BOTOX® 101: The Ultimate Guide
Mabrie Facial Institute
166 Geary Street
Floor 1300
San Francisco, CA 94108
Phone: (415) 445-9513
Text/SMS: (866) 618-9459
Monday–Friday 8 a.m.–5:30 p.m.
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
- What Is BOTOX and How Does It Work?
- What does BOTOX treat?
- Are there alternative BOTOX uses?
- How does BOTOX compare to Dysport and other toxins?
- How much does BOTOX cost in San Francisco?
- How many units of BOTOX will I need?
- Will anyone be able to tell I’ve had BOTOX?
- How long does BOTOX last?
- How can I make my BOTOX results last longer?
- Is BOTOX safe?
- BOTOX vs. Fillers: What’s the Difference?
- Can you combine BOTOX with dermal fillers?
- How do you know when to start BOTOX?
- Does preventative BOTOX work?
- Does BOTOX hurt?
- Can you get BOTOX while pregnant?
- When can you lie down after BOTOX?
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.
Our Favorite
BOTOX® Cosmetic
Before AND After Photos
Case #1002:
BOTOX for Neck Definition & SlimmingCase #1002
In her 20s, we welcomed a bright and vibrant woman to Mabrie Facial Institute with a unique goal in mind. She wanted relief from shoulder tension and desired a defined and slender neckline.MFI TREATMENT PLAN
Trapezius Botox - YES - Botox can do that! Dr. Mabrie, our seasoned injector, used Botox to trea... Read More
Case #1272:
i360 Full Face with Facial SlimmingCase #1272
Our patient is a 40-year-old man who felt his face lacked structure and appeared rounder than he desired. He wanted a more masculine, defined look with visible contours, particularly along his jawline and chin. The goal was to achieve a slimmer, more sculpted appearance that would enhance his overall facial structure and... Read More
Case #655:
Frown Line Filler for Permanent Forehead LinesCase #655
This male patient was bothered by the deep frown line between his eyebrows, especially when he saw photos of himself. He reportedly had this crease since high school and had considered treatment for a while but was not sure if this was a problem we could fix for him. MFI TREATMENT PLAN
This amazin... Read More
Case #702:
Facial Slimming with Masseter BotoxCase #702
This beautiful patient in her early 30’s, experienced continuous jaw tension from grinding her teeth. This led to sleep disruption and created bulky masseter muscle bulk creating a boxy/square facial shape.MFI TREATMENT PLAN
BOTOX was used to treat her masseter muscles (our Facial Slimming treatment).... Read More
Case #1173:
Chin Botox to Reduced Downward PullCase #1173
Meet one of our lovely nurses at MFI! In her late 20s, she was eager to address a specific concern with her chin. Whenever she smiled, she noticed a noticeable inward tucking and pulling of her chin, giving it a "witchy" and pointy appearance. Despite her big, beautiful smile, this particular feature bothered... Read More
Case #1248:
Lower Face Filler and Botox Package: Reducing Marionette LinesCase #1248
Case #49:
Botox for Crow’s FeetCase #49
This patient, an active professional woman, wanted a refreshed look for her eye area. She noticed fine lines developing at the corners of her eyes, commonly known as crow’s feet. These lines became more pronounced with smiling and expressions, leading her to explore non-surgical options for treatment. Living in San Franci... Read More
Case #1166:
i360˚ Full Face: Drooping Brow, Masseter & Chin Botox with Under Eyes, Midface, Cheeks, Lip, Chin & Jawline FillerCase #1166
This beautiful patient in her late 30s was concerned about a slightly drooping, uneven brow position that made her eyes appear more hooded and tired than she felt. She hoped to achieve a lifted, more open look — without turning to surgery.MFI TREATMENT PLAN
As part of her i360 Full Face rejuvenation, we performe... Read More
Keep in mind that each patient is unique and your results may vary.
What does BOTOX treat?
The most common applications of BOTOX are:
At MFI, we specialize in using BOTOX to sculpt, slim, and soften the face and neck, including:
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
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.
| Product | Key Features | Onset | Duration |
|---|---|---|---|
 BOTOX | Gold standard; versatile for wrinkles & medical uses | 3-7 days | ~3-4 months |
 Dysport | Spreads more; ideal for larger areas | 2-3 days | ~3-4 months |
 Xeomin | Naked formula; no additives, lower resistance risk | 3-4 days | ~3-4 months |
 Jeuveau | Purely cosmetic; often used for frown lines | 3-4 days | ~3-4 months |
 Daxxify | Newer; peptide technology for longer duration | 1-2 days | Up to 6 months |
 Letybo | Latest FDA-approved; developed in South Korea | 3-5 days | ~3-4 months |
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.
Back to TopHow 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
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.
Back to TopHow 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.
Back to TopHow 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.
Back to TopThe 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 MeIs 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 (uncontrollable 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 Approved for treating severe underarm sweating (hyperhidrosis). | 2010s–Present Expanded indications include chronic migraines, overactive bladder, neck spasms (cervical dystonia), and more. Cosmetic applications also grow to include crow’s feet and forehead lines. |
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.
Back to TopRisks & Complications
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.
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
Case #1259:
i360˚ Full Face: Under Eyes, Midface, Cheeks, Nose, Jowl, Chin & Jawline FillerCase #1259
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
Case #624:
i360˚ Full Face: Forehead, Under Eyes, Cheeks, Nose, Jowl, Chin, Jawline, Lip & Perioral FillerCase #624
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
Case #404:
i360˚ Full Face: Forehead, Under Eyes, Midface, Cheeks, Nose, Chin & Jawline FillerCase #404
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
Case #433:
i360˚ Full Face: Under Eyes, Midface, Cheeks, Nose, Jowls, Chin & Jawline FillerCase #433
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
Case #748:
i360˚ Full Face: Under Eyes, Midface, Cheeks, Nose, Chin, Marionette Line Filler with Chin BotoxCase #748
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
Case #1368:
i360˚ Full Face: Masseter, Trapezius Muscle, Lip Flip & Forehead Botox with Under Eyes, Midface, Cheeks, Nose, Lip, Marionette Lines, Chin & Jawline FillerCase #1368
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
Case #1162:
i360˚ Full Face: From Square to Heart-ShapedCase #1162
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
Case #1349:
i360˚ Full Face: Parotid Glands, Chin & Forehead Botox with Under Eyes, Midface, Cheeks, Nose, Lip, Marionette Lines, Chin & Jawline FillerCase #1349
This active father in his mid 50s came to MFI feeling that he looked tired and older than he felt inside. With a youthful mindset and busy life caring for young children, he wanted his appearance to reflect his energy and confidence. His primary concern was the overall tiredness in his face — especially under the eyes and... Read More
Keep in mind that each patient is unique and your results may vary.
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.”
BOTOX smooths expression lines, lifts the brow, and slims the face for a refreshed look.
Fillers contour the face by restoring volume, brightening under-eyes, and defining the lips, jawline, and chin.
Strategic use of BOTOX and fillers creates harmony and natural-looking refinement.
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.
Back to TopDoes 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.
Back to TopDoes 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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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.
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.
Back to TopWhen 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.
Back to TopCome 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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