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What Are Botox Injections (Botulinum Toxin Injections)? | A Doctor Explains the Effects, Costs, Duration, and Risks
"What effects do Botox injections have?"
"Can anything be done about the wrinkles on my forehead and at the corners of my eyes?"
"Is it true that jaw Botox can slim the face?"
"I want to do something about my sweating and odor concerns."
Do you have questions or concerns like these about Botox?
Hello. This is Smart Skin Clinic, an aesthetic dermatology practice.
In this article, a cosmetic dermatology practice that performs over 10,000 injection treatments a year offers a careful explanation of Botox injections—their effects and safety, the amount needed for treatment, downtime, and the treatment process.
*If you already know what you are looking for, you can jump straight to the relevant section using the table of contents below.
Group Chief Director, Smart Skin Clinic Group
Ishii Kota
Career
Graduated from Juntendo University School of Medicine
Worked at Tokyo Women's Medical University Hospital and affiliated facilities
Worked at a major aesthetic clinic in Tokyo
Affiliations / Qualifications
Board-certified specialist, Japan Surgical Society
Board-certified specialist, Japanese Society of Anti-Aging Medicine
What Is Botox?
Botox refers to "Botox Vista®," a type A botulinum toxin preparation made by Allergan Inc. of the United States.The name "Botox" is a registered trademark of Allergan, buttype A botulinum toxin preparations from other companies are also commonly referred to as Botox.
Type A botulinum toxin preparations were originally developed for medical purposes such as eyelid spasm and strabismus, and "Botox Vista®" is approved by the Ministry of Health, Labour and Welfare for "expression lines between the eyebrows or at the corners of the eyes."
It is approved in more than 90 countries, and its high level of safety has been confirmed through decades of use. Today it is also widely used off-label, for areas such as the forehead and the corners of the eyes.
What are expression lines?
Wrinkles that form when the skin folds as the facial muscles move—such as when smiling or frowning.
Young skin is rich in the components that provide firmness—collagen, elastic fibers, and moisture—so expression marks spring back quickly. With aging and UV exposure, the elastic fibers become damaged, and the marks may become slower to fade.
The Ingredients and Mechanism of Botox
"Type A botulinum toxin," the main ingredient of Botox, isa type of protein produced by the bacterium Clostridium botulinum.
Some people feel uneasy hearing the word "toxin," but only a very small amount is used in aesthetic medicine, and its action is limited to temporarily relaxing muscles. As long as the recommended dose is followed, it does not cause strong systemic side effects, and it is used widely around the world.
How Botox Works
Botox is taken up by the nerve endings and,by temporarily halting the "signals that move the muscles," curbs contractions and habitual expressions, making "expression lines" less noticeable.Because its action is temporary, after a few months the body's natural recovery forms new nerve connections, and muscle movement gradually returns.
- Botox injection
- The injected Botox binds to the endings of the nerves that move the muscles
- Botox is taken up into the nerves
- Botox stops the release of the neurotransmitter (acetylcholine) needed to send signals to the muscles
- Because the signals are not transmitted, muscle contraction is reduced, making wrinkles and habitual expressions less noticeable
- After a few months, the body's natural recovery forms new nerve connections, and the muscles begin to move again
The Effects of Botox
With Botox, there are conditions that may be improved and conditions that are difficult to improve.
| Conditions that may be improved with Botox | Conditions that are difficult to improve with Botox |
| Horizontal forehead lines Frown lines between the brows Wrinkles at the corners of the eyes Wrinkles under the eyes Bunny lines Vertical wrinkles around the mouth "Pebbly" chin wrinkles Vertical neck lines Stiff shoulders Hyperhidrosis (excessive sweating) | Horizontal wrinkles under the eyes Wrinkles of the under-eye area Wrinkles between the nose and cheeks (nasojugal groove) Streaks along the cheekbones (zygomatic bands) Nasolabial folds Marionette lines extending downward from the corners of the mouth |
By appropriately curbing muscle movement, Botoxeffectively improves wrinkles and muscle bulges formed by the repeated contraction of facial muscles.
Deep wrinkles visible even at rest, skin sagging or texture, lack of volume, and issues caused by descending fat are outside its scope. For sagging and deep folds, hyaluronic acid or lifting treatments are better suited.
Treatable Areas (Indications)
Horizontal forehead lines (frontalis muscle)
Forehead wrinkles form when the frontalis muscle contracts as you raise your eyebrows or make a surprised expression. As the skin loses elasticity with age, horizontal wrinkles become more deeply etched.
Botox injected into the forehead improves the smoothness of the entire forehead for a more youthful impression.
Regarding the efficacy of type A botulinum toxin injection into the forehead,wrinkles were significantly reduced within 1 to 4 weeks, with the effect still present at 16 weeks.no upper eyelid ptosis was observed, and patient satisfaction was favorableThese findings are also reported in the following paper.
Wrinkles at the corners of the eyes (orbicularis oculi muscle)
The fine wrinkles that radiate from the corners of the eyes ("crow's feet") form as the orbicularis oculi muscle contracts when you smile. As these wrinkles deepen, they can give an aged impression.
By not stopping the movement of the expression entirely but leaving it in moderation,you keep a youthful, natural smileThis is important.
Frown lines between the eyebrows (corrugator muscle)
Vertical lines between the brows tend to give a negative impression of looking "angry" or "displeased." These wrinkles are influenced by habitual use of the muscles that raise and lower the brows.
When Botox injection improves these wrinkles,the expression shifts to a calmer, more approachable impressionit changes.
Bunny lines (wrinkles at the bridge of the nose)
Bunny lines are the fine wrinkles that form at the bridge of the nose when you smile, squint, or scrunch your nose. They are named for their shape, which brings a rabbit to mind.
Because they may also appear along with loosening and sagging of the skin due to aging or to Botox treatment of the forehead, treatment may need to address not only the bunny lines but the surrounding muscles at the same time.
Gummy smile
A "gummy smile," in which too much of the gums shows when you smile, is partly caused by strong action of the levator labii superioris alaeque nasi muscle.
By injecting Botox into the appropriate area, the lifting of the upper lip can be moderately curbed to create a well-balanced smile.
Sides of the nose
One reason the nostrils flare sideways and the nose appears more prominent when you smile is a well-developed muscle that moves the nostrils (the nasalis alar muscle). Injecting Botox into this muscle relaxes its movement and curbs the flaring of the nostrils.
Philtrum
The philtrum is the vertical groove between the nose and the lips. When the philtrum looks long, it tends to give an elongated, aged impression.
By injecting Botox into the orbicularis oris muscle (the muscle around the mouth), the upper lip is gently lifted and gains dimension, andthe philtrum appears shorter, contributing to a small-face effect and a more youthful impression.
Corners of the mouth
If the muscles that pull the corners of the mouth down (the depressor anguli oris) are overdeveloped relative to the muscles that lift them (the levator anguli oris), the corners of the mouth always appear downturned, giving a displeased impression.
Downturned corners of the mouth are caused mainly by loosening of the facial muscles and by mouth breathing.
When Botox injection turns the corners of the mouth slightly upward,the expression can be softened.
Chin ("pebbly" chin wrinkles)
The bumpy "pebbly" wrinkles that form in the center of the chin are caused by excessive contraction of the mentalis muscle. Unconscious tensing due to a receding lower jaw or a poor bite creates unevenness on the skin's surface.
Injecting Botox smooths the unevenness of the chin, gives the chin tip a sharper shape, and refines the profile line.
Jaw (masseter muscle)
When the masseter muscle becomes well developed from clenching or grinding the teeth, the jaw can appear square and the lower half of the face can look larger.
By moderately reducing the masseter muscle with Botox,the jawline and profile can be refined, offering a small-face effect.Also,It may also help reduce nighttime teeth grinding, wear on the back teeth, and strain on the jaw joint, and ease morning jaw fatigue.Such effects may also be seen.
In men, more units may be needed because of greater muscle mass.
Regarding the efficacy of type A botulinum toxin injection into the masseter muscle,atrophy appears 2 to 4 weeks after injection, with an average 31% reduction in muscle thickness measured by ultrasound at 3 monthsThese findings are also reported in the following paper.
Neck wrinkles (platysma muscle / Botox lift)
Vertical neck lines (platysmal bands) form due to tension in the platysma muscle. Because part of the platysma pulls down the corners of the mouth and the lower face, it contributes not only to vertical neck lines but also to facial sagging.
With Botox, you can expect not only improvement of vertical neck lines but also refinement of the facial line.
Shoulders (trapezius muscle)
When you routinely hold your head forward—during desk work, smartphone use, or slouching—the trapezius muscle stiffens and bulges.
When Botox is injected into the trapezius muscle,reducing the volume of the bulging muscle refines the curve from the neck to the shoulders and can make the neck look longer.
Armpit
Botox reduces sweat secretion from the sweat glands by suppressing the transmission of signals from the nerves to the glands.
You may wonder, "But sweat has nothing to do with muscles, does it?" This is because signaling to both the muscles and the sweat glands is carried by acetylcholine.
It is especially effective for those whose severe underarm sweating interferes with daily life.Treatment is typically about once or twice per season.
Note that hyperhidrosis is classified as a skin condition, and treatment may be covered by insurance if diagnostic criteria are met. In cosmetic dermatology, however, it is generally not covered by insurance.
Hyperhidrosis is diagnosed when locally excessive sweating has been present for 6 months or more without an obvious cause, and two or more of the following six symptoms apply.
- Symptoms first appear at age 25 or younger
- Sweating is symmetrical
- Sweating stops during sleep
- Episodes of excessive sweating occur at least once a week
- There is a family history
- These symptoms interfere with daily life
Difference from Skin Botox
Whereas regular Botox injections are placed directly into the facial muscles, Skin Botox (MicroBotox) is a treatment in which a small amount is injected into the shallow layers of the skin.
| Item | Regular Botox | Skin Botox |
| Injection depth | Intramuscular | Dermis to fascia surface |
| Injection volume | Relatively large | Small amounts over a wide area |
| Main effects | Improvement of expression lines | Skin-texture improvement, pore refinement, and sebum control |
| Effect on expressions | Yes | Minimal |
For more about Skin Botox, please see the following article.
Amount needed by area
The effect of Botox injections is expressed in "units (U)," a standard medical measure.It is common to dilute the "powdered preparation (U)" with saline (cc) before injecting.
| area | Approximate amount needed (U) |
| Forehead | 4–12 U |
| Between the eyebrows | 10–20 U |
| Outer corners of the eyes | 8–24 U |
| Root of the nose | 4–8 U |
| Bunny lines | Around 6 U |
| Sides of the nose | 5–12 U |
| Philtrum | Around 5 U |
| Gummy smile | 4–8 U |
| Corners of the mouth | 4–10 U |
| Chin | 8–16 U |
| Jaw (masseter muscle) | 30–80 U |
| Shoulders | 50–100 U |
| Armpit | 50–100 U |
| Botox Lift (platysma) | 40–100 U |
These are only rough guides; the actual number of units needed varies from person to person and requires adjustment based on muscle mass, wrinkle depth, and treatment history. We may start with a smaller amount at the first session and adjust as we observe your progress.
Because Botox continues to work for 3 to 6 months once it takes effect, for a first treatment it is reassuring to start with a smaller amount and add more if needed, or to increase the number of units (U) at subsequent sessions.
At our clinic, we adjust the number of units and the method of administration to each patient's background and wishes.
Who Botox Is Recommended For and Who It Is Not
| Those for whom Botox is recommended | Those for whom Botox is not recommended |
| Those concerned about expression lines (forehead, between the brows, corners of the eyes) Those whose expressions tend to look stern Those concerned about a square jaw or the size of the face Those bothered by underarm sweating or sweaty hands Those who grind or clench their teeth Those who prefer a treatment without surgery Those who want to keep downtime to a minimum Those who are able to keep up regular maintenance | Those at risk of a contraindication Those with only deeply etched wrinkles present at rest (dermal wrinkles) Those whose wrinkles are caused mainly by sagging skin |
How Long Botox Takes to Work, How Long It Lasts, and Treatment Frequency
- When the effect appears: after 2 to 3 days; the effect on the masseter muscle may take around 1 month
- Peak effect: after 2 to 3 weeks
- Duration of effect: 3 to 6 months; not permanent
- Recommended treatment interval: every 3 to 6 months
Botox temporarily curbs muscle movement by preventing the "move" signal from reaching the muscle from the nerve, but the effect is not permanent. As the nerves regenerate, muscle movement is gradually restored. Over time, muscle movement slowly returns and the effect gradually fades.
Duration varies from person to person and depends on muscle strength and lifestyle (habitual expressions, smoking, UV exposure, and so on).
Signs it may be time to consider your next treatment
- Expression lines that used to not bother you are now noticeable when you wake up in the morning
- Wrinkles when you smile or furrow your brow have gradually started to return
- You feel that your muscle movement has become stronger
Botox treatment is not a one-time event; keeping it up regularly provides more consistent results. The ideal interval between treatments is roughly 4 to 6 months.Rather than re-treating after the effect has fully worn off, it is recommended to have your next treatment while about 70–80% of the effect still remains.
By doing so,excessive muscle movement is gradually curbed, natural "muscle atrophy (thinning)" occurs, and as a result the effect tends to last longer.A further advantage is that you can reduce the amount of product needed each time, maintaining stable results with a smaller injected volume.
When you feel the effect is starting to fade, it may be a good time to consider your next treatment.
The Pain of Botox Injections
Botox injections do involve some needle-prick pain, but because a very fine needle is used, it is not unbearable. Tape or cream anesthesia may be used if desired, but in many casesno anesthesia is needed.
Pain during treatment can be eased by cooling the area before injection and adjusting the injection speed.
Common Downtime Symptoms and How to Manage Them
- Symptoms: swelling, redness, and mild pain at the injection site
- Duration: several hours to a few days
- How to manage: cooling (for pain and bruising); makeup (for redness and bruising)
Irritation from the needle may cause mild swelling and temporary redness at and around the injection site, and mild pain may last a few hours. Cooling the area moderately can help ease pain and prevent bruising.
Bruising is uncommon, but it will gradually fade over about two weeks. Redness and bruising can be covered with foundation or concealer, and makeup can be worn from the next morning.
Aftercare｜What You Can Do to Enhance the Effect of Botox Treatment
[Key points]
- Avoid activities that promote circulation
- Moisturize and protect against UV rays
- Do not touch the treated area
- Be mindful of how you use your facial muscles
There are two reasons not to warm the body.
(1) Increased blood flow can interfere with healing, and (2) botulinum toxin, which is sensitive to heat, may denature and lose its effect.These are the reasons.
After injection, try to avoid touching the treated area as much as possible to prevent the risk of infection through the needle punctures.
Skin with tiny, invisible wounds has a weakened barrier function and is more susceptible to external stimuli. When it is dry, it is more prone to damage than usual, so focus on moisturizing and protect your skin from UV rays and other external aggressors.
Botox not only temporarily curbs excessive muscle movement but also, by making you mindful of your habitual expressions, helps prevent future expression lines.
[What not to do within 24 hours]
- Strong facial expressions
- Strenuous exercise
- Prolonged bathing
- Sauna
- Excessive alcohol consumption
【Things Best Avoided Within 24 Hours】
- Strong facial expressions
- Bathing *showering is fine
- Alcohol consumption
- Makeup at the injection site
【Things Best Avoided for One Week】
- Massaging the injection site
- Harsh skincare (retinol, hydroquinone, scrubs, and the like)
Risks, Precautions, and Drawbacks
Unfortunately, the risks, precautions, and drawbacks of Botox are not zero.
However,Botox is used widely around the world and is very safe; when performed correctly, the risks are very rare.
Allergic reaction / infection
An allergic reaction to the product or the needle may occur.
If you experience severe swelling at the injection site, a whole-body rash, or difficulty breathing, seek medical care immediately.Treatment involves administering anti-allergy medication.
Also, because an injection is involved, there is a slight risk of infection.If you have swelling, a sensation of heat, or increasing pain, please seek medical care.
Discomfort or headache
After the injection, the surrounding muscles may be strained, and you may feel a mild headache or fatigue for a few days.
In most cases these are temporary and improve over time.
Unexpected effects on muscles
Botox may spread slightly beyond the injection site into the surrounding area. As a result, it can sometimes affect movement in unexpected areas.
However,if the appropriate dose and site are observed, the risk is considered very low.
Production of neutralizing antibodies (Botox resistance)
If Botox is repeated over a short period or injected in large amounts continuously, the body can "get used" to it and it may become less effective. This is known medically as "the production of neutralizing antibodies (Botox resistance)."
To help prevent the production of neutralizing antibodies,it is recommended to keep each dose within 200–300 units and to leave at least 3 months between treatments.This is recommended.
Effect on chewing strength
When Botox is injected into the jaw (masseter muscle), chewing strength may weaken temporarily. However, this usually settles within about a week and rarely interferes with daily life.
Site-specific risks
- Injection into the forehead: the eyelids may feel heavy (ptosis)
- Injection between the brows: raised brows (Spock brow), a lowered brow tail, or a change in brow shape
- Injection at the corners of the eyes: the eyelid may turn outward, or the under-eye area may appear smaller
- Other: asymmetry between the left and right sides
Unfortunately, there is no treatment to reverse these symptoms immediately once they appear. However, because the effects of Botox naturally wear off within 4 to 6 months, they will return to normal in time. All of these risks can also be avoided through proper injection by a physician well versed in anatomy.
Contraindications and Those Who Require Caution
- Pregnant or breastfeeding women: contraindicated because safety for the fetus and infant is not established; contraception is needed for 3 months after treatment
- Allergy to botulinum toxin: contraindicated for those with a history of previous allergy
- Neuromuscular disorders: contraindicated for those with myasthenia gravis, amyotrophic lateral sclerosis, or Lambert-Eaton syndrome
- Certain medications: caution is needed with aminoglycoside antibiotics and muscle relaxants
- Blood-clotting disorders: increased risk of bleeding
- Immunosuppressed state: the risk of infection must be considered
- Infection or inflammation at the injection site: reduced treatment effect and risk of spreading infection
- Under 18 years of age: best avoided, as safety is not established
For other details, please contact the clinic.
Advantages and Disadvantages of Botox
| Benefits | Drawbacks |
| Treatment is completed quickly Little pain during treatment Little to no downtime | It takes time for the effect to appear The effects are not permanent There are site-specific risks (for example, with the forehead, there is a risk that the eyes become harder to open) |
Combining with Other Treatments
Treatments that offer a synergistic effect
Botox is highly effective for "expression lines caused by muscle movement," but that is not the only cause of wrinkles. Because deterioration of the skin's own texture and age-related sagging are often involved as well,combining it with other treatments can offer a more natural, comprehensive rejuvenating effect.
Photofacial
Special light (IPL) targets dark spots, uneven tone, and enlarged pores, and stimulates the production of collagen and elastin to refine the skin's overall texture. Softening "expression lines" with Botox while creating "beautiful skin" with device treatment at the same time gives a more youthful impression.
Volnewmer
Radiofrequency (RF) is designed to stimulate collagen production in the dermis, tighten the fat layer, restore firmness, and help improve sagging. It is suited to deep wrinkles caused by sagging and to nasolabial folds.
Juvelook Volume (Lenisna) Injection
This is a skin-conditioning treatment using an injectable that combines non-cross-linked hyaluronic acid and polylactic acid (PDLLA). Its particles are larger than those of Juvelook, so it works deep within the skin and may add volume. It stimulates the production of collagen and elastin and is effective for deep wrinkles such as nasolabial folds and on the forehead.
Gouri Injection
This is a liquid injectable containing PCL (polycaprolactone), effective for lifting and improving sagging. PCL is used in medical sutures and, as it gradually breaks down in the body, stimulates collagen production over a long period, tightening sagging areas. It can be used on the forehead, eye area, cheeks, and mouth, and results can be felt in anywhere from a few days to about a month.
Precautions for Combination Treatment
Botox can offer a strong synergistic effect when combined with other treatments, but please note the following points.
- Treatment intervals need to be adjusted
In some cases you may be able to receive multiple treatments at the same time, but depending on the procedure it may be better to leave several weeks between them. Always consult your physician. - The physician's skill determines the result
When combining multiple procedures, entrusting the work to a physician who can comprehensively assess the overall facial structure and the degree of aging leads to a natural, youthful result.
What Happens If You Keep Getting Botox?
- It becomes easier to maintain the effect
- It can help prevent new expression lines
When Botox is continued appropriately, the facial muscles atrophy moderately, making it easier to maintain the effect with fewer units. By curbing facial-muscle movement, it can also help prevent the formation of new wrinkles.
To avoid side effects and risks, follow the treatment intervals and the annual total number of units, and be careful not to overdose.
About the Types of Botox Preparations
Smart Skin Clinic offers two preparations: "Botox Vista®" and "Botulax."
Both can deliver ample results when used appropriately, but they differ in their approval status and characteristics.
At our clinic, the physician listens to your concerns and wishes during the consultation and proposes the most suitable preparation.
Botox Vista® (Allergan Inc. / USA)
It is the only preparation approved by the Ministry of Health, Labour and Welfare in Japan.
With a long track record around the world,it offers high reliability in both safety and efficacyThis is its hallmark. It is recommended for first-time patients and for those who place the highest priority on safety.
Reference:Botox Vista
Botulax (Hugel Inc. / Korea)
This preparation is approved by South Korea's MFDS (formerly KFDA) and is an unapproved drug in Japan.
Developed with reference to Botox Vista®, it is regarded as a "generic-like preparation" andis chosen by those who value cost-effectivenessis chosen by such patients.
Reference:Hugel Inc.
About Other Preparations
Overseas, preparations such as "Xeomin (made by Merz of Germany)" and "Dysport (made by Ipsen of the UK)" are also used. However, they are not approved in Japan and are not currently available at our clinic.
What You Can Do to Avoid Disappointment with Botox Injections
Botox is a very safe treatment when used correctly, but to keep the risks to a minimum, your own preparation matters as well.
Choose an experienced physician
With Botox, the result varies greatly depending on the "location," "amount," and "depth" of the injection.
By entrusting the work to a physician well versed in anatomy and with ample experience, you can avoid unnatural expressions and left-right asymmetry.
Refer to case photos and reviews.
Have a thorough consultation
It is important to clearly convey your ideals in advance, such as "where you want to improve" and "how much you want to prioritize a natural look." If your understanding differs from the physician's, there is a higher risk that the result will differ from your expectations. Be fully satisfied at the consultation before proceeding with treatment.
Follow proper intervals and doses
Repeating treatment over a short period, or using larger doses than necessary, increases the risk. Continuing treatment at 4-to-6-month intervals is generally recommended.
Aftercare
How you spend your time after treatment affects the results.
Immediately after treatment, it is important to avoid vigorous massage, alcohol, and strenuous exercise. This prevents the risk of the product spreading in unintended directions or losing its effect.
Treatment Flow
You can easily book from your smartphone.
You can book a convenient date and time through our online reservation system or by phone. Both first-time and returning patients can book anytime, 24 hours a day.
A smart, effortless check-in: just give your name and our clinic IT system completes reception right away.
When you arrive, simply give your name at the reception desk for a smooth check-in. First-time visitors will be asked to complete a brief medical questionnaire.
During counseling, please feel free to share any concerns. Rest assured, there is no pushy sales.
After disinfection and marking, we cool the area if necessary.
We adjust the number of units to your desired areas and perform the injections while checking in with you throughout.
Time required: approx. 10–15 minutes (varies by treatment area)
We explain in detail how to care for the treated area and precautions for daily life.
From the standpoint of prevention and maintenance, we also suggest appropriate home care, such as oral medications and skincare products designed to help address your concerns.
After the treatment, you can return to daily life right away. Makeup can be worn from the next morning.
If you have any concerns, please feel free to contact us at any time.
Frequently Asked Questions (FAQ)
- Is Botox painful?
-
Because we use a very fine needle, pain is minimal.
To ease discomfort, we also cool the area before injection, adjust the injection speed, and take care to create a relaxing environment. - Will I see results immediately after treatment?
-
The effects of Botox begin to appear gradually from about 2 to 3 days after injection. Results vary, but most people notice a satisfactory effect within 2 weeks.
- How long is the downtime?
-
Swelling, redness, and mild pain at the injection site may occur for several hours to a few days. They can be covered with makeup.
- Is Botox safe?
-
Botox has been used medically since the 1970s and received FDA approval for cosmetic use in 2002, making it a well-established treatment with a solid safety record.
- Are there any concerns about allergies?
-
Serious allergic reactions to Botox are extremely rare. However, anyone who has had an allergic reaction to Botox in the past cannot receive it.
- Will my expressions look unnatural?
-
Based on sound anatomical knowledge, injecting the right amount into the right area can effectively soften wrinkles while keeping your expressions natural. Choose a clinic you can trust.
- Can men receive this treatment?
-
Both men and women can be treated. Because men tend to have greater muscle mass, they may require more units than women.
- Are there any restrictions on daily life after treatment?
-
In general, there are no major restrictions on daily life. However, to maximize the effect and prevent side effects, please follow precautions such as "avoid activities that raise body temperature" and "avoid touching the treated area excessively."
- How often is treatment needed?
-
This varies with muscle mass and lifestyle, but an interval of 4 to 6 months is a good guide. Please leave at least 3 months between treatments.
- Can it be combined with other aesthetic treatments?
-
You can discuss treatment combinations and intervals in detail at your consultation.
Examples of compatible treatments: hyaluronic acid injection (for deep wrinkles), Photofacial (skin-texture improvement), thread lift (for sagging), and Skin Botox (skin-texture improvement)
Examples of combinations to avoid: other botulinum toxin products around the same time, and treatments that promote circulation on the same day
About Botox Pricing
Some people find Botox pricing hard to understand.
Unlike other treatments, we often hear people say they can't tell what costs how much, or what the unit (U) means. Here we explain the main pricing structures for Botox.
Comparison of Main Pricing Structures
The pricing structure for Botox injections varies from clinic to clinic. The two typical types are "per unit" and "per area."
| Pricing structure | Features | Benefits | Points to note |
| Per unit | The price is determined by the number of units used | ・Can be adjusted to muscle strength and symptoms ・The amount of product is clear and easy to compare | ・The total can vary greatly depending on the number of units needed ・The total needs to be confirmed before treatment |
| Per area | A price is set for each treatment area, such as "forehead," "between the brows," or "corners of the eyes" | ・The pricing is easy to understand and reassuring ・Little worry about additional charges ・Discounts may be available for multiple areas | ・A flat fee regardless of the number of units needed ・May be relatively expensive for mild cases |
*In general, the Botox dose is expressed in "units (U)" rather than in ml or cc.
As a rule, our clinic uses per-area pricing. Because the prices are clearly presented, the total is easy to understand before treatment, so even first-time patients can receive treatment with peace of mind.
Main Factors That Affect the Price
- The type of preparation used
- The characteristics of the treatment area
- The clinic's policies and setting
Because of these factors,the price can differ even for the same areaThis can happen. For example, drugs approved by the Ministry of Health, Labour and Welfare tend to cost more because their safety is well supported, and masseter (jaw) and hyperhidrosis treatments require more units because of the larger area. The physician's experience and the aftercare provided are also commonly reflected in the price.
Smart Skin Clinic Pricing
This is different from "cc" or "ml."
"units (U),"For botulinum toxin, units are a common medical measure used at every clinic.
| Contents | Korean-made | (price per area) | Allergan-made PREMIUM | (price per area) |
|---|---|---|---|---|
| 1 area | 11,800 yen | 11,800 yen | ¥16,800 | ¥16,800 |
| 2 areas | 18,400 yen | 9,200 yen | ¥30,400 | ¥15,200 |
| 3 areas | 25,500 yen | 8,500 yen | ¥43,500 | ¥14,500 |
| Each additional area (4th area onward) | — | 7,600 yen / area | — | ¥13,800 / area |
| Area / volume | Korean-made | Allergan-made PREMIUM |
|---|---|---|
| Jaw (masseter) 40U | 14,800 yen | ¥28,600 |
| Jaw (masseter) 80U | 28,800 yen | ¥51,400 |
| Botox Lift (platysma) 40U | 34,800 yen | ¥48,600 |
| Shoulders 50U | 19,800 yen | 35,800 yen |
| Shoulders 100U | 38,800 yen | ¥65,800 |
| Underarms 100U | 29,800 yen | 54,800 yen |
| Underarms 200U | 57,800 yen | 100,000 yen |
Details
| Item | Contents |
| Treatment Time | About 5 to 15 minutes (excluding consultation) |
| Recommended Number & Frequency of Treatments | Treatment is recommended at intervals of approximately 3 to 6 months |
| Downtime | A few hours to a few days |
| Treatment on the day of counseling | Available |
| Makeup | Recommended from the following morning onward to help prevent infection |
| Skincare | Possible right after the treatment |
| Shower | Possible from the same day |
| Pain | A slight pricking sensation when the needle is inserted. |
*Individual results may vary.
Legal Notices
Botox injections include treatments using drugs not approved in Japan. The drugs used in treatment are imported personally at the discretion of our clinic's physicians.
Please refer to this page for information on medications and similar items that require caution in personal importation.
Ministry of Health, Labour and Welfare, "Medications and Similar Items That Require Caution in Personal Importation."
Smart Skin Clinic for Botox Injections
Botox injections are a treatment that may deliver a wide range of effects, from improving expression lines and a square jaw to treating hyperhidrosis. Continuing treatment can provide more effective and lasting results, and may also help prevent new expression lines.
At Smart Skin Clinic, you can choose between Botox Vista®, approved by the Ministry of Health, Labour and Welfare, and Botulax, which offers strong value for money. We present our prices clearly and offer discounts for treating multiple areas in one session, as well as repeat-patient discounts.
If you have any questions or concerns about Botox injections, please feel free to consult us at a free consultation.
References & Citations
The Japanese Dermatological Association
Physician Who Supervised This Page
Smart Skin Clinic, Chief Medical Director / Physician
Kota Ishii
We oversee treatment policies across the entire group, tailored to the skin condition of each individual patient. The content on this page has been reviewed and approved in line with our clinic's treatment policies.
Interview with Director Kota Ishii
Kota Ishii, our Chief Medical Director, shares our clinic's approach to patient care.
Clinic List
Jimbocho Clinic
〒101-0054
3-16-1 Kanda Nishiki-cho, Chiyoda-ku, Tokyo, EX Kanda Nishiki-cho Building 8F (general reception) / 7F
Hours: Mon–Fri 11:00–20:00 / Sat & Sun 10:00–19:00
Yokohama Clinic
〒221-0835
TS Plaza Building 2F, 2-23-2 Tsuruya-cho, Kanagawa-ku, Yokohama-shi, Kanagawa
Hours: 10:00–19:00
About the physician supervision of this site
This site is operated under the supervision of a Smart Skin Clinic supervising physician.
This page was produced in accordance with the Medical Advertising Guidelines Medical Advertising Guidelines revised and enforced in June 2018, under which we produce and provide this information.
- Scope of supervision: treatment descriptions, risks and side effects, price display
- Last supervision date: June 26, 2025