If you want subtle, natural softening of lines without downtime, preparation matters as much as the injection technique. I have watched first-time patients walk in nervous and walk out relieved, and the difference often comes down to what they did in the days leading up to their appointment. Proper pre-care reduces bruising, improves accuracy in dosing, and sets realistic expectations for botox results. It also helps your injector read your facial animation and treat the right muscles at the right depth.
This guide distills what seasoned injectors ask their patients to do before botox injections and why those details matter. Whether you are exploring a botox lip flip, forehead lines, crow’s feet, a brow lift, or functional treatments like masseter botox for jaw slimming or migraines, these steps help you get the most out of your appointment.
The real goal of pre-care
Botulinum toxin type A relaxes muscle by blocking the release of acetylcholine at the neuromuscular junction. That simple sentence carries a lot of practical implications. The treatment works only where it is placed, at a dose that matches your muscle strength, and it depends on your anatomy and expression patterns. Pre-care helps your injector see the full picture, avoid the avoidable, and give you a plan that fits your face and lifestyle.
From a patient’s perspective, pre-care sharpens three outcomes. First, fewer side effects like bruising and swelling. Second, more predictable onset and duration. Third, a result that feels like you, just more rested.
How to choose where to go
“Botox near me” is a useful search, but proximity is not a qualification. What you want is a clinician who treats faces, not just foreheads. A board-certified dermatologist, plastic surgeon, facial plastic surgeon, or an experienced nurse injector under physician supervision are the usual safe bets. Certification in botox treatment courses helps, but watch for a portfolio of botox before and after photos that look like real people and show different ages, genders, and skin tones.
Ask how they dose for first-timers, what their policy is for touch ups, and whether they routinely photograph and map injection points. An injector who discusses botox risks and contraindications without being prompted is more likely to take your safety seriously. If the clinic leads with botox deals and botox specials but cannot explain technique or dosing, keep looking. Value is not the same as a low botox price.
The consultation sets the blueprint
Plan to spend time discussing your medical history. A thorough botox consultation covers:
- Your goals, such as softening frown lines, a gentle botox brow lift, or reducing under eye wrinkles without a frozen look. Your expression habits, like squinting, raising brows when talking, or clenching your jaw. Prior botox injections, average dosage used, botox how long it lasts for you, and any uneven results. Medications and supplements, recent illnesses, and allergies. Events on your calendar, from weddings to headshots, which affect timing.
A good injector will assess at rest and in motion. You will be asked to frown, smile, squint, and raise brows. That animation shows which parts of the frontalis and corrugator muscles dominate your forehead lines and frown lines, where crow’s feet creep in, and whether a small dose to the depressor anguli oris or mentalis would balance your smile. If you are interested in a botox lip flip, they will look at your lip length, tooth show, and how your upper lip curls with speech. For masseter botox, they will palpate while you clench, gauging bulk and bite patterns. Expect discussion of dosing ranges, not a one-size-fits-all chart.
You may also talk through botox vs fillers for static lines, under eye hollows, or smile lines. Toxin treats dynamic wrinkles, while fillers replace lost volume. Occasionally, both are needed for a refined result.
Timing matters more than most people think
Botox onset is not immediate. Early effect starts around day 3 to 4, peaks by day 10 to 14, and then holds. Duration varies. Most see a botox duration of 3 to 4 months in the upper face, sometimes 2 to 3 months for heavy expressers, and up to 5 to 6 months for smaller muscles or baby botox strategies. Masseter botox can last longer, often 4 to 6 months, because the muscle is thick and the dose higher.
If you have an event, schedule your botox appointment at least 2 weeks before photos and preferably 3 to 4 weeks earlier if you are new or adjusting technique. That gives time for results to settle and for a conservative touch up if needed. For preventative botox or first-timers who want subtle results, early booking keeps expectations aligned.
What to avoid and when
Several habits increase bruising or reduce the accuracy of injection placement. The general rule is to avoid anything that thins the blood or increases inflammation for about one week before botox, and to avoid massaging or heating the treated area for 24 hours afterward. Here is a concise pre-appointment checklist you can save:
- Stop non-essential blood thinners about 7 days ahead with your doctor’s approval. This includes aspirin, ibuprofen, naproxen, and high-dose omega-3s or fish oil. If you take a daily aspirin or a prescription anticoagulant, do not stop without medical guidance. Skip supplements known to increase bruising for a week: ginkgo, ginseng, garlic pills, St. John’s wort, high-dose vitamin E. A standard multivitamin is usually fine. Avoid alcohol for 24 hours before botox. Alcohol dilates blood vessels and increases bruising. Pause intense workouts the day of treatment and the day after. Increased blood flow right after injections may shift placement in the first hours. Limit sunburns, facials, chemical peels, or microdermabrasion within a week before treatment. Irritated skin complicates mapping and raises the risk of botox complications.
That list is short by design. Over-restriction helps no one, and you should live your life. Focus on what moves the needle.
Skin prep and what to bring
Arrive with a clean face, no makeup, no heavy sunscreen, and no oil-based products. If you come from work, the clinic can cleanse you. Avoid numbing cream on your own. It distorts the surface and can change muscle recruitment during animation, especially around the lips and eyes.
Bring a list of medications, supplements, and prior botox unit totals if you have them. If you track botox unit price and total spend, bring that too. Photos of your face at your favorite age can help articulate a botox NY look you like. Not aspirational celebrities, just you on a good day. If you have botox reviews saved from the clinic’s site, point to results that feel aligned with your taste.
What your injector is calculating behind the scenes
Dosing is not arbitrary. Forehead lines typically require 6 to 14 units if you want to preserve some brow movement and 10 to 20 units for a smoother look. Frown lines often take 12 to 24 units spread across the corrugator and procerus muscles. Crow’s feet may be 6 to 12 units per side. A conservative botox lip flip might be 4 to 8 units across the orbicularis oris. Masseter botox ranges widely, often 20 to 40 units per side for jaw slimming, sometimes more for bruxism or TMJ-related clenching. These are ranges, not prescriptions, and they vary by product.
On that note, botox vs Dysport vs Xeomin vs Jeuveau can all deliver similar outcomes when dosed correctly. Potency units are not interchangeable, so a Dysport dose may look higher numerically but target the same effect. Some patients report that Dysport has a faster onset, others prefer the feel of Botox. Xeomin is a “naked” toxin without accessory proteins, which matters to a small subset of patients. Jeuveau performs competitively for glabellar lines. Discuss prior experiences. Consistency often matters more than brand.
Pain, needles, and technique
Most people put pain at a 1 to 3 out of 10, a quick sting that fades fast. Needle size is usually 30 to 33 gauge for the upper face and sometimes 32 to 34 gauge for the lip border. Skilled injectors keep the syringe steady, map or mark light dots if needed, and use a firm but gentle stretch to reduce discomfort. Ice is better than topical anesthetic for most areas, and pressure with gauze immediately afterward minimizes bleeding.
The botox procedure takes 10 to 20 minutes for the upper face and longer if you add a botox neck treatment for platysmal bands or masseters. Expect small injection points, a pinprick of bleeding here and there, and slight swelling that settles within an hour. It should not feel chaotic or rushed.
Side effects, risks, and how pre-care lowers them
Common side effects: tiny bumps at injection sites for 15 to 30 minutes, a mild headache, and occasional bruising that lasts a few days. Less common events include eyelid or brow heaviness, asymmetry, a smile that feels altered after a lip flip, or difficulty whistling for a week or two. Rare but serious complications include eyelid ptosis, double vision from lateral spread near the eye, or a flu-like feeling.
Pre-care lowers these risks. Avoiding blood thinners reduces bruising. Avoiding heavy workouts and massage the day of treatment reduces migration. Proper skin prep reduces irritation. Honest medical history helps your injector avoid high-risk patterns if you have prior eyelid ptosis, dry eye, or a heavy brow.
Absolute contraindications are pregnancy and breastfeeding, active infection at the injection site, and known hypersensitivity to botulinum toxin components. Relative contraindications include certain neuromuscular disorders, recent facial surgery, and unrealistic expectations. Botox safety is excellent in trained hands with proper dosing, and the medication has decades of data, including FDA approval for glabellar lines, crow’s feet, forehead lines, chronic migraine, axillary hyperhidrosis, and more.
Expectations: how natural looks happen
Natural results come from three levers: dose, distribution, and communication. If you are new, a conservative first session protects expression and teaches your injector how your muscles respond. It is common to treat the frown lines fully, feather the forehead lightly to preserve lift, and place modest units at the crow’s feet to soften without erasing your smile. With a botox brow lift, tiny deposits above the tail of the brow relax depressors and allow the frontalis to lift subtly, not caricatured.
For a botox lip flip, remember this is not lip filler. You are reducing the inward roll of the upper lip by relaxing the superficial orbicularis. A small dose makes the pink show a bit more and can reduce a gummy smile. It can also make sipping from straws and saying certain consonants feel odd for a week. That trade-off may be worth it, or not. Honest discussion prevents disappointment.
Preventative botox or baby botox uses micro-aliquots to slow the formation of etched lines. It is popular among younger patients and those in front of cameras. The upside is subtlety and minimal botox downtime. The downside is more frequent visits to maintain the effect.
Budgeting and price transparency
Botox cost varies by market, injector expertise, and setting. Many clinics charge by the unit with a posted botox unit price. Others charge by area. A typical upper face treatment might use 30 to 60 units. Unit prices can range roughly from 10 to 18 USD in many US cities, sometimes lower during botox offers. Be wary of pricing that seems too good to be true. Counterfeit products and diluted vials do exist. A reputable clinic will tell you what brand they use, show you a sealed vial, and discuss your expected total units before the first injection.
If you care about botox maintenance and long-term budgeting, ask whether the clinic offers banking programs or memberships that reduce cost while ensuring you still receive authentic product. Be cautious with aggressive botox deals that require bulk purchases without clear refund policies.
Scheduling and the touch-up window
Because muscles vary left to right, symmetry is a target, not a guarantee on day one. The two-week mark is the usual check-in for botox reviews and touch ups. Minor tweaks might mean adding 2 to 6 units for a brow that sits lower, or a few units near the crow’s feet if one side still crinkles more when you smile. Having that plan in place ahead of time removes stress. Touch ups are not a sign of failure, they are how you dial in precision.
Preparing your skin and habits for better longevity
Healthy skin and steady routines help your botox longevity. Daily sunscreen, a retinoid at night if you tolerate it, and a peptide or niacinamide serum do more than any last-minute hack. If you grind your teeth at night, a mouthguard reduces clenching and can make botox https://www.facebook.com/Doctorlanna/ for bruxism last longer. If you squint a lot, update your prescription or wear sunglasses. The less the target muscle strains against the toxin, the longer your botox duration.
Hydration, sleep, and balanced nutrition help recovery, but there is no magic supplement that makes toxin last months longer. Marketing claims aside, consistency beats hacks.
What to do the day before and the day of
For patients who like a simple timeline, here is a short, practical sequence that fits most cases:
- One week before: stop non-essential blood thinners and bruise-prone supplements with your physician’s approval. Skip peels or microneedling. Two days before: avoid dental work, vaccinations, or major skincare procedures. You want a calm immune system and skin barrier. The day before: no alcohol. Confirm your appointment time and transportation if you bruise easily and prefer not to drive yourself. The day of: cleanse your face. Eat a small meal to avoid lightheadedness. Arrive early so you can complete consent forms without rushing. The first 24 hours after: stay upright for 4 hours, avoid heavy workouts, hot yoga, saunas, or facial massage. Gentle expressions are fine. Makeup can go on after an hour if the skin is intact.
This is not dogma. Your injector may adjust these steps to your case.
Special areas and their quirks
Forehead and frown lines: The biggest pitfall is overtreating the frontalis. A heavy hand can drop the brows, especially in patients with already low-set brows or excess upper eyelid skin. Conservative dosing and treating the glabella fully keeps lift balanced.
Crow’s feet and under eye wrinkles: Go too close to the eye and you risk changes to lower lid support. Most injectors place toxin laterally and slightly inferior to avoid altering the smile. If you have dry eye, mention it.
Smile lines: Toxin does little for nasolabial folds. This is where botox vs fillers matters. If your main concern is deep smile lines, filler or skin tightening may be more appropriate than toxin, or you may need both.
Lip flip: A charming tweak for the right candidate, but not a substitute for volume. If you have a thin upper lip and want more structure, filler gives shape while toxin gives roll and show.
Jawline and masseters: Excellent for square jaws, bruxism, and tension headaches. Expect a gradual slimming over 4 to 8 weeks as the muscle relaxes and atrophies slightly. Chewing tough foods can feel different at first. If you have TMJ instability, discuss it in detail.
Neck bands: Treating platysmal bands can smooth vertical cords and enhance jawline definition. The risk is diffusion into deeper neck muscles, which can alter swallowing if done incorrectly. Choose an injector with experience in the neck.
Hyperhidrosis: Underarm botox for sweating reduces perspiration dramatically for 4 to 6 months on average. The grid of injections feels like multiple pinches, but the relief is worth it for many. Pre-care is simpler here, but the bruising principles still apply.
Migraine: Dosing and placement for chronic migraine follow a specific, FDA-approved protocol. Pre-care overlaps with cosmetic guidance, but your neurologist’s plan leads. Share all headache medications to avoid surprises.
Myths that confuse first-timers
Botox does not fill lines. It relaxes muscles. If a line is etched into the skin at rest, it may soften but not vanish without adjunctive treatments.
Lower doses do not always look more natural. Underdosing the forehead while fully treating the frown lines can paradoxically drop the brows. Balance beats minimalism.
Starting botox early does not “force” you to keep doing it forever. Muscles recover as the toxin wears off. If you stop, your expressions return to baseline. What early, light treatment can do is slow the development of deep creases.
Migration is not a common event if you follow aftercare. The idea that toxin will “travel” across the face days later is folklore. Most diffusion happens within hours and millimeters, which is why the first day’s precautions matter.
Men need fewer units. Not usually. Men often have stronger muscles and may need higher doses for the same effect. Good planning can keep results subtle.
Aftercare starts before you leave
A clinic that cares about outcomes sends you home with written botox aftercare. Expect reminders about avoiding pressure on the treated areas, when to restart workouts, and how to reach the office if you notice anything off. You should also receive a record of the product, lot number, and units used per area. Keep it. Over time, that log becomes your personalized botox dosing guide.
If bruising appears, a cold compress for the first day and then a warm compress day two onward speeds resolution. Arnica can help bruising for some. Small lumps from the saline carrier fluid resolve quickly. If you feel heavy lids or uneven movement, wait 10 to 14 days before judging. If something seems wrong earlier, call. Adjustments are most effective when timed right.
When botox is not the answer
Sometimes the best pre-care is deciding not to do toxin that day. If you are pregnant or breastfeeding, dealing with a sinus infection, fighting off the flu, or you just had a laser resurfacing treatment, reschedule. If your main complaint is skin laxity, large pores, or deep etched lines at rest, consider skin treatments, microneedling, laser, or filler. If your brow is already low and heavy, a surgical brow lift or eyelid surgery may suit you better than chasing lift with toxin. An honest practitioner will tell you this and help sequence treatments.
The quiet art of maintenance
Once you know how your face responds, botox maintenance becomes easy. Most patients return every 3 to 4 months for the upper face and every 4 to 6 months for masseters or neck. Some prefer mini botox at eight to ten weeks to keep movement just below a wrinkle-forming threshold. There is no single right schedule. The right cadence is the one that fits your anatomy, budget, and taste.
I encourage patients to set a simple rule for themselves: aim for natural results you barely notice, but your camera does. If friends tell you that you look well-rested or your makeup sits better across the forehead and crow’s feet, you nailed it. If anyone can point out your botox, the dose or distribution needs a tweak.
Finding the right fit
You can browse “botox clinic” and “medical spa” websites for hours, but a brief in-person consultation reveals more than a dozen reviews. Watch how the injector studies your face, whether they discuss pros and cons, and how they respond to your questions. Ask about botox downtime, recovery time, and what happens if you do not like an area. You will know you are in the right place if the plan respects your anatomy, your calendar, and your comfort level.
The best appointments feel unhurried. The injector maps, you animate, and the conversation lands on a shared definition of success. With the right pre-care, that success becomes repeatable. You do your small part beforehand, they do theirs with technique and judgment, and the result is a smoother appointment with natural, durable outcomes.