Insights

Botox Injections: Costs, Side Effects & More

Talor Bianchini03 Aug 2021

Botox is a type of Botulinum type A injection used in small doses to treat a wide variety of medical conditions. Although it is more popularly known for its cosmetic purposes, it has uses in almost every sub-specialty of medicine. The cost of Botox is about $466 per procedure. Some side effects of botox include cold or flu symptoms, crooked smile/drooling, dizziness, and more.

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The Cost of Botox

It's important to find a provider within your budget but is also experienced and has had proper training. There are many risks associated with the procedure, so one should be wary of unlicensed professionals trying to offer big discounts on the procedure. This could lead to long-term damaging effects. 

Besides the provider, several other factors affect the cost, including supplies, amount, location, brand, and the area being treated. According to the American Society of Plastic Surgeons, the average cost of Botox is about $466 per procedure. 

How Botox is Priced

Botox is measured in units, which typically cost anywhere between $10 and $15 per unit. Normally, several units are needed for an injection site, but it varies for each person. The number of units used also depends on the area it is needed in. While one session may not be that expensive overall, it's important to note that botox injections are temporary. 

It only lasts for about 8-12 weeks and therefore requires a lot of follow-up appointments. Some doctors may provide a reduced cost for routine injections to help you save money. Keep in mind that an initial consultation with the person administering your injections may be an added cost. 

Types of Botox Injections

Botox is the most commonly used term for this type of medicine since it was the first injectable of its kind. There are other botulinum type A injections, including Dysport, Jeuveau, and Xeomin (although Botox makes up about 80% of the market). All of these are FDA-approved and safe to be used. 

Their distinction lies in how they are formulated, which affects factors like the dosage and how quickly one sees results. Therefore, they are not interchangeable, so speak with a provider to determine which is best for you. 

Comparison of Botulinum Type-A Treatment Costs

Drug Name

Average Cost per Treatment ($)

Average Annual Cost ($)

Botox

$714-$1428

$3570-$7140

Dysport

$428-$1428

$2428-6426

Xeomin

$660-$990

$3300-$4950

Jeuveau

$400-$600

$800-$1800

 Source: ncbi.nlm.nih.gov and enhancemyself.com

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Cosmetic vs. Therapeutic Botox Injections

Because of its versatility, botox treatments can be used for both cosmetic and therapeutic procedures. Originally, the drug was utilized to treat people with strabismus or crossed eyes. Only in 2002 did the FDA approve Botulinum type-A drugs to reduce the appearance of forehead lines and wrinkles. Both cosmetic and therapeutic botox work in the same way by stopping chemical signals from reaching certain muscles and stopping their contraction. 

Cosmetic 

Botulinum type-A injections are currently the most popular cosmetic procedure in the United States. People of all ages can utilize them to improve one’s appearance. The relaxation of the muscles at the injection site helps smooth the skin and reduce fine lines and wrinkles. However, results of the treatment are more dramatic for wrinkles seen during contraction (i.e., raising eyebrows, scrunching face, frowning, etc.) than those seen at rest. 

Areas where muscle activity changes your facial features are the most commonly treated and include things like:

  • Brow lift
  • Chin dents
  • Crow’s feet
  • Corners of the mouth
  • Frown lines
  • Forehead wrinkles

Recently, preventative botox has become popular to halt the onset of wrinkles. 

Therapeutic 

After its initial application for treating crossed eyes, botox was utilized for several spastic conditions. Today, Botox can be used in place of surgery in some cases. Most applications are for conditions that affect the neuromuscular system. There are multiple FDA approved medical uses for botox, including:

  • Preventing migraines that last 4 or more hours
  • Reducing overactive bladder
  • Eyelid spasms
  • Hypersalivation
  • Upper limb spasticity
  • Hyperhidrosis (palms of hands, armpits, soles of the feet)
  • Cervical dystonia

Although not FDA approved, people have found other therapeutic uses for botox like:

  • Jaw tension or TMJ
  • Alopecia
  • Psoriasis
  • Dyshidrotic eczema
  • Facial redness and flushing
  • Keloids
  • Scars from healing wounds

More research is necessary to confirm the safeness and effectiveness of these other off-label procedures. It's important to understand all of the risks and side effects of these uses of botox before moving forward with treatment. 

Side Effects of Botox

Botox is a powerful toxin and has the ability to lead to many complications if a qualified individual does not perform the procedure. As long as a licensed medical professional is administering your injections, there are only mild side effects to keep in mind. Most of these are experienced at the actual injection site, like bruising, infection, or redness. Your doctor may recommend that you stop taking any blood-thinning medication about two weeks before your treatment to help prevent intense bruising. 

Other potential side effects include:

  • Cold or flu symptoms
  • Crooked smile/drooling
  • Dizziness
  • Dry eyes
  • Headache
  • Muscle weakness
  • Nausea

Because of the potential reactions listed above, it's recommended to go home immediately following your appointment. Patients are also advised not to lay down facing up for at least 3-4 hours after receiving injections. 

To prevent the spread of the toxin to other parts of the body, you should not apply any heat to the area, massage the injection site, or participate in any activities that would cause flushing (like exercise or consuming alcohol). If this does happen, you may experience vision weakness, breathing problems, loss of bladder control, or trouble speaking. If these persist days (or even hours) after your procedure, be sure to contact your doctor immediately. 

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Another potential side effect is the possible development of neutralizing antibodies after the first round of botox a patient receives. This leads to non-responsiveness to the injections and could cause follow-up injections that are too close together or getting more units injected at each session. This is only experienced in 5-15% of patients. The best way to reduce this risk is by using the smallest amount of botox needed for the desired result and having follow-up appointments more than a month apart. 

Botox Injections Frequently Asked Questions (FAQs)

There are a lot of things to consider before deciding to get botox injections. Here are a few commonly asked questions about the drug and procedure to help you determine if it's the right decision for you. 

Where can I get botox injections?

Botox injections are most commonly performed at medical spas, skincare clinics, and cosmetic surgery offices. Because of its versatility, you may receive injections from a neurologist, a urologist, a dermatologist, or even an ophthalmologist depending on your medical needs. There are even some urgent care facilities that offer this procedure, but this too can get expensive. 

How long until I see results?

Overall, the effects of the procedure will vary depending on the treated area, the kind of botox used, and the patient themself. Typically, the toxin takes around 24-72 hours to take effect, but some may not see results until up to 5 days after. Botox reaches its peak at 10 days and lasts anywhere from 8-12 weeks after that. 

What is the procedure like?

First, you should expect to have a consultation of some sort with a medical provider to determine which areas they will be treating and what your desired results are. Before the treatment starts, a topical numbing treatment will be applied to the injection site. They will then begin injecting the toxin with a very thin needle at several points of the treatment area. You should expect to feel a slight pinching sensation from the needle. 

What are the risks of botox injections?

Small doses of botox are considered safe by the FDA, and there have only been 36 documented cases of adverse reactions in cosmetic uses. In fact, there are greater risks with therapeutic injections because they often require higher doses. There are also great risks associated with being pregnant or allergic to cow’s milk protein and receiving botox, so it is highly advised against. If you experience botulism-like symptoms, seek help immediately. Unfortunately, there is limited research on the long-term effects of botox. 

Will insurance cover Botox?

If you choose to get botox for a cosmetic reason, it will not be covered under your health insurance. On the other hand, depending on your provider, you could get a therapeutic procedure covered as long as it is FDA approved and other treatments have not worked for you. 

Bottom Line

Botox injections have multiple clinical and cosmetic applications that many people aren’t even aware of. Like many procedures, there are potential risks and side effects associated with the treatment, and it's important to educate yourself before following through with getting botox.