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Dr. Beverly Friedlander

BOTOX® Cosmetic

BOTOX® Cosmetic is the most commonly performed non-invasive cosmetic treatment in the world. For years, BOTOX® Cosmetic has made a name for itself as the number one option to treat frown lines, crow’s feet, and forehead lines without looking unnatural. This quick and simple treatment proves that sometimes the smallest change can have the most significant impact on your appearance and confidence. The presence of premature lines and wrinkles can affect the way patients present themselves in both social and professional settings. Using BOTOX® Cosmetic, Dr. Friedlander can restore natural-looking youthfulness so that her patients can look and feel their best.

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What is BOTOX® Cosmetic?

BOTOX® Cosmetic was the first of a group of products now known collectively as neuromodulators. These products are approved for cosmetic and non-cosmetic uses.BOTOX® Cosmetic was introduced in 2002 and was the first FDA-approved treatment for moderate to severe frown lines between the brows, fine wrinkles or lines next to the eyes called “crow’s feet”, and horizontal forehead lines.

Is BOTOX® Cosmetic safe?

Botox® Cosmetic has been extensively studied and is approved for cosmetic use in 96 countries. It has a long safety record.

How does BOTOX® Cosmetic work?

BOTOX® Cosmetic works by temporarily reducing the activity of muscles that cause wrinkles. It prevents the nerve impulse from getting to the muscle thereby preventing its contraction, resulting in the visible smoothing of your wrinkles. As the BOTOX® Cosmetic wears off, the muscle begins to respond to the nerve impulse, leading to contraction and reoccurrence of the lines and wrinkles.

Over the years, these repeat contractions imprint a furrow or wrinkle into the skin causing visible lines even in younger adults. These lines can be difficult to eliminate if they are longstanding or associated with sun damage. Your deep wrinkles are associated with muscle memory and are made worse by sun damage and age. Considering that we lose about one percent of the collagen in our skin per year after the age of 20, it’s no wonder that these lines can begin at an early age.

Am I a candidate for BOTOX® Cosmetic?

BOTOX® Cosmetic is ideal for you if you have moderate to severe wrinkles and are unhappy with your tired, angry, or rundown appearance. While some patients choose to wait until fine lines and wrinkles have already appeared, others use BOTOX® Cosmetic as a preventative treatment. While BOTOX® was initially created for therapeutic purposes, it has been adapted for cosmetic use to combat the appearance of:

  • Frown Lines (“11” lines)
  • Crow’s Feet
  • Forehead Lines
  • A Gummy Smile
  • A Downturned Smile
  • Neck Bands (seen on the neck as we age)
  • Strong or Square Jaw (caused by an overactive Masseter Muscle)
  • Smoker’s Lines (vertical lines seen on the lips)
  • Bunny Lines (lines on the side of the nose)
  • Peach Pit Chin (lines on the front of the chin)
  • Thin Upper Lip (it relaxes the muscle a bit)

How does BOTOX® Cosmetic differ from fillers?

While both BOTOX® Cosmetic and facial fillers treat fine lines and wrinkles, they are two very different treatments. BOTOX® Cosmetic prevents muscles from contracting while fillers add fullness to facial areas that have experienced volume loss. Fillers are better suited for static lines present at rest, such as nasolabial folds or marionette lines, while BOTOX® Cosmetic treats dynamic lines, or lines that are more noticeable with expressions such as frowning, squinting, smiling, or showing surprise.

What are dynamic lines?

Dynamic lines are created by repeated muscle movements. Over time, facial expressions create permanent lines and wrinkles in the skin. These lines often develop before static lines, which form due to age and are present even when the face is at rest. Dynamic lines can be challenging to eliminate because they are caused by everyday movements and not the aging process. BOTOX® Cosmetic is an effective treatment because it immobilizes the tiny muscles responsible for dynamic lines.

How does Botox® Cosmetic effect the surrounding muscles?

Botox® Cosmetic spreads a little after it is injected. That is why its important to have an experienced injector such as Dr. Friedlander perform your treatment. She will explain the concept of effect and counter effect. Muscles do many things. Using the brow as an example, some muscles pull it up, and some muscles pull it down. By precisely injecting the Botox® Cosmetic, you can selectively block the muscles that control brow movement. By weakening the muscle that pulls it down, the muscle that pulls it up becomes stronger, a lot like a SeeSaw. It is important to understand how all the surrounding muscles function to be able to create a natural look.

When should I start BOTOX® Cosmetic?

The best time to start using BOTOX® Cosmetic is when you see lines or wrinkles that are bothering you. Many women start seeing wrinkles in their 20s or 30s, particularly if they spend a great deal of time online or in the sun. Remember, we lose one percent of the collagen in our skin annually beginning in our 20s. That is why we cite age as a cause of wrinkles. Some people use BOTOX® Cosmetic for prevention. This makes sense because the reduction in repetitive muscle contractions prevents wrinkles and keeps the face looking natural and youthful.

How do I prepare for my treatment?

Make sure your skin is clear and free of acne. BOTOX® Cosmetic cannot be used in areas of active acne or infection. Dr. Friedlander asks that you avoid aspirin, NSAIDs, blood thinners, and tobacco use before your BOTOX® Cosmetic treatment. Blood thinners increase your chance of post-treatment bruising, and tobacco use puts you at higher risk for complications.

What will my BOTOX® Cosmetic procedure be like?

An effective BOTOX® Cosmetic treatment relies on the knowledge and skill of your provider. Every muscle in the face is responsible for different movements. Experienced doctors like Dr. Friedlander know precisely where the treatment will have the most significant, natural-looking effect. The BOTOX® Cosmetic procedure itself only takes a few minutes to complete and involves a series of injections using a fine needle. Most patients experience little discomfort and compare the feeling of the injection to a tiny pinprick or bug bite.

What can I expect after my treatment?

The effects of BOTOX® Cosmetic take between one and three days to become noticeable, with results lasting up to four months. BOTOX® Cosmetic injections may be repeated as often as necessary. The visible improvements may last longer after multiple treatments because of a loss of muscle memory.

You can resume normal activities immediately after your BOTOX® Cosmetic treatment. Do not go to the gym or perform strenuous activities for several hours after your treatment. Many patients feel nothing as the BOTOX® Cosmetic is kicking in, but some patients, including New Jersey Plastic Surgeon, Dr. Bev, a long-time user of BOTOX® Cosmetic, will get a headache or feel a tightness before the BOTOX® Cosmetic takes effect. Bruising or swelling at the injection site may occur, but will resolve quickly. Other side effects are uncommon and self-limiting.

What risks and side effects are involved?

BOTOX® Cosmetic has been safely reducing the appearance of wrinkles and fine lines while restoring patients’ confidence levels for years. BOTOX® Cosmetic temporarily prevents muscle movement. It is highly purified and will not result in long-lasting changes. While rare, some patients have experienced complications, such as:

  • Allergic reaction
  • Bruising
  • Swelling
  • Tenderness
  • Redness
  • Muscle weakness
  • Headache
  • Blood vessel rupture
  • Drooping eyelids

Is there a way to save money while using Botox® Cosmetic?

Allergan, the makers of BOTOX® Cosmetic, have created a frequent flyer program called Brilliant Distinctions, which gives you points every time you purchase an Allergan product. That means every time you are treated with BOTOX® Cosmetic, fillers such as JUVÉDERM®, KYBELLA®, LATISSE®, and now, CoolSculpting®, you receive points which can be redeemed for coupons to be used on future purchases. All you have to do is register with Allergan, and Dr. Friedlander’s staff does the rest.

Schedule a Botox® Cosmetic consultation

To learn more about Botox® Cosmetic injections and other wrinkle treatments, please contact us to schedule a consultation or call our New Jersey office at 973-524-7124.

More Information About Botox® Cosmetic & Other Injectables


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Beverly Friedlander MD
636 Morris Turnpike, Suite 1A
Short Hills, New Jersey 07078

Phone: (973) 524-7124

Fax: (973) 912-8070

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