Your Top Questions About Botox — Answered

Botox is the most popular aesthetic treatment in the world, and it’s also the one surrounded by the most patient questions. At Beverly Hills Aesthetics, Dr. Sam Assassa has been answering these questions since founding the practice in 1995 — and the questions that come up most consistently deserve their own dedicated answers. Here they are.

Q: How long does Botox actually last? Most patients experience results for three to four months with the first treatment, extending to four to six months with regular maintenance — because the targeted muscles gradually “train” to remain less active. The timeline varies by injection location, the dose administered, and individual metabolism. Patients who stay on a consistent schedule tend to see longer duration than those who treat sporadically.

Q: Does Botox hurt? Discomfort is typically minimal. The needles used for Botox injection are very fine gauge, and the treatment itself takes only a few minutes per area. Most patients describe the experience as a brief pinch with each injection. Topical numbing cream can be applied beforehand for patients who prefer additional comfort, and cold application before and after injection reduces any temporary injection-site sensation.

Q: I’ve heard Botox looks frozen. Is that true? The “frozen” look results from over-treatment: too much product applied in a way that eliminates all facial expression rather than relaxing the specific muscles producing the lines. At Beverly Hills Aesthetics, Dr. Assassa’s philosophy is to preserve natural facial expression while softening the dynamic lines that create tired, stern, or aged appearances when the face is at rest. The goal is always to look like yourself — refreshed, not altered.

Q: When is the right age to start Botox? There is no single “right” age. Botox is increasingly used preventively by patients in their late 20s and 30s — addressing dynamic lines before they become etched into the skin at rest — as well as therapeutically by patients in their 40s, 50s, and beyond who want to address lines that have developed. The conversation with Dr. Assassa at the consultation addresses each patient’s specific concerns and timeline, without pushing any particular starting point.

Q: What’s the difference between Botox and filler? Botox (and comparable neurotoxins including Dysport, Daxxify, and Jeuveau) relaxes specific muscles, reducing the dynamic lines created by facial movement: forehead lines, frown lines between the brows, and crow’s feet are the classic applications. Dermal fillers add volume to specific areas — restoring the fullness that deflates with age, defining contours, and addressing hollow areas. The two categories address different problems and are frequently used together for a more comprehensive result.

Q: Is it safe to get Botox regularly over many years? The long-term safety record of neurotoxin injections is well-established over decades of clinical use. There is no evidence that regular use over years creates long-term harm. Many patients have been receiving Botox treatments for ten, fifteen, or twenty years without adverse effects. Consistent treatment actually allows for lower dosing over time as the targeted muscles become less active — which some providers find reduces the dose required to achieve the same result.

Q: Are there areas Botox shouldn’t be used? Botox is FDA-approved for specific indications including glabellar lines (frown lines), forehead lines, and lateral canthal lines (crow’s feet). It is also used off-label for a number of other applications including brow lifting, jawline slimming (masseter reduction), neck band softening, chin dimpling, and the “lip flip.” Off-label use is common and appropriate when performed by a physician with specific training in the application. Dr. Assassa’s thirty-plus years of experience includes the full range of these applications — and the judgment to distinguish appropriate from inadvisable.

Q: How do I know if a provider is qualified to perform Botox? In California, Botox injection requires a license from a physician, nurse practitioner, physician assistant, or registered nurse (under physician supervision). Legal licensure, however, does not guarantee equivalent expertise. Providers with specific training in facial anatomy, a deep understanding of the muscles being targeted, and experience managing complications produce consistently better and safer results than those whose training is minimal. The consultation at Beverly Hills Aesthetics involves a conversation with Dr. Assassa personally — a board-certified physician who has been performing neurotoxin treatments since the treatment’s clinical emergence — not a technician working through a protocol.

Q: What can I expect immediately after treatment? Minor redness or pinpoint swelling at the injection sites is normal and typically resolves within 30 to 60 minutes. Bruising is possible but uncommon and resolves within a few days when it occurs. Results begin appearing within two to four days and reach full effect at approximately two weeks — which is also the appropriate time for a touch-up appointment if any areas appear undertreated.

Q: Can I combine Botox with other treatments at the same appointment? Yes, and this is commonly done at Beverly Hills Aesthetics. Combining neurotoxin treatment with dermal filler, laser, or other modalities in the same session is safe and efficient. Dr. Assassa assesses the full facial picture at every consultation and can recommend combinations that address multiple concerns in a coordinated way rather than treating each concern in isolation.

Q: What’s the difference between the various neurotoxin brands? Botox (onabotulinumtoxinA), Dysport (abobotulinumtoxinA), Daxxify (daxibotulinumtoxinA-lanm), and Jeuveau (prabotulinumtoxinA-xvfs) are all botulinum toxin type A products that relax muscles through the same basic mechanism. The differences are in formulation, diffusion characteristics, dosing units (which are not interchangeable between brands), and duration — Daxxify has shown extended duration of approximately six months in clinical trials. Dr. Assassa works with multiple neurotoxin products and selects the most appropriate one based on the treatment area, the patient’s history, and their specific goals.

Schedule Your Consultation at Beverly Hills Aesthetics

Dr. Sam Assassa and the Beverly Hills Aesthetics team are located at 640 South San Vicente Boulevard, Suite 410, in Los Angeles. The practice is open Monday through Friday, 10 a.m. to 6 p.m., and Saturday from 10 a.m. to 4 p.m. Call 424-284-8933 to schedule your consultation. The questions above represent the most common ones — and the conversation at the appointment always starts with yours.