What I Wish I'd Known Before My First Botox Appointment

Maybe you raise an eyebrow any time someone admits to getting Botox (which would make physical sense, since skipping the injectable neurotoxin means it's probably pretty easy for you to move your forehead). But the treatment is not just for the Real Housewives anymore. In fact, according to the American Society of Plastic Surgeons, 5,043,057 Botox procedures were performed in 2019 alone — and I was one of them. In the years since, public opinion on facial "tweakments" has also evolved, in part due to countless celebrities speaking openly about work they've had done.

Still, like most people about to jab their skin with a fancy-sounding liquid that effectively paralyzes the facial muscles for months at a time, I was terrified to make my first appointment. Will I look like a Stepford wife? What if I want to actually feign surprise at my surprise birthday party? Seven years since my first injection, though, and I've all but converted to the church that is Botulinum toxin type A . . . and learned a few tips and tricks along the way.

Here's everything I wish I'd known back then — the good, bad, and frozen (forehead) included.

1. No, Botox Doesn't Hurt (For the Most Part)

My pain tolerance falls somewhere between a newborn baby's and Batman's exoskeleton suit, and I'd rank Botox at about a 3. You'll feel a slight prick at the injection sight, but it's hardly anything you'll need Demerol for. As with most times you're getting poked with a needle, the worst part is mostly the anticipation of it all. That said, if you're especially sensitive to pain, ask your dermatologist to apply a topical anesthetic cream 20 minutes beforehand to numb the area. You won't feel a thing.

2. You Won't See Results Right Away

You wouldn't be a modern human living in the 21st century if you didn't want instant gratification when getting Botox injections. Unfortunately, though, this is an instance where you're just going to have to wait anywhere from four to seven days to see results.

3. The Best Time to Get Botox is During the Day

Serendipitously, after my very first Botox appointment, I had scheduled a massage for a few hours later, which I then had to promptly cancel after being advised to keep my head elevated for four hours after treatment. There's been little research on why or whether Botox will actually shift while lying down, but I've since retired my Dracula instincts and will only schedule morning or afternoon appointments to be safe.

4. Come to the Appointment Prepared

No need to bring a First Aid kit or every item in your 10-step skincare routine, but you may want to toss face powder or concealer in your bag if you plan on going somewhere after the appointment. To make sure the derm has the best view of your forehead (or whichever area they are injecting), the nurse will take off any makeup near the area with an alcohol wipe. I keep a mini vat of the Dr. Jart Cicapair Tiger Grass Color Correcting Treatment ($21) close at all times so I can squash any redness as soon as it pops up.

5. You May Get a Headache Afterward

Annoying but true: a common side effect immediately after getting Botox is that you can develop a mild headache. In most cases, Advil does the trick, but the Journal of the American Academy of Dermatology has reported that about one percent of patients experience severe head pain. (If that's the case, maybe lay off the 'tox for a bit — after you call your doctor, that is.)

6. Don't Get Injections Too Close to Your Eyebrows

Winking at every person around you should be optional, but if a needle gets too close to the upper part of either eyebrow, you may be stuck with the look for a few days or weeks. This droopy side effect happens when the toxin that's been injected in your skin migrates near the muscle above your eye (called the levator palpebrae), which can cause the lid to droop. It's not all that uncommon, either — even I've fallen victim to eyebrows that look more asymmetrical than Buzz Lightyear's.

7. Botox Won't Get Rid of Every Wrinkle — and That's OK

I started getting injections in my late 20s, so for me, it was about preventing fine lines from forming. My mom, however, was 54 when she went in for her first round of Botox, so she already had a few deep-set wrinkles that tend to be harder to treat. And because most derms aim to make you look as natural as possible, they'll never inject you with too much juice (and you don't want them to — trust), which means you'll have fewer lines, but they won't completely vanish.

8. It's Not Cheap

Much like a real estate agent might tell you, the price of Botox is all about location, location, location. In general, you are either charged by unit (i.e., how much of the actual Botox fluid you require) or by the specific area being treated, which varies depending on where you live. Each unit can set you back anywhere from $10 to $20, which the American Society For Aesthetic Plastic Surgery reports averages around $408 per session.

9. It Requires Zero Downtime

It's called a "lunchtime treatment" for a reason — the entire thing takes 10 to 15 minutes, tops. Even with the minimal redness at the injection sight (you have your concealer, right?), nobody will suspect a thing.