What exactly is Botox, and what does it really do? Botox has become a household name, but there’s still plenty of confusion around how it works and what patients should realistically expect.

Botox is a purified form of botulinum toxin type A that has been safely used in medicine for decades. In aesthetics, we use it in very small, controlled doses to temporarily relax specific muscles in the face. These muscles are responsible for what we call “dynamic wrinkles” — the lines that form when you frown, squint, or raise your eyebrows. Think forehead lines, crow’s feet, and the “11s” between the brows.

Here’s how it works: when Botox is injected into a targeted muscle, it blocks the nerve signals that tell that muscle to contract. When the muscle relaxes, the overlying skin smooths out. The result is a refreshed, more relaxed appearance — not a frozen or expressionless face when it’s done correctly. My goal as a doctor is always to preserve your natural facial movement while softening the lines that make you look tired, stressed, or older than you feel.

One of the most important things I tell patients is that Botox is both corrective and preventative. Yes, it can smooth existing lines, but it can also help prevent deeper wrinkles from forming over time. By reducing repetitive muscle movement, we slow the etching of lines into the skin. That’s why many patients in their late 20s and 30s choose Botox as a proactive part of their skincare routine, while others start later and still see beautiful, meaningful results.

Botox also does more than just address wrinkles. Medically, it has been used to treat migraines, excessive sweating (hyperhidrosis), jaw clenching and teeth grinding (TMJ), and even certain muscle spasms. In a medical spa setting, we often treat masseter muscles to slim the jawline and relieve tension, or address neck bands to create a smoother, more youthful profile. These treatments can be both cosmetic and quality-of-life enhancing.

Results from Botox are not instant. You’ll typically start to notice changes within three to five days, with full results appearing around two weeks after treatment. The effects generally last three to four months, depending on your metabolism, muscle strength, and lifestyle. Maintenance treatments are key to keeping consistent results.

Above all, Botox is a medical treatment. It should always be performed by a qualified, experienced provider who understands facial anatomy and aesthetics. When done thoughtfully and conservatively, Botox doesn’t change who you are — it simply helps you look more rested, confident, and like the best version of yourself. As a doctor, that’s exactly the outcome I strive for with every patient who sits in my chair.

Michael Mettler is a medical spa marketing specialist based in Washington State.