Botox, Dysport, Xeomin, and other neuromodulator injectables are non-surgical procedures for targeting active lines or age-associated wrinkles. These compounds are derived from botulinum toxin A, which temporarily weakens or paralyzes specific muscles underneath the skin. As a result, the weakened muscle does not contract as strongly and therefore the overlying skin is not creased as prominently.

While treatment is individualized, for most patients there are three separate potential areas for botox injection: (1) the vertical frown lines between the eyebrows (the "11's"), (2) the crow's feet lines extending out from the corners of the eyes, and (3) the horizontal forehead lines above the eyebrows. More specifically, the glabellar muscles are targeted for frown lines, orbicularis muscles are target for crow's feet, and the frontalis muscles are targeted for forehead lines. 

Good candidates for this procedure:

  • Patients with lines and wrinkles on their faces caused by common facial movements

  • Patients who desire softened or partially improved facial wrinkles

What to expect: Consultation

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All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for Botox injection.


Dr. Hsu will first ask you about your specific goals for the Botox procedure, including what areas of the face you would like to improve. He will also ask you about your general health history, including any existing medical problems, prior surgery, daily medications, allergies, and any smoking habits.

Dr. Hsu will then give you his assessment on whether you would be a good candidate for the procedure, and if so, how the surgical plan should be individualized for your anatomy. Since each patient's anatomy and surgical goals are different, you and Dr. Hsu will work together to reach optimal aesthetic results.  

Botox injection


To perform the injection, Dr. Hsu will use a very thin needle to minimize pain. More sensitive patients may also desire numbing cream. However, numbing cream requires a wait time of 15-20 minutes to be effective. After the procedure, most patients see partial effects in two to four days and full effects in a week. Injections are very well tolerated and are one of the most popular procedures performed in our office. The effects of Botox usually last from four to six months. However, there have been individual cases in which the effects last approximately three months or even longer than six months.

Botox not only provides cosmetic benefits, but also can help patients with migraines. While medication remains the first type of treatment, Botox can help alleviate pain if medication is not fully effective.

Dr. Hsu's view on Botox.


My approach to any injections, including all of the neuromodulators like Botox, Dysport, and Xeomin, is that the neuromodulators need to be injected in precise locations within specific muscles to achieve the best results. Every surgeon has a different technique, and for me, the technique that I use has provided very good results and very happy patients. I think that the key to success is precise injection technique and good judgment in deciding where to place the individual injections.

Overall, I believe a conservative approach can give patients very nice results that appear natural.  I’ve found that there is a balance to strike, in trying to lighten some of the lines in the face, but while maintaining facial harmony so that the overall facial appearance looks refreshed and still natural.