Expressions that are a natural part of our appearance and personality can become etched on our faces over time. When we smile, frown or squint, wrinkles form across the forehead, between the eyebrows and in the corners of the eyes. While the lines may only appear when we make those faces at first, they can become permanent fixtures on the face as the years pass. If you have noticed that there are more lines on your upper face, making you look perpetually tired, angry or worried, nonsurgical help is available.

BOTOX® Cosmetic is a neuromodulator that relaxes facial muscles when directly injected using a tiny needle. The medication serves to control the hyper-functional or overactive frown and squint lines. BOTOX® Cosmetic can also be used for other enhancements, such as elevating the brow line slightly at the first sign of drooping. In a few minutes of time at our office, you can refresh and rejuvenate your appearance with a visible reduction in facial lines.

Explaining Botox

Botulinum A toxin (Botox) is a therapeutic protein derived from the C Botulinum bacteria. It has been safely used for many years in the treatment of:

When injected in small doses, it works to temporarily paralyze the affected muscles to soften the facial imbalance release the spasm.

  • Eyelid spasm
  • Eye muscle spasm that causes crossed eyes
  • Correction of facial muscle imbalance
  • Neck muscle spasm

More recently, BOTOX® Cosmetic has been used to relax the active facial muscles that create seemingly permanent creases between the eyebrows, on the forehead and around the eyes over time. The same principles that make BOTOX® Cosmetic effective as a medical treatment make it efficient as a cosmetic treatment as well. Injecting small amounts of BOTOX® Cosmetic into these active facial muscles results in localized paralysis and a smoother, more relaxed facial expression.

BOTOX® Cosmetic Safety and Efficacy

Patients sometimes get nervous about BOTOX® Cosmetic and related products like Dysport, because they think of the botulinum toxin as a poison that was initially discovered in canned foods. However, the ingredient in the cosmetic products is a naturally-occurring protein. Like any medicine, in the right dose BOTOX® Cosmetic can be very beneficial, while the wrong dose or higher doses can be dangerous. Dr. Maas has been involved in the approval and comparative studies of neuromodulators including BOTOX® Cosmetic and Dysport. Both products have a 20+ track record of both safety and effectiveness for patients.

BOTOX® vs. Other Neuromodulators

Since neuromodulators all function essentially the same, the differences between them come down to tiny details in their applications. While one isn’t necessarily better than the others, one will definitely be better suited for you than the others depending on what you are trying to achieve. Here is a look at two of the most common other neuromodulators on the market and how they differ from BOTOX®.


One of the biggest differences between Dysport and BOTOX® is the dosage that is used during treatment. It is important that you find a physician like Dr. Maas who understands the differences in dosing requirements so that you have optimal and safe results. Dysport is also more prone to spreading to nearby muscle tissue, so using it on patients who are treating a larger surface area is generally better suited than those who need small, targeted areas. Dysport can also produce results slightly more quickly than BOTOX® in some cases.


The difference between Xeomin™ and BOTOX® is, for the time being, mostly theoretical. While other neuromodulators have “presumably inactive” proteins surrounding them, Xeomin™ strips those superfluous proteins away, thereby producing a purified version of a neuromodulator. The idea is that the inactive proteins could create antibodies that eventually block treatments like BOTOX® and Dysport from being effective. While very few of these blocks have ever developed, Xeomin™ is still a strong neuromodulator alternative that has shown to be just as effective as BOTOX® .

During your consultation with one of our medical professionals, we will work with you to determine which neuromodulator is best suited to your conditions. Since every patient is different — with their own unique anatomies and aesthetic goals — it is imperative that we take the time to ensure you aren’t just getting a cookie-cutter treatment instead of a highly tailored solution. 

BOTOX® Cosmetic Treatment Areas

BOTOX® Cosmetic works in the upper third of the face as primary therapy. The product may also be used for some lower facial applications, including the bands in the neck, the downturned corners of the mouth and small wrinkles around the upper and lower lip in some cases. By relaxing the overactive musculature that pushes the skin to form these lines when we squint, frown or raise our eyebrows, it addresses the root of this aging problem.

Dr. Maas has performed extensive research and published clinical papers related to the use of BOTOX® Cosmetic. In one of his recent articles, he writes:

“Botulinum toxin type A (BTX-A) has been used successfully for many years for various cosmetic indications. Its use for upper facial rhytides and dynamic line applications (most commonly for the treatment of glabellar lines, horizontal forehead lines, and crow’s feet) is particularly widespread. The use of BTX-A in the lower face initially was considered controversial because results were believed to be unpredictable. The demarcation between the upper and lower face was somewhat arbitrary and subjective, however, and the usefulness of this product for several lower facial and neck applications is becoming clear.

The forehead is probably the most unpredictable and poorly treated region of the upper face with neuromodulators. Injectors must balance the benefit of hyper-functional line improvement with relaxation of the only brow elevator, the frontalis, and attendant ptosis of the brow that will occur. Dosages exceeding 20 units in the forehead are rarely warranted, in the author’s opinion, because the trade of complete line effacement is not worth the side effect of noticeable brow ptosis.”

Can BOTOX® Cosmetic Change My Appearance?

While treatment of wrinkles is the primary purpose of BOTOX® Cosmetic injections, the formulation can also have a positive effect on the appearance in other ways in some patients. Keep in mind that neuromodulators like BOTOX® Cosmetic are relatively simple in their mechanism of action.

They relax the muscle that is treated. When administered, your surgeon is utilizing the different vectors of pull around the face to improve the shape, symmetry and overall contour of the face at the same time wrinkles are smoothed away.

In some cases, BOTOX® Cosmetic can even open up your eyes when you smile. In the early 2000s, Dr. Maas conducted a study that showed patients could achieve up to five mm of brow elevation when the brow is at rest after being treated with BOTOX® Cosmetic. When you smile, you elevate the cheek muscles, and the forehead comes down. With a BOTOX® Cosmetic lift, the brows will not descend as much, making your eyes look slightly more prominent when you smile. BOTOX® Cosmetic under the brow can also relax the downward pulling forces of the eye muscles, allowing the eyes to look more open at rest as well.

Who Should Administer Your BOTOX® Cosmetic Injections?

The BOTOX® Cosmetic injector you select does much more than merely administer your injections, according to Dr. Maas. This professional is also responsible for:

  • Providing information on the specifics of the procedure
  • Confirming that BOTOX® Cosmetic injections are the right choice for you
  • Offering reassurance about the safety and efficacy of the process
  • Bringing the experience, expertise and competence required for a safe and successful treatment

Dr. Maas has been a pioneer in the use of BOTOX® Cosmetic for cosmetic applications, and he and his associates have developed the techniques currently used to achieve maximum results while avoiding the “frozen,” “surprised” or “expressionless” look that concerns many prospective patients. His expertise in the use of BOTOX® Cosmetic injections has consequently led to the training of numerous other physicians for cosmetic applications.

Choosing a board-certified facial plastic surgeon like Dr. Maas to perform your BOTOX® Cosmetic injections means you’re in the hands of an expert who is intimately familiar with the movement and placement of each of the muscles and contours of your face.

Additional Uses for BOTOX®

While BOTOX® is used primarily as a remedy for fine lines and wrinkles, there are numerous alternative uses for this neuromodulator that have provided many patients with a ton of relief. Here are few of the different uses:

1. Migraines

While it isn’t the primary use, BOTOX® is actually FDA-approved for migraine treatment. By preventing muscle strain around your head, many patients are able to mitigate their chronic migraines by relieving the tension around that area.

2. Acne

There is preliminary research that shows that BOTOX® may be a good way to decrease oil production and acne through its injection into active acne lesions. While the market is already saturated with plenty of products that aim to rid you of lesions and blemishing, BOTOX® would provide a new, unique alternative way to reduce the appearance of acne.

3. TMJ 

Temporomandibular joint disorder is a condition in which the muscle that controls jaw movement begins developing pain. While this condition is typically treated by an oral surgeon or specialist, BOTOX® can help alleviate that pain through direct injections into the temporomandibular joint.

4. Hyperhidrosis

Some people experience overly active sweat glands, producing bothersome sweat that can seep through clothing in public despite tons of precautions and effort to avoid it. Luckily, combating hyperhidrosis is another treatment that BOTOX® excels at. By blocking signals to the sweat glands, you can prevent your body from producing the abundance of sweat that it usually does.

If you are interested in any of these alternative ways to use BOTOX®, let us know as soon as possible so that we can give you all the necessary information. 

About the Procedure

When you schedule your BOTOX® Cosmetic procedure at The Maas ClinicTM, we will make sure there is enough time to start your appointment with photographs. Images give us a baseline to work from, and if you have a concern or issue after your procedure, Dr. Maas can study the photos to produce optimal results. We encourage patients to come back two weeks after their treatment for additional pictures if possible so that we can ensure the best possible results from your procedure.

The second step of our Botox treatment is the application of a specially compounded topical numbing cream to reduce the sting of the injection needle. While Botox injections are not particularly painful, the addition of the numbing cream reduces discomfort by as much as 70 percent and is particularly helpful for patients who are sensitive to needles. The cream only takes around 20 minutes to take effect, so the addition of this step does not extend your appointment by a significant amount of time.

Combining Botox with other Neuromodulators

Patients sometimes ask Dr. Maas about mixing neuromodulators to take advantage of subtle differences between the products in hopes of improving their results. Dr. Maas has performed trials where BOTOX® Cosmetic was injected on one side of a patient’s face, and Dysport was administered to the other side. He found that Dysport had a slightly better smoothing effect on crow’s feet, which BOTOX® Cosmetic tended to work more efficiently locally in areas like forehead lines. Despite these findings, Dr. Maas generally advises against mixing neuromodulators in a single treatment session. There are no controlled trials to demonstrate the safety or efficacy of this practice, and it could even prevent a patient from getting the desired results.

After Your BOTOX® Cosmetic Treatment

Dr. Maas advises his patients to avoid aspirin and other nonsteroidal anti-inflammatories like Advil, Aleve and Motrin, to prevent bruising after Botox injections. Patients that follow these instructions tend to have few noticeable side effects after their procedure and can return to their activities without worry that their treatment is evident to others. Preliminary results may be noticeable right away and will continue to improve in the days following the treatment session. Injections of BOTOX® Cosmetic relax the facial muscle for three to four months on average.

Dr. Maas occasionally sees a patient that can go as long as six months between treatments. As a treatment that only needs to be performed two or three times a year, this minimally-invasive procedure is a popular one for patients that want to maintain a more youthful appearance but are not ready to invest their time and money into surgical options.

Beauty ValetTM: Beauty Made Convenient

You shouldn’t have to wait an hour for your injectable touch-up treatment. That’s a tenet that we firmly believe in, so, if you have a regular cosmetic regime that you stick to, it can be frustrating having to worry about making appointments and hassling with the process every single time.

This is why we developed Beauty Valet™ — to give you a convenient, hassle-free way to get your touch-up treatments without having to go through a frustrating process every time.

All you have to do is pull your car up to the door to be greeted by our personal, complimentary valet service and head into our office for your treatment. We work to get you in and out of your treatment within 15 minutes. No more waiting to be called as a walk-in or having to find parking.

Easy, smooth skin and a rejuvenated appearance with as little of your time as possible. Beauty Valet™ is available for BOTOX®, Dysport, Jeaveau or Xeomin™ treatments. You can give our office a call at (415) 567-7000 to learn more about this service.

Refresh, Rejuvenate, Restore

BOTOX® Cosmetic is a quick, efficient way to relax wrinkles in the upper face and achieve a refreshed, more youthful look. This procedure has a long track record of safety and just two or three treatments a year should be sufficient for allowing you to sport your rejuvenated appearance over the long term.

Corey S. Maas MDTM and the staff at The Maas ClinicTM look forward to answering any questions you might have about BOTOX® Cosmetic or any of our other anti-aging treatments. Call [phone] or contact us by email for more information.

The information about BOTOX was reviewed by Corey S. Maas MDTM. If you have any questions, please don’t hesitate to contact us using our contact form below.


Can Botox open up my eyes when I smile?

In some cases, it can! In the early 2000s, Dr. Maas conducted a study that showed patients can achieve up to 5 mm of brow elevation at rest after being treated with Botox. When we smile, we elevate the cheek muscles and the brow comes down. With a Botox lift, the brows will not descend so much, making your eyes look slightly bigger when you smile. At rest, Botox under the brow can also relax the downward pulling forces of the orbiculares (eye muscle), allowing the eyes to look more opened as well.

Choosing a board-certified facial plastic surgeon like Dr. Maas to perform your Botox injections means you’re in the hands of an expert who’s intimately familiar with the movement and placement of each of the muscles and contours of your face.

Schedule Consultation

Maas Clinic Patient Portal

Use myTouchMD to access important documents and information regarding your visits.

Copyright © 2024 Maas Clinic.

Privacy Policy

Designed By Incredible Marketing

"*" indicates required fields