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Botox Injection: Treatment, Procedure, Cost and Side Effects

Last Updated: Jun 28, 2023

What is botox treatment ?

Botox, also called botulinum toxin type A, is made from the bacteria that causes botulism. Although Botox is a powerful poison, when used correctly, it has a number of applications. Botox is the most popular non-surgical cosmetic treatment, with more than 6 million Botox treatments administered each year. Botox is a neurotoxin derived from Clostridium botulinum, an organism found in the natural environment where it is largely inactive and non-toxic.

Botulinum toxin blocks nerve activity in the muscles. Botox is used medically to treat certain muscular conditions, and cosmetically to remove wrinkles and fine lines by temporarily paralyzing underlying muscles. . Botox Cosmetic is used to temporarily lessen the appearance of facial wrinkles.

Botox injection is used to treat cervical dystonia (severe spasms in the neck muscles). It is also used to treat muscle spasms (stiffness) in the upper limbs (elbows, wrists, fingers) or lower limbs (ankles, toes). Botox is also used to treat severe underarm sweating (hyperhidrosis), muscular and bowel disorders.

Botox injection is also used to treat certain eye muscle conditions caused by nerve disorders. This includes uncontrolled blinking or spasm of the eyelids, and a condition in which the eyes do not point in the same direction. Botox is also used to treat overactive bladder and incontinence (urine leakage) caused by nerve disorders such as spinal cord injury or multiple sclerosis.

Botox injection is also used to prevent chronic migraine headaches in adults who have migraines for more than 15 days per month, each lasting 4 hours or longer. This medicine should not be used to treat a common tension headache.

How is botox treatment process?

Botulinum toxin is administered by diluting the powder in saline and injecting it directly into neuromuscular tissue. Most patients choose to have topic anesthetic ointment applied to the areas which will be treated in order to dull sensation in the area. Others prefer nothing at all. You will have the opportunity to choose before your treatment.

Just prior to botox injection, any topical anesthetic ointment that has been applied will be gently removed and an ice pack applied to the area. After a short time, typically measured in seconds, the ice pack will be removed, the treatment area will be cleaned with alcohol or an antiseptic such as betadine, and Botox (or other neuromodulator) injections will be performed.

It takes 24-72 hours for botulinum toxin to take effect. In very rare circumstances, it may take as long as 5 days for the full effect of botulinum toxin to be observed.

How long does Botox last in?

Since the key function of Botox is to resist the natural process of aging by blocking the nerves. The duration of Botox depends upon the skin portion, age, and wrinkling. In general, the Botox will last up to 3-4 months. In other cases, the duration can be less the 2 months or more than 6 months.

Summary: General duration of the Botox is between 2-6 months depending upon several factors like skin portion, age, and wrinkling.

Who is eligible for botox injection treatment? (When is the treatment done?)

There are many treatments available to combat infertility but neither of them vouches for the fact that the woman will get pregnant. However, in recent times improved technology has caused inflation in the rates of success.

At what age should I get Botox?

Botox is clinically approved for anyone who is above 18 years of age. However, it is been recommended to take advantage of the cosmetic procedure only when needed. There is no specific age to get injected with Botox after 18.

Summary: The skinning process of Botox is safe for anyone who is above the age of 18. However medical experts recommend undergoing the process if necessary.

Who is not eligible for the treatment?

Botulinum toxin should not be used in pregnant or lactating women, or by people who have had a previous allergic reaction to the drug or any of its ingredients. Not all migraine sufferers automatically qualify for Botox injection treatment. If you respond well to other migraine treatments or medications, you’re unlikely to be referred for Botox treatments.


Are there any side effects of botox treatment?

Injections with botulinum toxin are generally well tolerated and there are few side effects. Botox injections can cause side effects if not done properly. This has caused serious life-threatening side effects in some people receiving botulism toxin injections, even for cosmetic purposes.

It is possible for the Botox to spread a little beyond the intended injection site and affect the surrounding tissues. For example, if you receive injections into the forehead close to your eyebrows or your upper eyelids, they could be affected and may drop temporarily.

Along with its intended effects, botulinum toxin may cause some unwanted effects. These can include: Mild pain, local edema (fluid buildup) and/or erythema (reddening of the skin) at the injection site, Numbness, Headache, allergic reactions, rash, itching, asthma, red welts, shortness of breath, diarrhea, stomach pain, loss of appetite, injection site reactions including bruising, bleeding.

Common side effects of botox injection treatment are pain, redness, bleeding, swelling, or infection, Malaise - feeling generally unwell, Mild nausea, Temporary unwanted weakness/paralysis of nearby muscles or twitching, fever, cough, anxiety, fatigue, dry mouth

You can also feel these side effects after botox treatment such as ringing in your ears, increased sweating in areas other than the underarms, urinary tract infections, burning/painful urination, difficulty urinating, sore throat, runny nose, flu symptoms, cold symptoms, respiratory infections, dizziness, drowsiness, faintness, Weakness, swelling or bruising of the lower eyelid or lateral rectus (a muscle controlling eye movement), Dysphagia - trouble swallowing.

Other side effects of botox injection are neck weakness, Flu-like illness, Brachial plexopathy - a condition affecting the nerves either side of the neck and chest, Gallbladder dysfunction, Diplopia (double vision), Bleeding, Blurred vision, Decreased eyesight, Dry mouth, Fatigue, Hives, Rashes, Wheezing, Swelling.

How bad does Botox hurt?

The chemical composition of Botox does not cause any type of pain and discomfort during its course of treatment and even after it wears off its effects. However one may feel the slight pinch of the needle while injecting.

Summary: The chemical or the process that is used in Botox does not cause any discomfort. However one may feel the slight pinch of the needle while injecting.

What are the post guidelines after botox treatment ?

The guidelines to follow post treatment have been followed for years, and are still employed today to prevent the possible side effects of ptosis (drooping of the eyelids). These measures should minimize the possibility of ptosis. No straining, heavy lifting, vigorous exercise for 3-4 hours following treatment. Avoid excessive heat (sauna, hot tub) for 24 hours after your treatment. Avoid manipulation of area for 3-4 hours following treatment. This includes not doing a facial peel, laser treatments or microdermabrasion after treatment with Botox. Stay out of the sun for approximately four (4) hours following Botox treatment.

It is best to try to exercise your treated muscles for 1-2 hours after treatment (e.g. practice frowning, raising your eyebrows, and squinting). Stay in a vertical position for four hours following injection. DO NOT “rest your head” or lie down for 4 hours after your Botox treatment; sit upright. You may apply an ice or cold gel pack to the area(s) treated (avoiding pressure) as this helps reduce swelling and the potential for bruising.

Once you have adequately cooled/iced the area(s) as instructed and any pinpoint bleeding from the injection site(s) has subsided, you may begin wearing makeup. AVOID placing excessive pressure on the treated area(s) for the first few days; when cleansing your face or applying makeup, be very gentle.

You may take Acetaminophen/Tylenol if you experience any mild tenderness or discomfort. Be sure to apply an SPF 30 or higher sunscreen. Wait a minimum of 24 hours (or as directed by your provider) before receiving any skin care or laser treatments. Ideally no flying on a plane within 24 hours. Avoid any medications that may induce bleeding such as aspirin. Use arnica for any bruising or blemishes.

Some providers believe that smiling and frowning right after Botox injection treatments helps the Botox find its way to the muscle into which it was injected after treated. Use the treated muscles by frowning several times every 15 minutes for one hour after treatment. After this, try not to move the area any more. Avoid pain relievers, headache or arthritis medications, with the exception of acetaminophen for 24 hours after treatment.

If the desired result is not seen after 2 weeks of your treatment you may need enhancements (additional units of Botox). You are charged for the amount of product used. Therefore, you will be charged for a product used during any touch-up or subsequent appointment. It is recommended that the patient schedule an appointment no later than 2 weeks after treatment.

What should I avoid after Botox?

Here are some of the things that you should avoid in order to keep the treatment of Botox healthy and long-lasting:

  • Direct sunlight.
  • Places where the temperature is massively low or high.
  • Alcohol and tobacco ( smoking).
  • Any pressure on the muscles Botox was injected like exercise or sleeping that side of the face down.
  • Rubbing the site of injection.
  • Usage of any beauty product like creams or solution, especially the ones which may need to massage a little to absorb.
Summary: Botox is a sensitive skin treatment that helps you keep your skin wrinkle-free. So to maintain its effects for a longer period of time it is important to follow the restrictions given by your dermatologist.

How long does it take to recover after botox injection treatment?

The beautiful thing about Botox injection is that there is no recovery time. Botox can take anywhere from 2-7 days to see your final results. The results last for three months in most situations. Younger patients seem to have a longer duration of effect than older patients.

By this I mean that the older patients will start to show the wrinkles coming back in the 50-60 days and the younger patients it may be 70-80 days before they start to see the wrinkles coming back.

Does Botox make you look older after it wears off?

No, Botox helps you keep your skin smooth and young when it is injected into your skin. After it wears off its effects, your skin will come to its normal state. One may feel it wrinkled and dull as the long duration of Botox makes you habitual of smooth skin.

Summary: After the effects of Botox wears off, your skin will come to its normal state. This often makes the users of Botox feel that they are looking older than usual.

What is the price of botox injection in India?

The cost of Botox injections varies from one practitioner to another, from one place to another and also depends upon the part of the body to be treated. Most people are pleasantly surprised when they hear the cost. The crow’s feet would cost about Rs.6000 a session. Given that it needs to be repeated in 6 months that translates to Rs.1000 a month.

The upper face including the frown complex, crow’s feet and forehead would cost Rs.15, 000 to Rs.18, 000 per session. Drooping smile would cost Rs. 7,000, lip lines Rs. 7,000, Nefertiti Lift (for wrinkles on neck) Rs. 10,000 – Rs. 12, 500, Brow Lift Rs. 7,000, Gummy smiles Rs. 10,000 and cheeks and jawline lift Rs. 10,000 – Rs. 21,000.

Are the results of botox injection is permanent?

The effects of BOTOX injection are not permanent. But Botox gives the long time result if you choose professional for injecting. A treatment is required every 3-4 months, although some patients have reported longer wait times after repeated treatments. Treating dynamic wrinkles early with

Botox injection prevents permanent creases from forming, because the muscles that you treat can no longer create strong creases in your skin. By starting Botox early, and repeatedly treating your dynamic wrinkles, you will prevent these from maturing into permanent static wrinkles. You may eventually require Botox less often.

What are the alternatives to botox injection?

Frownies - These little patches of natural Kraft paper are ‘glued’ to the skin, temporarily ‘freezing’ the muscle movements that cause wrinkles, just as Botox injection does. Just like with Botox, over time with regular use, the muscles will lose their strength and their ability to wrinkle the skin, much like the injectable salon treatment does, but for way, way less money.

Face Saver Balls - The Face Ball, a rubbery ball that claims to work on the bone to improve its health and mass reduce skin sagging as a consequence. The ball also works out muscles, increases circulation, tones and helps reverse the effects of gravity—much like Botox does. The Face Saver ball was originally meant for women over 40, but women as young as 20 can start using the ball, in order to prevent repetitive stress patterns from becoming a problem as they age.

Frotox - Developed by California-based lab Myoscience Inche, this 20-minute procedure involves placing a device filled with liquid nitrogen beside the nerves that control wrinkle-causing muscles. The machine puts the nerves into temporary hibernation, allowing muscles to relax. The ultimate result? Your wrinkles disappear. Unlike Botox treatment, which takes four days to work, the effects of this treatment can be seen immediately and last for up to four months.

VTOX - This Botox injection alternative contains natural neuro-peptides and algae which surround the muscles with proteins to block the skin from contracting strongly around muscles, whilst still allowing for some movement. Apparently, when the algae extract is combined with other ingredients, the skin around it will appear more youthful, without seeming to be ‘frozen’. Rather than being injected by a needle, VTOX is absorbed directly by the skin and is so safe, it can be bought online and used at home.

Summary: Botox can be described as a cosmetic treatment that is used to keep the skin wrinkle-free and young. The procedure is quite safe for anyone above the age of 18. Since the effects of the treatment are temporary, one may have to re-visit within 6 months in order to keep it the same way. As per the research, there is no such side effect of Botox if used under the supervision of your doctor in a safe manner.


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Written ByDr. Ashish DavalbhaktaMBBS Bachelor of Medicine and Bachelor of Surgery,FRCS (UK),FRCS,MS General Surgery,Mch (Plastic Surgery)Cosmetology
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