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Botox >> What is Botox? >> FAQs

Leesburg | Loudoun | Virginia

BOTOX Treatment

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Why it is done?

BOTOX injections block certain chemical signals from nerves, mostly signals that cause muscles to contract. The most common use of these injections is to temporarily relax the facial muscles that cause wrinkles in the forehead and around the eyes. BOTOX injections are also used to treat conditions that affect how the body functions. Examples include:

  • Cervical dystonia. In this painful condition, your neck muscles contract involuntarily causing your head to twist or turn into an uncomfortable position.
  • Lazy eye. The most common cause of lazy eye is an imbalance in the muscles responsible for positioning the eye.
  • Muscle contractures. Some neurological conditions, such as cerebral palsy, can cause your limbs to pull in toward your center. In some cases, these contracted muscles can be relaxed with BOTOX injections.
  • Hyperhidrosis. In this condition, excessive sweating occurs even when the temperature isn’t hot and you’re not exerting yourself.
  • Chronic migraine. If you experience migraines more than 15 days a month, BOTOX injections may help reduce headache frequency.
  • Bladder dysfunction. BOTOX injections can also help reduce urinary incontinence caused by an overactive bladder.
  • Eye twitching. BOTOX injections may help relieve contracture or twitching of muscles around the eye.
What is Botox?


If you have never had BOTOX before, your evaluation and consultation will review the 4 pillars of aging. These include the loss of facial volume, the loss and break-down of tissue collagen, the resulting hyperactivity of the muscles of facial expression, and the surface skin changes that change the radiance of your skin. 


Based on how these changes may have affected you, we will develop a treatment plan. It is very possible that BOTOX is the only item on the treatment plan but we also offer a full line-up of complimentary treatment options like BBL and facial fillers.  


Based first on your concerns, and then on your physical evaluation, a treatment plan is created just for BOTOX. This includes deciding whether you would benefit from treatment of your forehead, 11’s, crow’s feet, or bunny lines. Each area will generally require about 20 units of BOTOX for optimal results. 

Your treatment will be done by one of our cosmetic nurses who have been personally trained by Dr. Chang. Their training requires a full year internship. At the end of the internship, they would have had more experience than 90 percent of non-plastic surgeons and 70% of plastic surgeons. They are trained in surgery to see the real muscles in action that they will at some point address.

Each area is treated with a 30 gauge needle. This is the smallest needle available provided for your comfort. Topical numbing is generally not provided as it is not particularly effective. You may, however, request it if you want. Each area will have 2-4 injections per side.  In general, there is no significant bruising.

The reduced muscle activity starts 3-4 days after receiving your injections. from that point, it will take another 2 weeks to see maximum benefit. Although we will often hear anecdotal stories of Botox lasting 6 or more months. The manufacturer reports an average of about 3-4 months. The strategy is to be re-treated in 3 months in order to avoid having the muscle get worked up and strong again.

Your smooth, younger-looking skin will remain for approximately three to four months before the muscles slowly being to move again. Maintenance injections every three to four months will preserve your smoother, more youthful look.

Treating the forehead will not only reduce the lines of the forehead but because the muscles will not be able to contract, the skin collagen does not break down as fast. This will ultimately keep the skin from stretching or sagging with time, thereby preserving your brows where they are supposed to be.


If you already have low brown, then relaxing the forehead muscles (which normally elevate the brows) will cause the brows to fall; giving you the feeling and expression that your brows are heavy.

Treating the crow’s feet lines will not only reduce the visible wrinkles around the eye, but it will slow down the apparent aging in the area. Because the muscle is no longer able to contract the skin, the collagen does not break down as fast. The lower eyelid skin does not stretch or sag as fast over time.


Some inexperience practitioners will get too close to the upper eyelid which has a different muscle that raises the upper eyelid. The BOTOX will stop the upper eyelid muscle from working which normally raises the upper eyelid. The result is and eyelid droop. Eyelid droop can be partially treated with iodipine drops.

Treating the 11’s will not only reduce the lines of the forehead, but because the muscles will not be able to contract, the brows will stay in a higher position over time. Not only are higher brows more youthful, but they take the pressure off of the upper eyelids.

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