If you thought you knew all about BOTOX and what it can do, keep reading—we might just surprise you.

You know BOTOX smooths frown lines, crow’s feet, and forehead furrows, but the best injectors take it to the next level. Our team uses BOTOX and its sister products (Daxxify®, Dysport®, XEOMIN®) to treat much more than wrinkles. That’s why Mabrie Facial Institute in San Francisco was voted BEST BOTOX IN THE BAY AREA by SFGATE readers.

As a facial plastic surgeon, Dr. Mabrie was among the first to embrace injectables and has dedicated his practice to the masterful use of fillers and BOTOX. He has spent thousands of hours training his PA-C Injectors and creating an elite team of experts.

SFGATE - 2024 - Best of Bay Area Winner

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

Our Favorite BOTOX® Cosmetic
 Before AND After Photos

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Case: 1 of 9
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Before & After Forehead Wrinkles & Frown Lines Case 521 View #1 View in San Francisco, CA

Case #521:

BOTOX for Forehead Wrinkles and Frown Lines
Case: 1 of 8

Case #521

MFI TREATMENT PLANWe treated her horizontal forehead lines, frown lines, and crow's feet with Botox and Dysport to give her a refreshed but natural looking result.THE OUTCOMEThe patient is shown 2 weeks after her treatment.  Read More
Before & After Drooping Brow Case 821 View #1 View in San Francisco, CA

Case #821:

Drooping Brow Botox with Under Eye Filler
Case: 2 of 8

Case #821

ABOUT OUR PATIENT
Wanting a refreshed and rejuvenated look, this dedicated mother of two sought a solution to alleviate the constant effort required to keep her eyes open. MFI TREATMENT PLAN
PA-C Tiffany used Botox to the forehead and around the eyes to rejuvenate the upper eyelids, alleviating visible heavines... Read More
Before & After Drooping Brow Case 309 View #1 View in San Francisco, CA

Case #309:

Botox for Drooping Brow
Case: 3 of 8

Case #309

See her Full Face dermal filler Case here!ABOUT OUR PATIENT
This California woman in her 50's came to San Francisco to see me about taking care of the shadows that were beginning to appear underneath her eyes. I found her to be an excellent candidate for non-surgical facial fillers.MFI TREATMENT PLAN
In additi... Read More
Before & After Chin Bumps & Dimples Case 431 View #1 View in San Francisco, CA

Case #431:

Smoothing Chin Dimpling with Botox
Case: 4 of 8

Case #431

MFI TREATMENT PLAN
If you have a dimpled chin that doesn't project quite enough, BOTOX can help. A hyperactive mentalis muscle creates visible tension, causing the chin to appear less projected than desired.Even though Dr. Mabrie uses fillers for nonsurgical chin augmentation in some cases, they don't adequately addre... Read More
Before & After Facial Slimming Case 702 View #1 View in San Francisco, CA

Case #702:

Facial Slimming with Masseter Botox
Case: 5 of 8

Case #702

ABOUT OUR PATIENT
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
Before & After Facial Slimming Case 803 View #1 View in San Francisco, CA

Case #803:

Facial Slimming with Masseter Botox and Jawline Filler
Case: 6 of 8

Case #803

ABOUT OUR PATIENT
This busy mom wanted to contour/slim her face and keep looking fresh and vibrant. 

MFI TREATMENT PLAN
Our Facial Slimming with BOTOX was a perfect procedure to get started. To amplify her results, we added fillers to her cheeks, chin, and nose. BOTOX to the upper face (forehead, glabella, and c... Read More
Before & After Under Eye Wrinkles Case 863 View #1 View in San Francisco, CA

Case #863:

Before and After
Case: 7 of 8

Case #863

Case description coming soon!
Before & After Chin Bumps & Dimples Case 1186 View #1 View in San Francisco, CA

Case #1186:

Contouring & Projecting the Chin with Botox and Filler
Case: 8 of 8

Case #1186

ABOUT OUR PATIENT
Meet our lovely patient, a radiant woman in her 30s, who was eagerly preparing for her upcoming wedding. Like many brides-to-be, she had a vision of radiance and confidence for her special day. Entrusting her appearance to the expert hands of Dr. Mabrie, she wanted to enhance her natural beauty and achieve the perf... Read More

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

What Is BOTOX and How Does It Work?

BOTOX is in a class of medications called neuromodulators, which includes  Dysport®, XEOMIN®, Jeuveau®, and Daxxify®. Neuromodulators are made with a purified protein that, when injected into a targeted facial muscle, blocks the nerve impulses to that muscle. As a result, the muscle relaxes, and the skin lies smooth, reducing the appearance of wrinkles or, in the case of chin BOTOX, dimples. Relaxing certain overdeveloped muscles with BOTOX can shrink them, as is the case with the masseter (jaw) and the trapezius (neck).

The most experienced injectors have learned to use the muscle-relaxing powers of BOTOX in truly remarkable ways. By manipulating the delicate interplay of the facial muscles, a skilled BOTOX injector can

  • Gently lift the brows
  • Add upper lip height
  • Soften marionette lines
  • Reduce nasolabial folds
  • Smooth under eye bulges
  • Flatten neck bands

These applications should only be performed by injectors with a high degree of medical training and extensive knowledge of facial anatomy, like those at MFI. Incorrect injection techniques can cause cosmetic or even functional complications.

How Many Units of BOTOX Will I Need?

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, 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

How Does BOTOX Compare to Dysport and Other Toxins?

Here is a very quick comparison of the four neuromodulators we offer at Mabrie Facial Institute in San Francisco.

  • BOTOX: Considered the “gold standard” by some due to its history; versatile for wrinkles and medical uses. Onset: 3 to 7 days. Duration: ~3 to 4 months.
  • Dysport: Similar to BOTOX but spreads more; ideal for larger areas. Onset: 2 to 3 days. Duration: ~3 to 4 months.
  • XEOMIN: “Naked” formula (no additives), reducing the risk of resistance. Onset: 3 to 4 days. Duration: ~3 to 4 months.
  • Daxxify: Newer option with peptide technology. Onset: 1 to 2 days. Duration: Up to 6 months.

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 (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.

Preventative BOTOX

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 “micro-BOTOX” or “baby BOTOX,” and it’s becoming a routine self-care ritual for many young people.

After Your BOTOX Treatment

The beauty of BOTOX is that it’s truly a “lunchtime treatment.” The process is quick, and you can return to your typical daily activities right away. You may have some redness and swelling at the injection sites, but we’ll help you soothe these with a cold pack. You can apply concealer after about 30 minutes which should hide any redness.

Things to avoid for the first 24 hours after BOTOX injections:

  • Facials or other skin treatments, touching or rubbing the area
    Manipulating the skin may interfere with product placement and increase the risk of migration or irritation.
  • Alcohol, aspirin, or anti-inflammatories
    These increase the risk of bruising by thinning the blood.
  • Hot showers, saunas, steam rooms, strenuous exercise
    Heat, sweating, and elevated heart rate can increase blood flow, potentially affecting the product’s settling process and increasing the risk of bruising.

To learn more, visit our page about understanding the recovery process.

Once the treated muscles relax (in about 5 to 7 days), the skin smooths and lines and wrinkles fade. It can take up to a month to see a reduction in muscles like the trapezius or the masseter. 

BOTOX

Risks & 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 bruisingTemporary at the injection site.
Pain or discomfortMild and short-lived during or after treatment.
HeadacheTypically resolves within 24 to 48 hours.

Less Common Side Effects

AsymmetryUneven 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 appearanceOver-injection can lead to unnatural or stiff expressions.

Rare Complications

Allergic reactionsSymptoms may include rash, itching, or difficulty breathing.
Dry eyes or excessive tearingParticularly if injections are near the eyes.
Flu-like symptomsFatigue or mild fever post-treatment.
Double vision or blurred visionIf BOTOX migrates near the eye muscles.
Difficulty swallowing or speakingExtremely rare, usually from injections around the neck.
Muscle weakness in unintended areasIf the toxin spreads away from the injection site.

Minimizing Risks

Aside from the very common and expected side effects of redness, swelling, and sometimes bruising, the most likely risk with BOTOX is an unsatisfactory outcome such as asymmetry, drooping brows, or a frozen appearance. These, as well as some of the more serious yet rare medical risks, are more likely with a less experienced injector.

The key to avoiding these unwanted consequences is to choose a highly qualified injector. Look for a dedicated physician or PA-C injector with extensive training and experience with neuromodulator injections.

Here are some other things you can do to ensure a positive outcome.

  • Avoid specific medications: Blood thinners, NSAIDs, and supplements like fish oil can increase bruising risks.
  • Disclose your medical history: Mention any neuromuscular conditions (e.g., ALS, myasthenia gravis) or previous adverse reactions to BOTOX.

Most complications are mild and temporary, with serious risks being extremely rare when BOTOX is administered correctly. Always follow your provider’s pre- and post-treatment care instructions to reduce potential risks.

Combining BOTOX With Dermal Fillers

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 Complete Facial Rejuvenation or Contouring package, often called a “liquid facelift.”

Our Favorite Complete Facial Rejuvenation or Contouring
 Before AND After Photos

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Before & After Complete Facial Rejuvenation or Contouring Case 519 View #3 View in San Francisco, CA

Case #519:

i360˚ Full Face: Under Eyes, Midface, Nose, Chin & Jawline Filler
Case: 1 of 8

Case #519

ABOUT OUR PATIENT
This Bay Area professional consulted with Dr. Mabrie to revive her appearance.  In her 30s, she felt that she projected a tired appearance and was unhappy about her under eye bags.  She also wanted to contour and enhance her features without looking overly done.MFI TREATMENT PLAN
We creat... 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: 2 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 723 View #1 View in San Francisco, CA

Case #723:

i360 Full Face: Forehead, Under Eyes, Midface, Cheeks, Nose, Chin, Jawline, Lip & Perioral Filler
Case: 3 of 8

Case #723

ABOUT OUR PATIENT
After learning that MFI had a reputation for the most natural looking non surgical results, this patient in her 50’s selected us for her rejuvenation.  She felt her cheeks lacked volume and definition, hated the routine of overlining her lips, and noticed these “puppet lines'' and jowling in her... Read More
Before & After Complete Facial Rejuvenation or Contouring Case 571 View #1 View in San Francisco, CA

Case #571:

i360˚ Full Face: Cheek & Chin Contouring & Botox for Baby Face
Case: 4 of 8

Case #571

ABOUT OUR PATIENT
Our talented Physician Assistant Injector was continuously told that she looked younger than she was. She wanted her appearance to be age appropriate and to match her sophisticated maturity level. She also had a lot of clenching and jaw locking in her medical history, so the treatment she received helped her aesthetical... 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: 5 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 f... 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: 6 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
Before & After Complete Facial Rejuvenation or Contouring Case 532 View #1 View in San Francisco, CA

Case #532:

i360˚ Full Face: Under Eyes, Midface, Cheeks, Nose, Nasolabial Folds, Chin & Jawline Filler with Bunny Lines, Masseter, Chin Botox
Case: 7 of 8

Case #532

ABOUT OUR PATIENT
The first time our staff met this patient was through Skype since he lives in a different country! Our wonderful patient flew from Israel to come to visit our office based on his research and admiration of our website of various before and after photos. His goals were to fix the asymmetry in his facial structure and to... Read More

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

BOTOX Cosmetic FAQs

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.


Are there alternative BOTOX uses?

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

  • Migraines
  • Hyperhidrosis (excessive sweating)
  • Muscle spasms
  • Strabismus (lazy eye)
  • Overactive bladder

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.


How long does BOTOX Last?

Results appear in several days and will last about 3 to 4 months. You can maintain and improve upon the longevity of your results with regularly scheduled maintenance treatments.


How can I make my BOTOX results last longer?

If regularly scheduled BOTOX treatments aren’t providing you with the longevity you’re looking for, you might consider Daxxify, an advanced neuromodulator designed to extend the effects of treatment. While BOTOX typically lasts about 3 to 4 months, we are seeing Daxxify results last up to 6 months or more in many patients. It works similarly to BOTOX but contains a unique peptide stabilizer that helps prolong its effects. If you’re looking for fewer maintenance treatments while still achieving smooth, natural-looking results, Daxxify could be a great option to explore!


Can you get BOTOX while pregnant?

Researchers haven’t done studies on BOTOX in pregnant women, but out of an abundance of caution, 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.


When can you lay down after BOTOX?

Out of an abundance of caution, we recommend that you don’t lie down for the first 4-5 hours after you get your BOTOX injections. This isn’t because BOTOX “migrates” or shifts location when you lay down. It’s to prevent you from putting pressure or inadvertently rubbing on the treatment sites, which can cause the product to spread.


How do you know when to start BOTOX?

That is a very personal decision, but one we’re happy to discuss at MFI. 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.


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.


BOTOX isn’t working for me anymore. What can I do?

You may have developed antibody resistance, where the immune system neutralizes the botulinum toxin, or tachyphylaxis, where the body becomes less responsive over time. Daxxify might be a good option for you. It uses a peptide-enhanced formula that may reduce the likelihood of antibody formation and it lasts significantly longer—up to 6 months compared to BOTOX’s 3 to 4 months. This makes it a great option if you’re experiencing diminished results with BOTOX.

We’d Love To See You 

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 Procedure page was created just for you to help make planning your trip as smooth as possible.   

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.

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My experience at Mabrie Facial Institute was nothing short of amazing! Upon arriving the first thing...
My experience with The front office team, Nurse Lindsey and Dr. Mabrie was just fantastic. You walk...
Nurse Lindsay is phenomenal!! The education and follow up was detailed and concise. I have gotten fillers...
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