How to Pick a Good Botox Injection Doctor

Two Parts:Choosing a DoctorKnowing What to Expect

In the United States, more than 3.5 million men and women had cosmetic Botulinum (Botox) injections in 2013.[1] Botox injections temporarily paralyze or reduce muscle contractions in order to reduce the appearance of facial wrinkles, treat neck spasms and reduce excessive sweating. Botox was the first drug to use botulinum toxin, although there are a variety of other similar drugs available now (Dysport, Myobloc, Xeomin). Finding a qualified and compatible doctor to give you a Botox injection is important so that you feel comfortable and minimize the risk of any side effects.

Part 1
Choosing a Doctor

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    Choose a dermatologist. The best way to minimize your risks, enhance your experience and get the best results from Botox injections is by choosing a qualified and experienced doctor.[2] However, although all licensed medical doctors can legally inject you with Botox, it's probably best to go with a dermatologist (skin specialist) if you are getting the muscles of your face done to reduce wrinkles and promote a more youthful appearance.
    • Dermatologists are experts at treating a wide-variety of skin problems and cosmetic concerns for the face, so your search should start within this group of specialists.
    • If you're getting Botox injections for neck spasms or a lazy eye, then you can expand your search to include other types of doctors, such as orthopedists and ophthalmologists, although your family physician might be very experienced also.
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    Make a list of qualified doctors in your area. Using the internet or yellow pages, make a list of about a dozen or so qualified doctors in your area who work in established clinics and advertise that they offer Botox injections. Call their offices and ask if they have a background in cosmetic medicine, as well as training and experience administering botulinum toxin injections injections.[3] Cross any doctor off the list who doesn't meet these criteria.
    • If you are getting injections into your facial muscles, you need a doctor who has specialized training in facial anatomy and a well-developed aesthetic eye. Most family practitioners don't have these skills, so ask around.
    • Give some preference to Botox doctors who come recommended from family members or close friends. If their experience was positive, they is a good chance yours will be also.
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    Research their professional records. Once you have your list narrowed down to under 10 potential doctors, spend a few hours researching their names on the internet, particularly their state medical boards and associations.[4] You want to verify they haven't had their license revoked and haven't had any malpractice claims or other lawsuits against them. Keep doctors on the list who are in good standing and have clean records.
    • In some cases, otherwise good doctors have to deal with and settle frivolous law suits that don't reflect their competence. As such, talk to the doctor on the phone and ask them about the case.
    • A doctor with a clean record doesn't mean they are competent or experienced with Botox, just that they likely haven't been grossly negligent and endangered someone's life.
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    Look up testimonials and reviews online. Another way to find out information about doctors is to read reviews, testimonials and comments made online by previous patients. Stick to the information about Botox injections and not other procedures performed by the doctor. Decide if the balance of comments are positive or negative, and eliminate any candidates that have more than a few bad or scathing reviews.
    • Botox therapy can be dangerous if it's administered incorrectly, so there can be legitimate complaints by patients and not just petty cosmetic concerns.[5]
    • Keep in mind that most people tend to take the time to write something online only if they are really angry or disappointed, which can bias the reviews. Satisfied and happy people don't frequently write reviews online.
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    Make an appointment and interview them. Once your list is at a more manageable number of qualified and experienced doctors (6 or less), it's time to make an appointment and see them for a consultation. Ask for a tour of the office and get a feel for the doctor's demeanor and professionalism. Eliminate doctors from your list who seem too busy, distracted, rude or are too pushy and money focused.
    • Ask the doctor to see samples of their work, such as authorized before & after photos of their Botox patients.[6]
    • Ask who actually does the injection. If a registered nurse or physician’s assistant does the injection, that may be fine, but they should be working closely under the doctor's supervision.
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    Compare prices and dose strengths. Botox injections are the most commonly performed cosmetic procedure in the world, so competition can be fierce and prices are more affordable than ever.[7] Cost matters to most people, so ask each remaining doctor on your list about their total price that includes all services. Keep in mind that doctors add varying amounts of liquid to the Botox crystalline to make it injectable, so find out how concentrated their doses are.
    • Although there is no specified amount of liquid to add to Botox crystals, most doctors add between 2-3 mL of liquid to each vial.[8] Make sure you're paying for more concentrated doses.
    • Ask if you get a discount for referring other people or coming in with a friend or spouse.
    • Don't always choose the cheapest fee. Balance it against your gut feeling of the doctor, their staff and the facility.
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    Make an appointment for the procedure. Once you've narrowed it down to your top choice, find out if they can accommodate your schedule and time frame. Most highly recommended and reasonably priced doctors have long waiting lists for Botox injections, which may not suit you. Whoever you pick has to be able to fit you in, so keep a alternate doctor in mind in case there's scheduling conflicts.
    • Hours of operation is also an issue. Established clinics with successful doctors often have shorter hours and aren't open on weekends. Make sure your doctor's availability suits you.
    • Newer clinics and less experienced doctors are often open more days and have more flexible hours, but they might not have had time to build a good reputation in the community.

Part 2
Knowing What to Expect

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    Share your medical history. Once you've selected the right doctor for your Botox procedure, you'll have a pre-treatment consultation and and go over your medical history.[9] Make sure to tell the doctor about all your previous procedures, prescription medications and allergies, so the risk of complications is reduced.
    • Tell your doctor if you've had any Botox injections within the past 4 months because more frequent treatments than that are not recommended.[10]
    • If you take blood thinners, such as warfarin, you may need to stop for several days before your Botox injection to reduce the risk of excessive bleeding or bruising.
    • Other drugs to stop or avoid before your Botox injection include aspirin, ibuprofen, naproxen, muscle relaxants, sleeping aids and allergy medications.
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    Ask about reducing the discomfort. Although most people tolerate the injection very well, some are more sensitive to needles than others. If your pain threshold is low, ask your doctor about topical anesthetic creams or gels to numb the area prior to injection. This is particularly relevant if you are being treated for excessive sweating in the palms of your hands or soles of your feet because it involves numerous injections.
    • The needles used to inject Botox are very thin and the injections aren't very deep, so discomfort during the procedure is usually minimal.[11]
    • Other methods used to numb your skin prior to an injection include ice therapy and vibration anesthesia, which uses a special vibrational massage to desensitize the nerves.[12]
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    Get the Botox injection. You will be placed in a raised position on an exam table and your carefully chosen injection sites will be cleaned with a non-alcohol based cleanser. After any numbing procedures are completed, the Botox solution is diluted and then injected into the desired sites directly into the muscles fibers. Typical injection patterns for the face include 4-5 areas on each side of the forehead and 2-3 areas around both eyes.[13] More sites can be injected by experienced doctors depending on the number and type of wrinkles, as well as the "look" you're after.
    • Most patients describe a pinching feeling during Botox injections to the face, but not much pain.
    • Immediately after the injections, you'll remain upright on the exam table for about 5 minutes to make sure you don't have a negative reaction. Then you can go home.
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    Don't lie down for a few hours. In general, you can go back to normal activities right after a Botox injection, although you should avoid lying down for 2-4 hours and take it easy in terms of vigorous exercise.[14] Lying down promotes swelling and inflammation, so staying upright for a while is important.
    • Consider getting your treatment done in the morning so you have lots of time to recover before bedtime.
    • If you're getting Botox injections in the face, you may want to take the day off work if you're in the public eye because of the expected mild-to-moderate facial swelling.
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    Be patient for results. Regardless of the skill and experience of your doctor, you will not see significant results in your forehead / face immediately.[15] As such, don't worry and be patient. Depending on your skin's health, the concentration of the Botox solution, number of injections and the area treated, final results take between 3-7 days to manifest.
    • For your first Botox treatment, your doctor will likely inject a lesser amount and then touch-up the results during a follow up.
    • Over-treating the face can make a person expressionless and look like a mask, so patience and conservatism is needed.


  • Remember to go with your gut feeling about people. Usually, if something doesn't feel right, it probably isn't.
  • Ask your doctor if they offer Botox Parties. The parties are usually cheaper, since the doctor can offer a bulk rate. They often take place in someone's home rather than an office.
  • The wrinkle-reducing effects from Botox injections treatments typically last from 3-6 months.[16]
  • Try not to rub, scratch or massage the treated areas on your face after a Botox injection as it can cause the toxin to move to different areas and create unwanted effects.


  • Botox injections can have some significant side effects and may not be for everyone. The most common problems include: pain, swelling or bruising at the injection site, headache, crooked smile, drooling and/or a droopy eyelid.[17]

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Categories: Finding a Medical Specialist