Cosmetic Botox®

Every treatment plan is built around your anatomy and what you actually want changed. Common areas include:

Forehead Lines

The horizontal lines that appear when you raise your eyebrows. Treated by relaxing the frontalis muscle. FDA-approved indication.

Frown Lines (Glabellar Lines)

The vertical “11s” between the eyebrows that can make you look angry or tired when you are neither. This was the original approved use and remains the most requested. FDA-approved indication.

Crow’s Feet

The fine lines fanning out from the outer corners of the eyes when you smile or squint. Treated conservatively so your smile still reaches your eyes. FDA-approved indication.

Bunny Lines

The diagonal creases across the bridge of the nose that appear when you scrunch or laugh. Off-label use.

Lip Flip

A tiny dose along the upper lip relaxes the muscle that pulls it down, allowing slightly more of the pink of the lip to show when you smile. It adds definition without adding volume, and it is not a filler. Off-label use.

Gummy Smile

Where the upper lip lifts high enough to expose a band of gum tissue, relaxing the elevator muscles lets the lip rest a little lower. This is squarely dental territory, it is a smile-line problem, and it is assessed alongside your tooth proportions and gum contour. Off-label use.

Chin Dimpling

The pebbled or orange-peel texture on the chin caused by an overactive mentalis muscle. Off-label use.

Downturned Mouth Corners

Relaxing the depressor anguli oris muscles allows the corners of the mouth to sit level rather than turning down, which softens a permanently displeased resting expression. Off-label use.

Jawline and Masseter Slimming

Where the chewing muscles have enlarged from years of clenching, relaxing them softens a heavy or square lower face. If you also have jaw pain or grinding, read our therapeutic Botox® page you may be able to treat both at once. Off-label use.

It is a fair question, and the answer is more substantial than most people expect.

• Head and neck anatomy is the core of dental training. Dentists spend years studying the muscles, nerves, and blood vessels of the face in detail, and then work in that anatomy every day of their careers.
• Injecting is routine, not occasional. A dentist administers precise injections in the face more often than almost any other clinician that is what local anaesthesia is. Comfort, angle, and depth are practised skills.
• The lower face is judged as part of a smile. A lip flip, a gummy smile, or downturned corners cannot be assessed sensibly without also assessing tooth proportion, lip line, and gum contour. That is cosmetic dentistry, and it is what we do.
• Cosmetic and clinical can be planned together. If your lines are partly the product of clenching, or your smile concern is partly the shape of your teeth, we can see and treat the whole picture including whitening, porcelain veneers, or Invisalign rather than one slice of it.
• Virginia requires accredited training. Dentists administering botulinum toxin for cosmetic purposes in Virginia must complete formal, accredited training including supervised hands-on treatment of live patients.

• Consultation. We talk about what bothers you and what you want to keep. Dr. Sobieh assesses your facial anatomy at rest and in motion, reviews your medical history and medications, and tells you plainly what Botox® can and cannot achieve for your face. You will have the treatment plan and the exact cost before you decide.
• Treatment. The skin is cleaned and a series of very small injections is placed with a fine needle. Most people describe a brief sting. Numbing cream or ice can be used if you would like it. The appointment usually takes 10 to 20 minutes.
• Immediately after. You can drive yourself home and return to work. For the rest of the day, stay upright for about four hours, skip strenuous exercise, and do not rub or massage the treated areas. Small red bumps at the injection points settle within an hour; a bruise, if you get one, covers easily with makeup.
• Results. Softening starts in about three to five days and reaches full effect at around two weeks. We will see you for a review so we can fine-tune the plan for next time the second treatment is usually better than the first because it is based on how your muscles actually responded.
• Maintenance. The effect typically lasts three to four months. Results and duration vary by person, dose, and area treated.

Does it hurt?

Most patients say it is easier than they expected a quick sting at each point, over in seconds. The needle is far finer than the one used for dental anaesthetic. Numbing cream or ice is available if you would prefer it.

How long does Botox® last?

Typically three to four months for cosmetic areas. Duration varies with the dose, the area, your metabolism, and how strong the treated muscle is. People who exercise heavily sometimes find it wears off a little faster.

When will I see results?

You will usually notice something in three to five days, with the full result at about two weeks. It is a gradual softening, not an overnight change which is part of why it tends to look natural.

Will I look frozen?

Not if it is dosed properly. A frozen look comes from too much product placed in too many muscles. We deliberately start conservative: it is easy to add a little more at your two-week review, and impossible to take it away.

Is Botox® safe?

Botulinum toxin has been in clinical use for decades and is one of the most-studied aesthetic treatments available. The doses used cosmetically are very small. Safety depends heavily on who is injecting it, which is why training and anatomical knowledge matter more than price.

Can I have cosmetic and therapeutic Botox® in the same visit?

Often yes. If you clench or grind as well as wanting your frown lines softened, both can usually be planned together. Dr. Sobieh will confirm at your consultation.

What is the difference between Botox® and Dysport or Xeomin?

They are all botulinum toxin type A products from different manufacturers, with slightly different formulations, dosing units, and onset times. We will tell you which product we use and why.