Botox in Beverly Hills: what it is and which lines it treats
Botox is the brand name of onabotulinumtoxinA, a purified botulinum toxin type A, FDA-approved for the frown lines between the brows in 2002 and later for crow's feet and forehead lines. Injected into a muscle in a tiny dose, it blocks the signal that tells the muscle to contract, so the skin over it stops creasing and the line softens. Over three to four months the muscle wakes up and the effect fades on its own.
Botox treats lines that appear when you move. A line still there when your face is at rest is a fold in skin that has lost collagen, and relaxing a muscle does not fill it: that is a job for facial fillers, and our Botox or fillers page explains which your lines need. Dysport, the practice's other neuromodulator, does the same job with a smaller unit at $8.50 per unit; our Botox or Dysport comparison covers the choice.
Forehead lines, the 11 lines and crow's feet
Forehead lines run across one wide, flat muscle, and the aim is even softening with enough movement left for the brows to lift. The 11 lines between the brows are made by the muscles that pull the brows together. Crow's feet fan out from the corners of the eyes over a thin ring of muscle, where placement matters more than the count. These three areas are Dr. Cat's.
How Dr. Cat approaches Botox
Dr. Cat is a board-certified plastic surgeon, trained in both head and neck surgery and plastic and reconstructive surgery, Harvard-educated and UCLA trained, and she calls injectables a technical art. Her rule for Botox is short: take out the wrinkles, keep the movement. She works toward a smoother forehead over a brow that still lifts symmetrically, never a frozen forehead or a heavy brow, and she injects her own face by the same rule.
The muscle map comes first
Every treatment starts with a facial muscle analysis, not a vial. Dr. Cat watches your face raise, frown, squint and smile, marks where each muscle actually pulls, which is rarely symmetrical, and only then sets the units for each area, with you. She spaces several small injections across the whole forehead rather than a few large ones, and almost always treats the frown lines at the same visit, because relaxing the muscle that lifts the brows while leaving the muscles that pull them down can let the brows drop. A first-time patient is dosed conservatively and adjusted at the two-week check.
The injections
The skin is cleansed and a topical numbing cream is offered, then small amounts go in through a very fine needle in a series of injections that feel like a brief pinch. The injections take about 15 minutes; a first appointment runs closer to an hour because of the analysis. Small bumps at the sites settle within the hour.
Who injects Botox at the practice
The area decides who holds the syringe. Dr. Cat injects Botox of the forehead lines, the frown lines and crow's feet herself. The masseter, the chin, the platysmal bands of the neck, the lip flip, a Botox brow lift, the jawline and underarm Botox for sweating are injected by our board-certified facial plastic surgeon. A nurse injector or physician assistant, when one is engaged, treats the forehead and eye area only and never injects filler, by Dr. Cat's rule. The price is $25 per unit whichever provider injects.
Masseter Botox, the lip flip and the other areas
Masseter Botox relaxes the thick chewing muscle at the angle of the jaw, so a square jaw slims over the following weeks and clenching eases; the doses are larger, and the masseter is the usual reason a plan climbs toward 100 units. Botox for the jawline means the masseter; a jaw that has lost its edge is a filler question. A lip flip relaxes the muscle along the upper lip border with about 4 to 6 units so the lip rolls slightly outward, and wears off sooner because the dose is so small.
A Botox brow lift places a small dose in the muscles that pull the outer brow down, so the tail of the brow sits a few millimeters higher; it does not lift a fallen brow. The chin takes a small dose when it dimples, bunny lines a few units each side, and the platysmal bands of the neck a larger total. All of these are our facial plastic surgeon's, at the same $25 per unit.
Underarm Botox for sweating
Botox is also FDA-approved for severe underarm sweating, and the practice offers it: a grid of small injections just under the skin of each underarm blocks the nerve signal to the sweat glands, so the sweating stops for several months, usually longer than a facial result. It is injected by our board-certified facial plastic surgeon, uses a larger number of units than the face, with the count agreed at your visit, and is priced at the same $25 per unit.
Preventative Botox and baby Botox
Preventative Botox is a low dose started before the lines have set, usually in the late 20s or 30s. Dr. Cat began Botox in her own forehead and frown lines at about 28, and her analogy is a piece of paper: a sheet that is never folded never gets a deep crease.
Baby Botox is the name patients use for a lighter dose: fewer units across the same area, so the lines soften without the muscle switching off. At the practice it is the same treatment at a lower count, planned from the same muscle map, with the number of units agreed at your visit.
Botox for men
Botox for men treats the same three areas with the same aim: lines softened, expression kept, nothing that reads as work. Men usually need more units because the muscles of the forehead and brow are thicker, so a plan sits at the higher end of each range. The price per unit and the aftercare are the same.
How long does Botox last?
Botox lasts three to four months, the usual range rather than a promise, with the first softening at three to five days and the full effect at about two weeks; a first treatment often lasts a little less. Most patients treat three to four times a year.
What happens after years of Botox
Muscles relaxed for years become thinner and weaker, so the lines they made stay soft and the dose needed usually falls; at cosmetic doses there is no evidence of cumulative harm to the skin. Two things can go wrong over a decade: heavy dosing that flattens the forehead and drops the brow, and, rarely, antibodies that stop a product working, answered by switching products.
Botox aftercare: the 4-hour rule and the first day
The 4-hour rule is the first instruction after Botox: stay upright, with no lying down, bending over or leaning your head back, for four hours. For the first 24 hours skip strenuous exercise and alcohol and do not rub the treated areas. Avoid saunas and hot yoga for a few days and wear sunscreen; our post on making Botox last longer covers the rest.
- Your visitThe muscle analysis, the units agreed, the skin cleansed, then about 15 minutes of injections.
- The first 4 hoursUpright: no lying down, bending over or leaning your head back.
- The first 24 hoursNo strenuous exercise, no alcohol, no rubbing the treated areas.
- Days 3 to 5The first softening shows; any small bruise fades over the first week.
- Two weeksThe full effect. The follow-up visit checks the two sides; a touch-up, if needed, is done then.
- 3 to 4 monthsMovement returns; the next visit is booked before the lines fully return.
Botox before and after: what to look for
In Botox before and after photos, look at the face in expression, not only at rest: a forehead that is smooth at rest says nothing about whether the brow still lifts. The pair that matters is the same expression, raising the brows, frowning or smiling, before and at two weeks or later. The case below, from the practice's Botox before and after gallery, shows the forehead and the eye area in three views, with the lines softened and the expression kept.
Botox gone wrong: the heavy brow and the drooping lid
The complication people fear is product reaching a muscle it was not meant for: too many units too low on the forehead and the brow feels heavy; product drifting into the muscle that lifts the eyelid and the lid droops. Both are temporary, fading over weeks as the product wears off, and both are avoided with conservative dosing and careful placement.
What can go wrong
- Small bumps for an hour, redness, or a bruise
- A mild headache in the first day or two
- A heavy brow or a drooping eyelid, temporary, when product reaches the wrong muscle
- Asymmetry, corrected at the two-week check
- Rarely, flu-like symptoms, dry eyes or an allergic reaction
How the practice avoids them
- A surgeon maps the muscles before a unit is placed
- Conservative first doses, adjusted at the two-week check
- The frown lines treated with the forehead, so the brows do not drop
- Crow's feet injections kept a few millimeters outside the bony rim of the eye
- The week-before list, and a follow-up built into the treatment
Who is a good candidate for Botox?
The right candidate has lines that move.
You may be a good candidate if
- Your forehead lines, 11 lines or crow's feet appear when you raise, frown or squint, and are starting to linger at rest
- You want to keep those lines from setting, usually starting in your late 20s or 30s
- You are a healthy adult, late 20s through 60s, with realistic expectations
- You want your expression kept
Not yet, or a different plan, if
- You are pregnant or breastfeeding: treatment waits until breastfeeding has finished
- You have a neuromuscular disease such as myasthenia gravis, an active skin infection at the site, or an allergy to a botulinum toxin product
- You take a prescribed blood thinner: a brief pause may be needed, only with your prescribing doctor's approval
- Your lines are there when your face is completely still: a filler line, not a Botox line
- Hooded eyelids or a fallen brow are the complaint: no injectable removes skin
Tell us about every medication, because some antibiotics increase the effect of Botox, and bring the product and units per area of any previous treatment elsewhere.
How much does Botox cost in Beverly Hills?
Botox costs $25 per unit at Dr. Cat Plastic Surgery, the price on our published non-surgical price list, the same whichever provider injects, and your total is the number of units multiplied by $25. The number of units is agreed at your visit. Our post on Botox units per area gives the usual starting ranges: for example, the frown lines are often 10 to 20 units, the forehead 10 to 30 and crow's feet 5 to 15 per side, so a 20-unit frown-line treatment is $500, forehead and frown lines together at 40 units is $1,000, a full upper face at 64 units is $1,600, and 100 units, a whole vial, is $2,500. A first visit is dosed conservatively and often costs less; the two-week check is part of the treatment. Cosmetic Botox is not covered by insurance. Our Botox cost guide explains why per-unit prices vary between providers.
Booking, the $500 deposit and financing
Injectable visits are booked directly: the appointment is reserved with a $500 deposit credited to the treatment, new patients are evaluated and treated at the same visit, and the $500 stays as a credit if treatment is not right for you. The surgical $500 consultation fee and its credit toward surgery are a separate arrangement. The practice partners with Cherry, its primary financing partner, which offers Cherry Pay in 4 for non-surgical treatments on the day of treatment, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans.
Your Botox appointment with Dr. Cat
It starts with a free 15-minute discovery call with our Patient Concierge, who books your appointment; new patients are evaluated and treated at the same visit on Rodeo Drive, as our consultation page describes. If you are coming from outside Los Angeles, our out-of-town patients page covers travel and the office, and a private video consultation through OnPatient, the HIPAA-secure patient portal, can answer your questions first.
How to prepare
No alcohol for 24 hours before your visit. With your prescribing doctor's approval, stop aspirin, ibuprofen and other anti-inflammatories, fish oil, vitamin E and herbal supplements for about a week, because they add to bruising. Arrive with a clean face, no makeup, after a light meal.
When Botox is not enough
Botox has a ceiling. A line etched into the skin at rest softens but does not vanish at once; kept relaxed over several cycles it fades further. Hooded upper eyelids are excess skin, and no injectable removes skin: an eyelid lift, which Dr. Cat performs, does. A brow that has fallen is lifted by a surgical brow lift, performed at the practice by our facial plastic surgeon; a Botox brow lift only previews the change.
