Botox Treatment Guide: Benefits, Side Effects, and Who Is a Good Candidate

Author: Medical Corporation Shingetsukai

Dr. Shinya Sasagawa　 Doctor Profile

Specialized Clinic for Nasolabial Folds & Wrinkle Treatment
Osaka / Tokyo / Nagoya Houreisen Skin Clinic

“People often tell me I look angry even when I am not.”

“I want to reduce forehead wrinkles, but I do not want my facial expressions to look unnatural.”

Botox is an injectable treatment that can improve these expression lines. It is also used for concerns such as a square jaw caused by strong chewing muscles and excessive sweating. Although the procedure itself is short, the final result depends greatly on where and how much Botox is injected.

At our clinic, we also see patients who hesitate to try Botox again because they previously experienced unnatural facial expressions after treatment elsewhere. Reducing wrinkles is important, but maintaining your natural smile and expressions is equally important.

Key Takeaway

Botox works by relaxing excessive muscle movement, helping to reduce wrinkles that appear when making facial expressions.

For expression wrinkles, results usually begin to appear around 2–3 days after treatment, with the effect becoming more noticeable within 1–2 weeks. The typical duration is approximately 3–6 months, although this varies depending on the individual.

At Houreisen Skin Clinic, we carefully evaluate facial movements, eyebrow position, eyelid movement, muscle strength, and asymmetry to achieve natural-looking results.

目次

• What is Botox? How Does It Work?
• Areas That Can Be Improved with Botox
  • What is Mid-face Botox?
• Botox Before & After Cases at Our Clinic
  • Nasolabial Folds That Become Deeper When Smiling
  • Glabellar Lines (Frown Lines Between the Eyebrows)
  • Forehead Wrinkles
  • Crow’s Feet and Under-Eye Wrinkles
  • Gummy Smile
  • Downturned Mouth Corners & Chin Dimpling Wrinkles
  • Masseter Botox for Jaw Slimming & Teeth Clenching
• Botox for Excessive Sweating (Hyperhidrosis)
• When Does Botox Start Working and How Long Does It Last?
  • When should Botox be repeated?
• How We Focus on Natural-Looking Results
  • Forehead Botox
  • Mouth Area Botox
  • Masseter Botox
• When Botox Is Not Enough: Botox vs Hyaluronic Acid
  • Combining Botox and Hyaluronic Acid
• Procedure Time, Pain, Downtime & Aftercare
  • Aftercare Instructions
• Possible Side Effects and When to Contact Us
  • Who Should Avoid Botox Treatment?
• Botox Products and Treatment Fees
• Frequently Asked Questions About Botox
  • Does Botox make wrinkles worse if I stop?
  • Can I continue receiving Botox regularly?
  • How long does Botox take to work?
  • Can I receive Botox while pregnant or breastfeeding?
  • Can I have a consultation only?
• Achieving Natural Results While Reducing Wrinkles

What is Botox? How Does It Work?

Botox injection is a treatment that uses botulinum toxin type A. It works by reducing the nerve signals that tell muscles to contract, helping overly active muscles relax.

Vertical lines between the eyebrows and horizontal forehead lines appear because the muscles underneath the skin repeatedly contract. By reducing excessive muscle movement, the skin folds less frequently and wrinkles become less noticeable.

Botox can also be used for other concerns. For example, it may help reduce the appearance of a square jaw by relaxing enlarged chewing muscles. It can also reduce excessive sweating by temporarily reducing the activity of sweat glands.

The word “Botox” is originally a product name, but in this article we use it as a general term for botulinum toxin injections. At our clinic, we offer Coretox and Allergan products.

Areas That Can Be Improved with Botox

Different concerns require different injection techniques, including the location, depth, and amount of Botox used.

Forehead, Glabella (between eyebrows), Crow’s feet
Helps soften horizontal forehead lines, vertical frown lines, and wrinkles around the eyes caused by facial expressions.

Nasolabial folds & Gummy Smile
May improve wrinkles around the nose and mouth that become deeper when smiling, as well as excessive gum exposure caused by strong upper lip movement.

Downturned Mouth Corners & Chin Wrinkles
Relaxes muscles that pull the mouth corners downward and improves dimpling wrinkles on the chin.

Masseter Muscle (Jawline) & Teeth Clenching
Reduces excessive masseter muscle activity, helping improve jaw muscle enlargement and teeth grinding.

Shoulders, Neck & Calves
Can be used for muscle-related concerns such as shoulder muscle prominence, neck bands, and bulky calf muscles.

Underarms, Palms & Soles
Reduces excessive sweating by decreasing sweat gland activity.

Pores & Excess Sebum (Skin Botox)
A superficial injection technique that may help improve oily skin and the appearance of enlarged pores.

What is Mid-face Botox?

The mid-face generally refers to the area from below the eyes to the upper lip. At our clinic, “mid-face Botox” refers to skin Botox treatment.

Unlike traditional muscle injections, skin Botox is injected into the superficial layer of the skin. It may help improve enlarged pores and excessive sebum production on the cheeks.

Botox for Pores & Sebum / Botox and Acne Concerns

Botox Before & After Cases at Our Clinic

The stronger the original facial muscle movement, the more noticeable the difference before and after Botox treatment may be. Here are some examples of treatment results from our clinic.

Each photo shows an individual patient’s treatment progress. Results and duration may vary depending on the individual. All treatments are cosmetic procedures and prices include tax.

Nasolabial Folds That Become Deeper When Smiling

For patients whose nasolabial folds become deeper when smiling due to strong movement of the nose and upper lip area, Botox may be an effective option. By relaxing the muscles that pull up the upper lip, Botox can help reduce wrinkles that appear during smiling.

The photo shows improvement in nasolabial folds when smiling. This patient also received Growth Factor injection to improve nasolabial folds that were visible even without facial movement.

Treatment: Nasolabial fold Growth Factor injection + Botox injection.
Follow-up: Before treatment and 3 months after treatment.
Regular price: Growth Factor injection (both sides) ¥180,000 + Nasolabial fold Botox ¥13,000. Total ¥193,000.

Main risks: Swelling, bruising, discomfort, asymmetry, and difficulty smiling due to excessive Botox effect. Growth Factor treatment may rarely cause overcorrection, lumps, or unevenness.

Botox does not improve nasolabial folds that remain visible even when the face is relaxed.

For static wrinkles, we recommend selecting a treatment based on the condition of the skin and facial structure. At our clinic, we first evaluate your facial movement and determine whether Botox is suitable.

Learn more about nasolabial fold Botox

Glabellar Lines (Frown Lines Between the Eyebrows)

Repeatedly frowning can create vertical lines between the eyebrows, sometimes making a person appear angry or tired. Botox relaxes the muscles responsible for this movement and helps create a softer expression.

After treatment, the patient was asked to make the same frowning expression. The wrinkles became less visible because excessive muscle movement was reduced.

Treatment: Botox injection between the eyebrows.
Follow-up: Before treatment and 2 weeks after treatment.
Regular price: One area Botox ¥13,000.

Main risks: Pain, swelling, bruising, allergic reactions, facial expression changes, asymmetry, eyelid heaviness, or eyebrow position changes.

Forehead Wrinkles

Horizontal forehead lines appear when lifting the eyebrows or opening the eyes. Forehead Botox reduces excessive muscle movement and helps soften these wrinkles.

The forehead is one of the areas where controlling the strength of Botox is especially important. If Botox is too strong, some patients may feel their eyebrows drop or their eyelids become heavy.

Treatment: Forehead Botox injection.
Follow-up: Before treatment and 2 weeks after treatment.
Regular price: One area Botox ¥13,000.

Main risks: Pain, swelling, bruising, allergic reaction, asymmetry, eyebrow lowering, and eyelid heaviness.

Crow’s Feet and Under-Eye Wrinkles

Fine lines around the eyes appear due to repeated movement of the muscles when smiling. Botox reduces excessive muscle contraction and helps make these wrinkles less noticeable.

Because the eye area greatly affects facial expression, our goal is not to freeze movement completely, but to maintain a natural smile.

Treatment: Crow’s feet Botox.
Follow-up: Before treatment and 2 months after treatment.
Regular price: One area Botox ¥13,000.

Main risks: Pain, swelling, bruising, asymmetry, unnatural appearance around the eyes, or reduced visibility of the tear trough.

Gummy Smile

A gummy smile refers to a condition where the gums become noticeably visible when smiling because the upper lip lifts too much. Botox can relax the muscles responsible for excessive upper lip movement and help reduce gum exposure.

This is a case of a woman in her 30s. Botox was used to reduce excessive gum exposure when smiling. Growth Factor injection was also performed to improve nasolabial folds.

Treatment: Nasolabial fold Growth Factor injection + Botox injection.
Follow-up: Before treatment and 1 month after treatment.
Regular price: Growth Factor injection (both sides) ¥180,000 + Botox ¥13,000. Total ¥193,000.

Main risks: Swelling, bruising, discomfort, asymmetry, and difficulty smiling caused by excessive Botox effect. Growth Factor treatment may rarely cause overcorrection, lumps, or unevenness.

Learn more about gummy smile treatment

Downturned Mouth Corners & Chin Dimpling Wrinkles

When the muscles pulling the corners of the mouth downward are overactive, Botox can help relax these muscles.

Botox can also improve “orange peel-like” chin wrinkles caused by excessive tension in the chin muscle.

This patient received Botox injections to the glabella, nose root, and chin. The tension of the chin muscle was reduced, making the wrinkles less noticeable.

Treatment: Botox injection to glabella, nose root, and chin.
Follow-up: Before treatment and 2 weeks after treatment.
Regular price: 3 areas ¥34,000. Chin only ¥13,000.

Main risks: Pain, swelling, bruising, allergic reactions, facial expression changes, asymmetry, and difficulty moving the mouth.

Masseter Botox for Jaw Slimming & Teeth Clenching

When the masseter muscles are enlarged, the jaw area may appear wider and stronger. Botox reduces excessive masseter muscle activity and can help improve teeth clenching and grinding.

This patient experienced improvement in jaw muscle prominence and facial asymmetry. Because jaw width can also be affected by bone structure and fat distribution, we evaluate the masseter muscle carefully before treatment.

Treatment: One session of bilateral masseter Botox.
Follow-up: Before treatment and 6 months after treatment.
Regular price: ¥26,000 (standard dose).

Main risks: Pain, swelling, bruising, asymmetry, difficulty chewing, jaw fatigue, cheek hollowing, and sagging appearance.

Learn more about Masseter Botox

Botox for Excessive Sweating (Hyperhidrosis)

Botox is also used for excessive sweating concerns such as underarm sweating and sweaty palms.

By reducing nerve signals that activate sweat glands, Botox can decrease sweating in areas such as the underarms, palms, and soles.

For facial sweating and oily skin concerns, we combine skin Botox with skin booster treatments.

Our underarm sweating Botox treatment using Coretox is available from ¥33,000 (tax included).

When Does Botox Start Working and How Long Does It Last?

When should Botox be repeated?

A general guideline is around 3 months after the previous treatment.

The ideal timing depends on when wrinkles, muscle tension, or sweating begin to return. We evaluate your condition and recommend an appropriate treatment schedule.

How We Focus on Natural-Looking Results

Many patients want to reduce wrinkles but are concerned about losing their natural expressions. This is an important concern.

Botox does not need to completely stop facial movement. The goal is to reduce excessive muscle activity while maintaining a natural appearance.

At Houreisen Skin Clinic, we carefully evaluate facial muscle movement, eyebrow position, eyelid movement, and facial balance before treatment. We adjust the injection points, depth, and dosage to achieve natural results.

Forehead Botox

Some people use their forehead muscles to help open their eyes. If Botox is injected too strongly in these cases, eyebrows may lower or eyelids may feel heavy.

We carefully evaluate eyebrow position and muscle movement to determine the appropriate amount of Botox.

Mouth Area Botox

For mouth-related treatments, we evaluate how the upper lip moves when smiling and check differences between the left and right sides.

Our goal is to improve wrinkles while maintaining a natural smile.

Masseter Botox

For jaw slimming treatment, we consider the overall facial balance and muscle volume. Using too much Botox may cause cheek hollowing, so appropriate dosage is important.

If you have experienced an unnatural result from Botox in the past, please feel free to discuss it with us.

When Botox Is Not Enough: Botox vs Hyaluronic Acid

Botox is suitable for wrinkles caused by facial movement, such as wrinkles when smiling or frowning.

However, wrinkles that remain even when your face is relaxed may require a different approach.

Hyaluronic acid injection may be suitable for wrinkles that have already become deeply etched into the skin.

Combining Botox and Hyaluronic Acid

Botox reduces muscle movement, while hyaluronic acid improves wrinkles caused by volume loss or skin indentation. Because they work differently, combining both treatments may provide better results for certain concerns.

Procedure Time, Pain, Downtime & Aftercare

After evaluating facial movement and muscle condition, the injection area is determined. The procedure itself usually takes approximately a few minutes to 15 minutes, depending on the number of treatment areas.

A fine needle is used, and some discomfort may occur during injection. For patients concerned about pain, laughing gas sedation is available as an option.

Small needle marks, redness, or slight swelling usually improve within several hours. If bruising occurs, it generally fades within 1–2 weeks.

Aftercare Instructions

Possible Side Effects and When to Contact Us

Possible side effects include injection pain, redness, swelling, bruising, and allergic reactions.

If Botox affects surrounding muscles too strongly, temporary changes may occur.

If you feel your expression looks unnatural, smiling is difficult, or your eyelids feel heavy, please contact the clinic where you received treatment.

Who Should Avoid Botox Treatment?

Botox treatment is not performed for:

• Patients who are pregnant or breastfeeding
• Patients who may be pregnant
• Patients with neuromuscular disorders such as myasthenia gravis
• Patients with severe allergies to treatment ingredients

Botox Products and Treatment Fees

At Houreisen Skin Clinic, we mainly use Coretox. Coretox is selected with consideration for antibody formation risks associated with repeated Botox treatments.

We also offer Allergan Botox products.

Additional areas, increased dosage, and anesthesia options are charged separately.

Frequently Asked Questions About Botox

Achieving Natural Results While Reducing Wrinkles

Botox is a convenient treatment that can improve expression wrinkles, jaw muscle prominence, and excessive sweating.

However, the injection technique and dosage greatly influence the final appearance.

At Houreisen Skin Clinic, we listen carefully to your goals and adjust treatment so that your facial expressions remain natural.

If you are unsure whether Botox is suitable for you, please feel free to contact us.