When it comes to your face, straight answers matter. At Mabrie Facial Institute, we combine deep expertise in facial anatomy with over two decades of hands-on experience to bring you clear, honest guidance. On this page, you’ll find everything you need to know about BOTOX—from how it works and how long it lasts to treatment areas, risks, recovery, and more. Consider this your expert guide to BOTOX, from a facial plastic surgeon with 20+ years of experience. 

Looking for the most advanced, personalized BOTOX treatments and stunning results?

Learn about how MFI provides the Best BOTOX in the San Francisco Bay Area.

Quick Facts About BOTOX

Action:1. Smooths wrinkles
2. Reduces tension

Pain Level:Minimal

Safety:FDA Approved

Appointments Needed: 1

Duration:Results Last 3 to 4 Months

Visible Results:Lines, 5 to 10 days;
Muscles, 3 to 4 weeks

Downtime:None

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What Is BOTOX and How Does It Work?

BOTOX is an advanced clinical tool derived from a purified protein that temporarily relaxes targeted muscles—and in some cases, glands—by blocking the signals that cause them to contract. For most classic uses, this relaxation smooths away wrinkles caused by overactive muscles. But at MFI, we also use BOTOX in a more sculptural way: to release tension in areas like the masseters (jaw), trapezius (neck/shoulders), and mentalis (chin). This not only brings comfort but can also refine the contour of the jawline, neck, and chin, helping shape the face in addition to softening lines.

diagram showing muscle relaxation using Botox
diagram showing muscle relaxation using Botox
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Our Favorite BOTOX® Cosmetic
 Before AND After Photos

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Case: 1 of 9
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Before & After Bunny Lines & Nose Wrinkles Case 876 View #1 View in San Francisco, CA

Case #876:

i360 Full Face with Botox for Bunny Lines
Case: 1 of 8

Case #876

ABOUT OUR PATIENT
This female in her 40’s wanted to soften the wrinkles to her upperface. MFI TREATMENT PLAN
Dr. Mabrie customized a plan, expertly administering BOTOX to address the forehead lines, frown lines, and crow's feet. By skillfully anchoring facial muscles, a harmonious result was achieved, allowing... Read More
Before & After Nasolabial Folds Case 1154 View #2 View in San Francisco, CA

Case #1154:

Softening Nasolabial Folds with Botox
Case: 2 of 8

Case #1154

ABOUT OUR PATIENT
Nasolabial folds (NLFs), aka “smile lines” or “laugh lines,” can be especially bothersome to patients as they tend to be noticeable even at rest and deepen over time as the face naturally loses collagen.This female patient in her 60s was particularly troubled by these lines that gave her an aged appearance. Moreove... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 748 View #1 View in San Francisco, CA

Case #748:

i360˚ Full Face: Under Eyes, Midface, Cheeks, Nose, Chin, Marionette Line Filler with Chin Botox
Case: 3 of 8

Case #748

ABOUT OUR PATIENT
This patient, a woman in her 50's, came to Mabrie Facial Institute seeking facial rejuvenation. She expressed concerns about the appearance of fine lines, wrinkles, and volume loss, particularly around her cheeks, eyes, and mouth. As an African American woman, she desired a treatment plan that would enhance her natural fe... Read More
Before & After Facial Slimming Case 854 View #1 View in San Francisco, CA

Case #854:

i360 Full Face with Facial Slimming
Case: 4 of 8

Case #854

ABOUT OUR PATIENT
Let me introduce you to our delightful 35-year-old patient, who exudes vibrancy and charm. She grappled with the frustration of a square-shaped face, a feature she felt was exacerbated by the persistent tension she held in her jaw. Years of clenching and grinding her teeth had inadvertently sculpted her masseter muscles... Read More
Before & After Under Eye Wrinkles Case 890 View #1 View in San Francisco, CA

Case #890:

Before and After
Case: 5 of 8

Case #890

ABOUT OUR PATIENT
This former athlete in his 40s came to us after years of trying (and tiring of) under eye creams that never delivered the results he wanted. His primary concern was the fine lines and creasing under and around his eyes that made him appear older and more fatigued than he felt. He was ready for a lasting, natural-looking s... Read More
Before & After Forehead Wrinkles & Frown Lines Case 905 View #1 View in San Francisco, CA

Case #905:

Forehead Botox with Under Eye Filler
Case: 6 of 8

Case #905

ABOUT THIS TREATMENT
Allow us to introduce our patient, a vibrant 40-year-old man who, like many of us, was troubled by the presence of deep horizontal indentations on his forehead, commonly referred to as "frownies." Despite his youthful spirit, these pronounced lines were starting to affect his confidence and how he perceived... Read More
Before & After Crow's Feet Case 510 View #1 View in San Francisco, CA

Case #510:

Botox for Crow’s Feet
Case: 7 of 8

Case #510

ABOUT OUR PATIENT
This patient in his 40s came to us at the encouragement of his wife, who noticed that fine lines around his eyes and deeper wrinkles between his brows were giving him a more serious appearance than his naturally upbeat personality. His primary concern was softening his crow’s feet, while still looking like himself — just... Read More
Before & After Drooping Brow Case 770 View #1 View in San Francisco, CA

Case #770:

Botox for Drooping Brow
Case: 8 of 8

Case #770

ABOUT OUR PATIENT
This late 20’s beauty was looking for a way to give her eyes some vibrance of brightness and openness. MFI TREATMENT PLAN
Botox was used near the eyebrows to elevate making this patient's eyes appear more open.THE OUTCOME
The focal point has shifted from the heavy eyelid skin to sc... Read More

Keep in mind that each patient is unique and your results may vary.

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What does BOTOX treat?  

The most common applications of BOTOX are: 

Forehead Lines

Before & After Forehead Wrinkles & Frown Lines Case 687 View #2 View in San Francisco, CA
Before
After

Brow Lift

Before & After Drooping Brow Case 1333 Right Oblique View in San Francisco, CA
Before
After

Frown Lines

Before & After Forehead Wrinkles & Frown Lines Case 751 View #1 View in San Francisco, CA
Before
After

Crow’s Feet

Before & After Crow's Feet Case 510 View #1 View in San Francisco, CA
Before
After

Bunny Lines

Before & After Bunny Lines & Nose Wrinkles Case 818 View #1 View in San Francisco, CA
Before
After

At MFI, we specialize in using BOTOX to sculpt, slim, and soften the face and neck, including: 

Temple Slimming

Before & After Sunken Temples Case 1346 Left Oblique View in San Francisco, CA
Before
After

Nasolabial Folds

Before & After Nasolabial Folds Case 485 View #1 View in San Francisco, CA
Before
After

Facial Slimming

Before & After Facial Slimming Case 1217 View #1 View in San Francisco, CA
Before
After

Lip Flip

Before & After Lip Filler - Subtle Case 864 View #1 View in San Francisco, CA
Before
After
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Are there alternative BOTOX uses? 

In addition to their cosmetic applications, BOTOX injections are also used to treat medical conditions including: 

  • Migraines 
  • Hyperhidrosis (excessive sweating) 
  • Muscle spasms 
  • Strabismus (lazy eye) 
  • Overactive bladder 
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How does BOTOX compare to Dysport and other toxins? 

While BOTOX is the most well-known, other FDA-approved neurotoxins like Dysport®, XEOMIN®, Jeuveau®, Daxxify®, and Letybo® offer subtle differences in formulation, onset, duration, and diffusion, making the best choice dependent on your unique anatomy, goals, and provider expertise. 

ProductKey FeaturesOnsetDuration
Botox vialBOTOXGold standard; versatile for wrinkles & medical uses3-7 days~3-4 months
Dysport vialDysportSpreads more; ideal for larger areas2-3 days~3-4 months
Xeomin vialXeominNaked formula; no additives, lower resistance risk3-4 days~3-4 months
Jeuveau vialJeuveauPurely cosmetic; often used for frown lines3-4 days~3-4 months
Daxxify VialDaxxifyNewer; peptide technology for longer duration1-2 daysUp to 6 months
Letybo vialLetyboLatest FDA-approved; developed in South Korea3-5 days~3-4 months
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How much does BOTOX cost in San Francisco? 

The price of your BOTOX treatment is dependent on the amount of product used, the number of treatment areas, and the Injector. Prices are subject to change, so please call or check our Procedure Pricing page for current pricing. 

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How many units of BOTOX will I need? 

On average, each treatment area takes between 10 and 30 units, but you could need as few as one unit or as many as hundreds of units; it all depends on the concern being treated, the number of treatment areas, and other factors. Interestingly, men tend to require more BOTOX than women due to their larger and stronger facial muscles. While we cannot precisely determine how much product each patient will need for specific treatment concerns without a consultation, we can provide a general estimate. Please refer to the graphic for the average units per treatment area for both women and men. 

Average botox units used per area

units of botox for women
units of botox for men
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Will anyone be able to tell I’ve had BOTOX? 

Ideal BOTOX results are detectable, but not obvious. You should look relaxed and refreshed, as if you’ve had a restful vacation. At MFI, we specialize in BOTOX treatments that produce natural-looking results. We like to say that people will notice, but no one will know. 

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How long does BOTOX last? 

Results appear in several days and last about 4 to 6 months, depending on the treatment area. Regularly scheduled touch-up treatments can maintain and improve the longevity of your results. 

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How can I make my BOTOX results last longer? 

If you’re interested in longer-lasting results, you may want to consider Daxxify, the next generation of neuromodulator. On average, most patients experience a similar duration to BOTOX—about 3–4 months. That said, around 25% of our patients have seen results last about 50% longer. We’ve also treated patients who noticed little to no effect from BOTOX but responded beautifully to Daxxify. If you’d like the possibility of fewer maintenance visits while still enjoying natural, smooth results, Daxxify may be a great option to explore. 

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The MFI Advantage

MFI focuses exclusively on injectables and has set the bar in the art and science of fillers for more than 15 years. Dr. Mabrie, trained as a facial plastic surgeon, has dedicated thousands of hours to refining the most innovative, effective, and safe techniques for injectables. There is no other practice in the Bay Area with the level of experience, education, and passion for injectables you’ll find at MFI.

Schedule Me
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Is BOTOX safe? 

When performed by an experienced medical professional (like all MFI Injectors), BOTOX is extremely safe. Botulinum toxin has been used therapeutically for more than 35 years and was approved by the FDA for cosmetic use in 2002. Here’s a brief timeline of the development of BOTOX for clinical and cosmetic uses: 

1970s Dr. Alan Scott develops botulinum toxin for medical use, initially exploring it as a treatment for strabismus (crossed eyes).1980s The FDA approves botulinum toxin (under the name Oculinum) for treating strabismus and blepharospasm (eyelid twitching).1989 Allergan acquires the rights to botulinum toxin and rebrands it as BOTOX®.
2002 The FDA approves BOTOX for
cosmetic use
to reduce frown lines (glabellar lines) between the eyebrows.
2004 The FDA approves BOTOX for treating severe underarm sweating (hyperhidrosis).2010s–Present The FDA expands BOTOX indications to include crow’s feet and forehead lines, and medical uses like migraines and neck spasms.

According to the American Society of Plastic Surgeons (ASPS), in 2023, their members performed 4,715,716 BOTOX injections, with only a relative handful of adverse effects, most of which were related to underlying medical conditions. Research indicates the number of BOTOX injections in the United States last year likely exceeded 9 million.

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What are the risks & complications of BOTOX?

While BOTOX is generally considered safe when administered by a qualified professional, some risks and complications can occur. These include:

Common Side Effects

  • Redness, swelling, or bruising: Temporary at the injection site.
  • Pain or discomfort: Mild and short-lived during or after treatment.
  • Headache: Typically resolves within 24 to 48 hours.

Less Common Side Effects

  • Asymmetry: Uneven results if BOTOX affects one side more than the other.
  • Eyelid or brow drooping (ptosis): Caused by diffusion or injection of BOTOX into unintended muscles.
  • Frozen appearance: Over-injection can lead to unnatural or stiff expressions.

Rare Complications

  • Allergic reactions: Symptoms may include rash, itching, or difficulty breathing.
  • Dry eyes or excessive tearing: Particularly if injections are near the eyes.
  • Flu-like symptoms: Fatigue or mild fever post-treatment.
  • Double vision or blurred vision: If BOTOX migrates near the eye muscles.
  • Difficulty swallowing or speaking: Extremely rare, usually from injections around the neck.
  • Muscle weakness in unintended areas: If the toxin spreads away from the injection site.
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BOTOX vs. Fillers: What’s the Difference? 

It’s common to confuse dermal fillers and neuromodulators like BOTOX®, but these treatments work in very different ways. 

Dermal fillers add structure and volume. They build and contour areas where the face has lost fullness or definition, smooth deeper folds, and enhance features like the lips, cheeks, and jawline. Think of fillers as adding support beneath the skin. 

Neuromodulators (BOTOX, Dysport®, XEOMIN®, Daxxify®) work by relaxing overactive muscles that cause wrinkles and unwanted bulk. They soften expression lines, slim or debulk certain facial areas, and prevent new dynamic wrinkles from forming. 

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Our Favorite Complete Facial Rejuvenation or Contouring
 Before AND After Photos

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Case: 1 of 9
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Before & After Complete Facial Rejuvenation or Contouring Case 624 View #2 View in San Francisco, CA

Case #624:

i360˚ Full Face: Forehead, Under Eyes, Cheeks, Nose, Jowl, Chin, Jawline, Lip & Perioral Filler
Case: 1 of 8

Case #624

ABOUT OUR PATIENT
This vibrant patient in her 40s came to us after transforming her body through professional bodybuilding, but still felt her face didn’t reflect the same vitality and strength. Her primary concern was facial volume loss, particularly in the midface, which became more noticeable with time. She wanted to feel as confident i... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 1331 Front View in San Francisco, CA

Case #1331:

i360˚ Full Face: Under Eyes, Midface, Cheeks, Nose, Lips, Chin & Jawline Filler
Case: 2 of 8

Case #1331

ABOUT OUR PATIENT
This vibrant 20-year-old patient began her MFI journey with subtle enhancements to her nose, lips, and chin—laying the foundation for a natural, balanced aesthetic. Over time, she returned to refine additional areas, with the shared goal of enhancing her features while maintaining soft, harmonious proportions. Using our I... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 434 View #2 View in San Francisco, CA

Case #434:

i360˚ Full Face: Lips, Under Eyes, Midface, Cheeks, Nose, Chin & Jawline Filler with Masseter Botox
Case: 3 of 8

Case #434

ABOUT OUR PATIENT
This beautiful patient in her 30s, who’s also one of our own nurses, came to MFI looking to refresh her appearance and bring her natural energy to the surface. Though she felt youthful and vibrant on the inside, she noticed volume loss and early signs of facial aging that didn’t match how she felt. Her primary concern was... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 1162 View #1 View in San Francisco, CA

Case #1162:

i360˚ Full Face: From Square to Heart-Shaped
Case: 4 of 8

Case #1162

ABOUT OUR PATIENT
This radiant patient, in her late 30s, came to us from out of state seeking a refreshed, more balanced appearance. She was about to celebrate a milestone of turning 40! Her main concern was a tired look that didn’t reflect how vibrant she felt inside. She also wanted to correct facial asymmetry and achieve a brighter, lif... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 1259 Right Oblique View in San Francisco, CA

Case #1259:

i360˚ Full Face: Under Eyes, Midface, Cheeks, Nose, Jowl, Chin & Jawline Filler
Case: 5 of 8

Case #1259

ABOUT OUR PATIENT
This vibrant woman in her 60s came to MFI seeking a non-surgical way to refresh her appearance while still looking like herself. Her primary concern was overall facial aging, and she hoped to restore volume, balance her features, and achieve a more lifted, youthful look — without surgery. She also had a specific functiona... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 1368 Front View in San Francisco, CA

Case #1368:

i360˚ Full Face: Masseter, Trapezius Muscle, Lip Flip & Forehead Botox with Under Eyes, Midface, Cheeks, Nose, Lip, Marionette Lines, Chin & Jawline Filler
Case: 6 of 8

Case #1368

ABOUT OUR PATIENT
In her 20s, this patient came to us seeking an expert opinion on how to elevate her overall appearance — not with a single treatment, but with a strategic plan to restore balance, glow, and subtle definition across her face. She had previously received filler elsewhere, particularly in the cheeks, which left her looking o... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 404 View #2 View in San Francisco, CA

Case #404:

i360˚ Full Face: Forehead, Under Eyes, Midface, Cheeks, Nose, Chin & Jawline Filler
Case: 7 of 8

Case #404

ABOUT OUR PATIENT
This patient came to me with two goals. The first was to correct his nose, he had a Surgical Rhinoplasty 2 decades previously but felt his nasal bridge could be straighter and his nasal tip more defined. The second was to enhance his cheeks and he was interested in learning the difference between cheek implants, fat tra... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 433 View #1 View in San Francisco, CA

Case #433:

i360˚ Full Face: Under Eyes, Midface, Cheeks, Nose, Jowls, Chin & Jawline Filler
Case: 8 of 8

Case #433

ABOUT OUR PATIENT
Our patient from Texas, flew to the West Coast to receive a full face treatment with us. He previously had a mini surgical face lift but was still interested in a procedure that would enhance his anti-aging goals without going under the knife twice. He also wanted to correct the volume loss and loose skin in his face af... Read More

Keep in mind that each patient is unique and your results may vary.

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Can you combine BOTOX with dermal fillers?  

Yes, combining BOTOX with fillers is a popular approach to non surgical enhancement. While BOTOX improves wrinkles or contour irregularities caused by muscle contractions, dermal fillers can improve a wide variety of concerns caused by volume loss, such as nasolabial folds (parentheses), smile lines, and under eye circles and bags. We also use filler to sculpt features such as the nose, cheeks, lips, and jawline. At MFI, we combine BOTOX and fillers in our Illumination 360° Full Face package, often called a “liquid facelift.” 

Strategic Balance With BOTOX + Fillers
Botox - Before
Before

BOTOX smooths expression lines, lifts the brow, and slims the face for a refreshed look.

Botox + Fillers
BOTOX + Fillers

Fillers contour the face by restoring volume, brightening under-eyes, and defining the lips, jawline, and chin.

Botox - After
After

Strategic use of BOTOX and fillers creates harmony and natural-looking refinement.

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How do you know when to start BOTOX? 

The starting age for BOTOX can range from your 20s to 50s and beyond. Some people wait until they are bothered by lines and wrinkles that won’t go away. This is commonly anytime from your late 30s to your 50s. Other individuals take a preventative approach and choose to start treatment in their 20s or early 30s. 

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Does preventative BOTOX work? 

Yes—preventative BOTOX can delay the formation of deeper lines by relaxing facial muscles before wrinkles become etched in. In fact, Millennials and Gen Z have embraced BOTOX as a “pre-juvenation” treatment. Starting neuromodulators in your 20s or 30s can postpone the formation of dynamic wrinkles such as the vertical lines between the brows, crow’s feet, and forehead furrows. We have patients who are now in their late 30s and 40s who swear by preventative BOTOX—they still don’t have lines in these areas. Due to the smaller quantities used, this is often referred to as “baby BOTOX,” and it’s becoming a routine self-care ritual for many young people.  

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Does BOTOX hurt? 

While BOTOX injections aren’t entirely pain-free, our patients find them very tolerable. The needle we use is very fine, and injections are shallow. Most people describe the sensation as comparable to an insect bite. 

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Dr Mabrie and clinician showcasing machine

Nervous About Needles?

We understand that some patients feel anxious about facial injections. We’ve curated an experience designed to help you feel calm, confident, and in-control every step of the way:

  • Nitrous Oxide (Laughing Gas) – Self-regulated for instant anxiety relief
  • Topical Numbing Cream – Applied before injections for comfort
  • Calming Vibration Devices – Distract and soothe
  • Stress Balls & Weighted Blankets – Grounding, tactile reassurance

Choose what you need, when you need it. Visit our full Comfort & Care page for more.

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Can you get BOTOX while pregnant? 

Researchers haven’t done significant studies on BOTOX in pregnant women, but it is not recommended that you get BOTOX while you are pregnant or breastfeeding. The primary concern would be the possibility of the drug entering your bloodstream and affecting the baby’s health, and there simply isn’t enough research to say conclusively that there is no risk of this. 

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When can you lie down after BOTOX? 

Give your BOTOX a little time to settle in before you do. For the first 4–5 hours, stay upright—not because gravity makes the product “wander,” but to avoid pressing or rubbing the treated areas, which could cause it to shift. After that, feel free to recline, nap, or relax knowing your results are right where they should be. 

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Come In for a Consultation 

Find out why so many women and men choose Mabrie Facial Institute for BOTOX treatment in the San Francisco Bay Area. Request a consultation online with one of our Injectors, or call us at (415) 445-9513 to schedule your initial appointment. If you’ll be visiting us from outside the area, our Fly in for Your Procedurepage was created just for you to help make planning your trip as smooth as possible.    

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A Reputation Built on Results

Crystal was so sweet and helpful for this whole process. I was so nervous but she was great!
I cannot recommend Dr. Mabrie and Lyndsey enough! From my very first consultation to the final result,...
I have been a patient of Dr. Mabrie's for a long time and I truly appreciate him and the entire staff....
I had my long overdue appt with Dr Mabrie today. There aren’t words to express how much I love this...
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