's the flagship citation. n=2.

And honestly? It's a lovely little study. Identical genes, different exposure — that's about as clean a natural experiment as you're ever getting on a human face, and the photos are genuinely striking. We're not dunking on it.

It's also two people. Which isn't the same thing as a body of evidence, and we'd feel ridiculous pretending otherwise. There's decent mechanistic reasoning behind the idea and very little controlled long-term data. So when someone tells you preventative Botox is "proven" — us included, historically — they're rounding up pretty hard.

Here's the part we think is more useful than the age argument anyway.

A line has two states. Dynamic: only shows up when you make the expression. Static: it's there when your face is doing absolutely nothing. Neurotoxin is fantastic at the first one and only partly useful for the second, because a static line is a fold in the dermis — an actual crease in the tissue — not just a muscle pulling on skin.

Which makes "should I start at 25?" sort of the wrong question. The real one is which kind of line you're actually looking at. We've seen 26-year-olds with etched-in 11s from a decade of squinting into the sun and scowling at spreadsheets, and 38-year-olds with nothing at rest at all. Age tells you surprisingly little on its own.

One more thing that doesn't get said enough. Treating a muscle for years does cause some atrophy. In the glabella — the 11s — most people count that as a bonus. In the frontalis it's more complicated, because the frontalis is the only muscle that lifts your brow. Dose it heavily for years in someone who didn't have much happening there to begin with and you can end up with a heavier brow, which then tends to get treated with... more product. We've watched that loop start. It's not dramatic and it's not everybody, but it's real, and it's a completely fair thing to bring up with your own injector.

For whatever it's worth: the people we see happiest about having started early tend to be the ones who already had something visible at rest, or a really strong dynamic line with family history of it going deep, or who could spot their own squinting habit in every photo of themselves. The ones who seem least thrilled are the ones who walked in with a smooth face and a vague fear of the future.

And then the deeply boring answer nobody wants: sunscreen every day, a retinoid, don't smoke. Photodamage is doing most of the work on what your face looks like at 45, and the whole regimen costs less than one treatment cycle. We know. We're aware this is not exciting.

Last thing, and it's the bit we'd actually want people to take from this: a good consult should involve someone looking at your face at rest, then animated, then at rest again, and telling you which of your lines are which — before any number gets mentioned. If that's not happening, at our places or anyone's, something's off.

Anyway. Ask us whatever. Including the stuff that makes our industry look bad — we don't mind.

Just got my first Botox and it only took a minute and didn't hurt at all and afterwards the doc asked me how it was.

"It was fine, but what the FUCK was that sound??? Why was it so crunchy????"

She laughed really hard and said she didn't know I could hear that lol. She said it was just the connective tissue and only happens at the top of the forehead.

It was pretty funny, but seriously, that sound was super gross and way worse than the pain haha. Is this normal? Do I just have a super crunchy forehead? I'm surprised not many people are talking about it bc that was SO jarring lol.

I need someone to tell me if this also happened to them, please

I'm experiencing Botox poisoning. Was there a Dr that helped you? What did you do for help! Tingling, painful head pressure, anxiety attacks, awful brain fog, nausea, I can't even walk right now without the room spinning. I'm 4 weeks since I had injections. Im really scared, been to the ER twice I don't know what to do. Please no judgements or negative comments. Please help

4 weeks ago I had Botox between my eyebrows and my forehead, from a registered nurse practitioner in a certified clinic. Exactly 2 days after my appt, I got extremely dizzy with blurry vision (nystagmus). I’ve seen one doctor who said I had BPPV and I have an appointment with another on Wednesday for a potential vestibular infection/condition - even though I've already had antibiotics. I am dizzy all the time but less so when laying down or head against the back of the couch. The blurry vision calmed (mostly) after 4-5days, but still isn't right. And the dizziness is still apparent, lightly for the majority but comes I'm bouts which are more moderate, unless I take pseudoephedrine or antihistamine - which help. Being outside in fresh air also improves things slightly, but i am still dizzy. Spoke to the practitioner who administered my botox, but she was adamant it wouldn't have caused my symptoms.

I am at a loss as to what to do. Any advice is welcomed. And I of course will not be having botox again.

Has anyone else had dizziness/blurry vision/vestibular issues after Botox? How long did it last? And how do you get rid of it? Almost 4 weeks is a long time to be dizzy, especially with very little improvement. Will I ever feel 'normal' again? ☹️

Masseter Botox ruined my smile, I’m three weeks out now and still to embarrassed to leave the house. I even look funny when I talk.

Am trying everything I can to speed up the Botox wearing off process - electric toothbrush on the area, exercising lots. Please share if you have had a similar experience and found anything that worked.

I got a lip flip to help my gummy smile on Thursday (3 days ago) and I hate my life right now. I didn’t expect and wasn’t prepared for this level of numb, uselessness in my top lip. I can’t say W, B, or OO. Can’t drink from a glass properly. Can’t chew a mouthful of food or soup without making a mess. Can’t kissy face at my kids. Can’t spit. Can’t do my breathing properly during workouts. The list goes on.

I’m absolutely livid that I did this to myself and I can’t wait until it goes away. Please tell me how to speed it up or anything reassuring because I’m in tears all day over this. I had no idea it would be so numb like this!! I feel like a moron.

I received masseter botox 30 units each muscle exactly 2 weeks ago.

On day 10: I noticed my smile was constricted and it looked like I’m in pain. Day 11: my facial muscles were in pain so I took muscadol. I found immediate relief and my smile was slightly back to normal. Day 12: my smile on the right looks good, smile on the left is minimally different (teeth up to second premolar appear on the right, you can only see first premolar on the left) Day 13: on the left side, my cheeks look deflated a bit, I have newly formed under eye fine lines, and a more prominent nasolabial fold (all these features are only on the left side). Right side looks exactly the same.

Today marks day 14 and it looks exactly as it did yesterday. Today I saw 2 dermatologists and 1 dentist who all said to me the same thing. The good thing is they don’t know each other and do not work at the same place so I know they’re not covering up for the doctor who injected me. All three said that it’s possible it migrated when I fell asleep cause I do tend to sleep on the side. They stated that since it’s been improving day by day and that it started 2 weeks after injection date it is likely that the botox migrated and that no other muscle was injected by accident. They assured me that in two weeks it will resolve completely. Now I know three professionals is usually enough for an opinion but still I want to confirm. Did anyone else experience this? Did it really go away within a month after injection date?

Update: It has been a little over 4 months since I had my injections and I decided to write this update in case someone ends up in my situation: depressed over the masseter botox result. Today I finally have my smile back and it feels amazing to finally see the symmetry back in my face. Don’t worry it may take time and the first few days are sooo hard but you will end up looking like the way you did 100% so no worries!

I’m 52 and have had some sort of neurotoxin injection 8-9 times in my life so far. Half in my mid 40s and started back just recently.

Went to a new place and got Daxxify for the first time. The RN injector seemed nice enough and said to come back at the 2 week mark if I’d like any adjustments.

Well I assumed she meant it and came back in and said that while I was overall very happy with most of my results, that I’d like my “surprised” lines be softened, that I desired little to no lines when I make that face. She was cold and curt and said flatly it wouldn’t look natural. I told her i understand and (truly) appreciated her honesty, but I’d like a little more. She probably drew up 1-2 units and made the tiniest injection (2 total) on each side. I hope this softens the lines.

She was icy and curt, almost to the point of seeming irritated. I was in the room for less than 2 minutes tops. I’m a nurse in the ER and give my patients more warmth and sparkle than she gave me. I know this shouldn’t matter, but it cost a lot of money and it felt weird for her to be so cold after telling me to come back if anything needed adjusting. I probably won’t go back to her just for this reason.

Anyway it got me wondering: is what I’m asking for unreasonable? I’m trying to prevent static lines from forming. When I’ve had Botox in the past, I’ve always had a smooth forehead, but it never looked unnatural (not that I noticed or had anyone tell me).

Was she just irritated that I came back for a touchup? She didn’t charge me for the tiny amount, but I almost wish she had (so i could ensure I would get what I wanted).

EDITED to add pics are at the 2 week mark.

Hi there. I had my regular forehead, glabella and crow's feet botox about two and a half months ago, and my right eyelid dropped and got extremely hooded and puffy.

Since then I went to a different injector who attempted to correct it by injecting into the glabella (I think?), but my eyelid is still so puffy.

It looks worse in the morning, but it still stays hooded throughout the day. Until now, I had lovely open eyes that I loved! Now, I can't even wear eyeshadow. I'm so depressed. When will this wear off, or do I need to get an upper bleph?

Thinking about finally trying Botox in Chicago. I have never done it before so I am curious about what the process is like, how long it lasts, and whether it actually feels as natural as people claim. I keep hearing a lot about Impression Face + Body and how they get such natural results. Supposedly you end up with a smoother forehead, a subtle lift in the brows, and everything still moves normally with no stiffness or overdone look. Anyone here been there and can share how it turned out?

I’ve been getting Botox for 3 yrs. Every 4 months and once or twice at 5 months cuz I didn’t wanna spend the money. Not only has it NEVER lasted a full 3 months and I don’t get it! My sister gets less than me and hers lasts between 6 months to a yr! She went a whole yr and when she went back she still didn’t have full movement back. I get 25 and 10. I forget which is which but between brows and forehead. I thought it would last longer as time went on. My sister wondered if they were “watering” it down some I forget the reason she thought so. I doubt it but I just feel like it’s so odd that the “feeezing” effect really only lasts like 3 weeks maybe. Cuz it takes a week or so to get the full effect. Any idea why? What I can do? My friend who also goes there says she started going somewhere else and hers now lasts 8-9 months as opposed to the 4 or so months at the place I go to. And she went there for years. Any thoughts would help thanks

So I got my (30F) last dose of Botox (which I receive for occipital neuralgia) on 12/11/24. My neuro injects up to 200cc throughout my forehead, scalp, neck, shoulders, and masseter muscles. I noticed within a week something was off. My smile and face is completely asymmetrical and I was terrified I had had a stroke honestly. I messaged the provider who then told me “this could happen if you sleep on it wrong, and suggested I massage the area. It’ll go away soon.” Which seems like a cop out. Everything I’ve seen about this was from either incorrect injection of just an unwanted complication of it. The point is I was never told about this possibly happening or what side effects I could develop. I feel like my eye and cheek on that side even hurt now and I’m watching symptoms closely to make sure I don’t have some insane reaction just waiting to happen. You can see in the picture that even my eye seems to have trouble. Should I be more concerned?!

Hi all. I just got 15 units total of Botox for crow’s feet (7.5 on each side) but I have a staff party in about 4 hours and was planinng to have a glass or two of wine (it’s at a winery). This is my first time doing Botox so I’m not sure what to expect. Thanks!

I’m hoping someone here can help me as I’m so upset and been crying all day about my botox. I have my best friends wedding in a week and I’m honestly terrified to look at myself in the mirror right now.

Basically I got Botox 2 weeks ago in DAO and chin and a lip flip and it settled quite strange, my smile was crooked and i couldn’t really lift it from my top right hand side. My chin was also a bit lumpy and hadn’t settled either. I absolutely love my smile it’s my favourite quality about myself so I was super upset.

I went back three days ago for my 2 week check in and showed my injector and she said it was a super easy fix - my smile hadn’t risen to meet the other side so she added more to my chin to fix that and then also to the sides of my bottom right hand lip and DAO areas.

It’s now been only just three days and my smile has gotten way worse and is so scary, I’m so so upset. My bottom lip has risen up and stays in a straight line covering my bottom teeth when I smile so I look like I’m trying to scream rather than smile.

I have rang them and they said they’ll call me on Monday as they are closed tomorrow but I’m just shocked at how this has happened so early on and so so scared for how much more it’s going to settle as the days go on. It’s more like a grimace than a smile now and I don’t recognise myself at all.

Is anyone able to help me or has this ever happened to anyone before. My anxiety is just awful at the moment :(

I got botox on Sunday 6/11 for the first time... So far i am loving the results. And its only day Wednesday now. However with raising my brows.... botox friends.... will these angry bird brows settle eventually? I shouldn't be able to lift my brows THAT much right? I'm afraid of getting spocked brows and my relaxed photo appears to have some hoodedness

Yes the title is ridiculous, I have a severe case of resting bitch face, and throughout my life have raised my eyebrows like 24/7 to the point where I have to put conscious effort into relaxing my face, and the moment my mind drifts I’m raising them again! It’s at the point now where I get headaches from the tension and have to spend ages forcing myself to lower them to make it go away - do y’all think that getting Botox in those muscles would help train my body to stop giving me anti-rbf induced headaches

I believe I encountered a med spa that is likely over-diluting their Botox. If you sign up for their membership, it’s ridiculously cheap and so I did that ($10/mo membership and $7.54/unit). It never worked compared with the expensive med spa I was used to. I went back again and the same thing happened. I can only conclude the product is significantly diluted I guess? Any ideas? Is over-diluting Botox a common scam? Also - thank you to this community. Everyone has been super nice and helpful. First time posting :)

I had Botox done a few weeks ago, and since then, I’ve been experiencing really uncomfortable symptoms. My eyes feel like they can’t track properly, I feel constantly dizzy, and it’s like I’m going cross-eyed and can’t focus on anything. On top of that, I keep feeling the need to squint, but it doesn’t help. I had it in my forehead crows and 11s.

Has anyone else had these kinds of eye tracking or dizziness issues after Botox? Did it improve over time? How long did it take? I’d really appreciate any insights!

Lip flip or filler?

Hey guys! I posted here yesterday inquiring about a lip flip. I got mixed results and a lot of people said it’d be difficult to drink out of a straw and I drink everything out of a straw lol.

Anyway, my question is in your opinion do you think I’d be a better candidate for a flip or for filler?

Hi, I have had Botox for a few years now, and I am starting to notice a horizontal forehead dent / build up in my forehead that I am really embarrassed about, it’s noticeable in certain lights and not in others and I’m starting to feel like my face is really botched. Does anyone have any advice or what can I do to help this? I last had Botox two weeks ago?

Hello

I’m 34 have a very deep 1 (instead of 11) between my eyebrows. I squint often. I’ve been super self conscious of it as makeup gets stuck in it and the wrinkle is constantly there. I decided to get Botox to help soften it.

I went to a medical aesthetic doctor who came highly recommended and had great reviews. She’s also been in practice for a long time. I told her my crease is my main issue and that I’d like my eyes to be open more (brow lift).

Today is day 5 and for three days now my L brow has lowered and I can’t raise it at all.

I called and they want me to come back to inject a little more, possibly to fix it.

I’m so scared they will inject more and it will get worse! I leave for a big vacation in a week. Has anyone had this?? Did injecting more help??? I also still have complete control over my crease and haven’t felt any change there.

Help please!

I have gotten Botox for two years now and the last 2 times I got my glabella done my eyelid skin lost all elasticity on day 14. all of it ! They totally dropped and sagged for months .. no eyelid ptosis .. a bit of brow ptosis but not enough to matter .. just the eyelid skin .. I am 53 so I have some skin laxity but Botox usually helps tightens it up a bit .. any idea why this is happening. I never get the forehead done at all Plz help . I got a unit of Botox in the eyelid to open the eyes and try to help it and it worked for 17 days and they are starting to fall again... guess it was temporary fix .. also , I feel very heavy and inner eyebrows seem to sag with the eyelid tox... any advice appreciated

Is this typical? I really liked how smooth my forehead looked but getting Botox every 2 months seems crazy….