Not every wrinkle responds to Botox®, and knowing which of yours will is the first useful thing to establish. Lines caused by muscle movement soften with treatment. Lines etched by sun damage, thinning skin, or lost volume beneath do not, because no amount of muscle relaxation changes them. Most faces have both, which is why a treatment plan built around only one produces a partial result.
Sam Assassa, MD was among the first physicians on the West Coast to introduce the CosmoFaceLift™ and has practiced non-surgical facial aesthetics in Los Angeles since founding Beverly Hills Aesthetics in 1995. He is board certified in Internal Medicine and has performed more than 25,000 aesthetic procedures.
“Half the wrinkles people ask me to treat with Botox are not muscle wrinkles. Telling them that costs me an injection and saves them a year of wondering why it did not work.” — Sam Assassa, MD
Dynamic Wrinkles Versus Static Wrinkles
Dynamic wrinkles appear when you move. Frown when you concentrate, raise your brows, or smile, and the line appears with the movement and softens when your face relaxes. These come from muscle contraction pulling on the skin above, and they are what Botox® treats.
Static wrinkles are visible when your face is completely still. They have become etched into the skin itself, generally through years of the same movement combined with collagen loss and sun damage. Botox® softens them only indirectly, by stopping the movement that keeps deepening them.
There is a spectrum between the two. A dynamic line treated consistently over years frequently never becomes fully static. A static line already present may soften somewhat with treatment but usually needs resurfacing, microneedling, or filler alongside it.
Areas Treated for Wrinkles
- Frown lines: The elevens between the brows. FDA approved, at 20 units across the corrugator and procerus.
- Forehead lines: Horizontal lines from raising the brows. FDA approved, at 20 units.
- Crow’s feet: Lines fanning from the outer eye. FDA approved, at 12 units per side.
- Bunny lines: Diagonal creases across the nose. Off label.
- Chin dimpling: Pebbled chin texture. Off label.
- Neck bands: Vertical platysmal cords. Off label.
Three of the six are FDA approved indications with published dosing. The remainder are off-label applications, which is legal, common, and well established in aesthetic practice, and is discussed at consultation.
What Botox® Will Not Do for Wrinkles
Being clear about this prevents the most common disappointment. Botox® will not restore lost volume, so hollow cheeks, flattened temples, and deepened nasolabial folds need filler. It will not remove sun damage, pigmentation, or texture, which need resurfacing or microneedling. It will not tighten loose skin.
And it will not, on its own, erase a deep static line. It stops that line getting worse and softens it over time, which is a real result and a different one from erasure.
What to Expect
Treatment takes ten to twenty minutes with no downtime. The effect develops over three to seven days and reaches full expression at about two weeks, so judge your result at two weeks rather than day three, and book at least two weeks before an event.
Results generally last three to four months. Many patients find intervals lengthen after several rounds, since repeatedly treated muscles weaken over time.
Risks and Safety
Common effects include temporary bruising, swelling, tenderness, and headache in the first day or two. Product affecting a muscle other than the target can cause temporary brow or eyelid droop, asymmetry, or altered expression, resolving as the effect wears off over several weeks.
Rarely, effects of the toxin can spread beyond the treatment site. Patients with neuromuscular conditions, patients who are pregnant or breastfeeding, and patients with an infection at the injection site should discuss this before treatment. Individual results vary and no outcome can be guaranteed.
Frequently Asked Questions About Botox® for Wrinkles
Will Botox® get rid of my wrinkles completely?
It depends on whether the line is dynamic or static. Lines that appear when you move generally soften substantially and can become almost invisible at rest. Lines already etched into the skin when your face is still will improve but usually not disappear, because the skin itself has changed rather than the muscle beneath it. Those respond better to resurfacing or filler alongside Botox®, and treating both is how the deepest lines are addressed.
At what age should I start Botox® for wrinkles?
There is no correct age, and the honest answer depends on what your face is doing rather than what year you were born. The reasonable trigger is when a line has started to remain faintly visible after your face relaxes, which indicates it is beginning to etch. Some people see that at twenty-eight and others at forty-five. Starting because of a birthday, or because of what other people are doing, is not a clinical reason.
How many units of Botox® will I need?
It depends on the area and on how strong your muscles are, and men typically need more because the muscles are larger. Approved dosing exists for three areas: 20 units for frown lines, 20 for the forehead, and 12 per side for crow’s feet. Actual dosing is adjusted from there based on examination and on how much movement you want to retain. Treatment here generally starts conservatively with a review at two weeks.
Will my wrinkles be worse if I stop Botox®?
No, and this is a common worry with no basis. When treatment stops, muscle activity gradually returns and lines return to where they would have been. They do not become worse than if you had never started. If anything, years of reduced contraction mean the lines are often slightly less deep than they otherwise would have become.
Can Botox® prevent wrinkles from forming?
Partially, and the claim is usually overstated in marketing. What is reasonably supported is that reducing repeated muscle contraction slows how deeply a line etches over time. What is not established is that early treatment prevents wrinkles from ever appearing. Sun exposure, collagen loss, and volume change all continue regardless, and they account for a large share of facial aging.
How much does Botox® cost in Beverly Hills?
Cost depends on how many areas are treated and how much product each requires. Pricing is confirmed at consultation and current figures are published on the fees page. Several payment options are available.
Why Patients Choose Beverly Hills Aesthetics
- Dynamic And Static Assessed Separately: Which of your lines will respond is established before treatment.
- Physician Performed: Dr. Assassa injects every patient himself.
- Conservative Starting Doses: Built up with review rather than started at maximum.
- Approved Dosing Where It Exists: Three areas treated per published guidance, with off-label uses disclosed.
- Combination Planning: Resurfacing or filler recommended where Botox® alone will not deliver.
Schedule a Consultation in Beverly Hills
Dr. Assassa will look at your face moving and at rest, tell you which lines will respond to Botox® and which will not, and explain what treating the rest would involve. Beverly Hills Aesthetics serves patients from Beverly Hills, Los Angeles, West Hollywood, and Century City. Request a consultation or schedule your appointment online.
BOTOX® FOR WRINKLES BEFORE & AFTER
BOTOX® FOR FROWN LINES BEFORE & AFTER
BOTOX® FOR CROWS FEET BEFORE & AFTER
For more information or to find out the right option for you, call Beverly Hills Aesthetics at 424-284-8933 Or Request a Complimentary Consultation with Dr. Assassa. We look forward to meeting you.