Skip to content Botox is an FDA-approved injectable that temporarily relaxes the specific muscles that crease your skin, softening forehead lines, the “11s” between your brows, and crow’s feet, usually within three to seven days. At Skynn MD, treatment is led by board-certified physician Dr. Raghav Gotur, a single visit takes about 15 to 20 minutes with no real downtime, and results typically last three to four months. Because muscle strength and the areas you want treated vary from person to person, your dose is matched to your anatomy and goals rather than a one-size template. Beyond wrinkles, the same medicine treats clenching and jaw tension, chronic migraine, and excessive sweating, which is why a physician-led approach matters here.
Botox is a purified form of botulinum toxin type A. When a tiny amount is placed into a target muscle, it briefly interrupts the nerve signal telling that muscle to contract. The muscle rests, the skin over it stops folding, and the lines that come from years of squinting, frowning, and raising your brows gradually smooth out. It does not fill or plump — that is the job of dermal fillers, which address volume and deeper static folds. Many people in Holly Springs combine the two, but they solve different problems, and a good injector will tell you which one your concern actually calls for.
Because the effect is muscular and temporary, the goal is control, not paralysis. Dosed well, you keep your expressions — you simply lose the etched-in lines that make you look tired or tense when you are neither.
Botox is priced per unit, which is the honest way to quote it: your total depends on how many muscles are treated and how strong they are, so a light first-timer and someone treating three areas are not the same plan. Rather than a flat package that bills you for units you may not need, your dose is matched to your anatomy and goals at your visit. For a current quote built around your specific plan, call our front desk at +19193229865 or book a consultation. If you are weighing Botox against Dysport or Xeomin, keep in mind those products are dosed differently, so comparing them by the area treated is more meaningful than unit for unit.
As a planning guide, here are the areas patients ask about most and the dosing each tends to take:
| What you’re treating | Typical unit range* |
|---|---|
| Forehead lines (frontalis) | ~10–20 units |
| Frown lines / “11s” (glabella) | ~20–40 units |
| Crow’s feet (both sides) | ~12–24 units |
| Brow lift / bunny lines / lip flip | ~2–10 units |
| Lip lines / perioral (smoker’s lines) | ~4–6 units |
| Masseter / jaw (per side) | ~20–30 units |
| Neck bands / platysmal (Nefertiti lift) | ~25–50 units |
*Unit ranges are general clinical guidelines for planning, not a quote or a finished treatment plan. Your dosing is set during your visit.
For a first-time forehead treatment, many patients land somewhere around 10 to 20 units, while the frown-line complex between the brows often needs 20 or more because those muscles are strong. Crow’s feet usually take a handful of units per side. These are starting points, not promises: muscle mass, how expressive you are, your goals, and whether you have had Botox before all change the math. Men frequently need more units than women because the muscles are larger, which is a good reason to be skeptical of any one-size-fits-all dose.
A physician-led plan starts conservative on a first visit, then fine-tunes at your two-week check so you are not over- or under-treated. You can always add; you cannot subtract once it is in.
The classic three are the upper face: horizontal forehead lines, the vertical 11s between the brows, and crow’s feet at the outer eyes. From there, smaller, more advanced placements can lift the tail of the brow for a subtly more open eye, soften “bunny lines” on the nose, relax a “gummy” smile, smooth a dimpled or pebbled chin, and ease vertical neck bands. A few units in the upper lip — a “lip flip” — can roll the lip slightly outward for people who want a touch more show without lip filler. These finer uses reward an experienced hand; the difference between natural and odd is a couple of units and a couple of millimeters. If your real concern is crepey texture or fine lines and wrinkles that Botox alone will not fix, we will say so and map out what actually will.
Fine vertical lines above the lip — often called smoker’s lines, whether or not you have ever smoked — come from the muscle that purses the mouth, and a few carefully placed units can soften them. This is different from a lip flip, which uses Botox to roll the lip slightly outward: here the goal is to relax the muscle just enough to ease the etched lines without flattening your ability to purse, sip, or speak clearly. Because the mouth is a working muscle, the dose is deliberately small — usually only a handful of units — and precision matters more than almost anywhere on the face. For deeper, set-in lip lines, Botox is often paired with a little dermal filler or a resurfacing treatment, and we will tell you honestly which combination your lines actually call for.
As the platysma — the broad sheet of muscle across the front of the neck — tightens with age, it can tug the jawline downward and throw vertical bands into relief. Relaxing those bands with Botox softens the cords, eases that downward pull, and can sharpen the line where the jaw meets the neck — an effect often called a Nefertiti lift, after the defined jawline of the Egyptian queen. It usually takes more product than a forehead, since the platysma is large, and it works best alongside treating the lower face rather than as a fix for loose, heavy skin, which is a different problem with different solutions. The neck is anatomically busy, so correct placement is what separates a clean result from an unwanted one — exactly where a physician’s read earns its keep.
This is where a physician-led practice earns its keep, and it is the use most local med-spa pages gloss over. The masseter is the thick muscle at the back of your jaw that powers chewing and clenching. Botox placed into the masseter does two things at once: over time it slims an overdeveloped, square jawline for a softer lower-face contour, and — more importantly for a lot of people — it relaxes the muscle so it stops grinding and clenching.
If you wake up with a sore jaw, tension headaches, or worn teeth, or your dentist has flagged bruxism, masseter Botox can quiet the muscle that is causing it. Because jaw pain and headaches can have several sources — dental, joint (TMJ), nerve, even sleep-related — Dr. Gotur’s internal-medicine background matters here. The job is not just to inject a muscle; it is to confirm the muscle is actually the problem, screen for anything that needs a dentist or other specialist first, and dose therapeutically rather than cosmetically. Relief typically builds over a few weeks and lasts a few months, and the jaw-slimming effect deepens with repeat sessions. For the visible jawline, Botox softens muscle bulk; if your concern is submental fullness, that is a fat problem we treat differently with Kybella.
Botox is also FDA-approved for chronic migraine — defined as 15 or more headache days a month — using a specific multi-site protocol that is very different from a cosmetic forehead treatment. If migraines are running your life, that is a medical conversation, and you can read more about how it works on our Botox for migraines overview and our migraine treatment page. The same medicine, placed in the underarms, palms, or soles, also shuts down the overactive sweat glands behind hyperhidrosis — a quiet relief through a humid Holly Springs summer. Treating these conditions well takes clinical judgment about candidacy, dosing, and what else might be going on, which is exactly the standard we hold every Botox visit to.
Most healthy adults bothered by dynamic lines — the forehead creases, frown “11s,” and crow’s feet that deepen when your face moves — are good candidates, as are people looking for relief from jaw clenching, chronic migraine, or excessive sweating. Because Botox works on lines made by muscle movement, the people who get the most out of it are treating wrinkles that are still forming or just beginning to etch in, rather than deep folds that stay put when the face is fully at rest. If your concern is volume loss or set-in static lines, Botox is not the right tool by itself, and we will tell you what is.
A few conditions mean Botox should wait or be reconsidered, and screening for them is part of every visit. It is not recommended during pregnancy or breastfeeding, and it is not appropriate for anyone with a known allergy to botulinum toxin or an active skin infection where the injections would go. Certain neuromuscular conditions — myasthenia gravis, Lambert-Eaton syndrome, ALS — can be worsened by it, and some medications, including specific antibiotics and muscle relaxants, change how it behaves. This is exactly the kind of judgment Dr. Gotur’s internal-medicine background is built for. A short review of your health history and current medications confirms Botox is both safe and right for you before a single unit goes in.
Not much. The needle is very fine, and most people describe each injection as a quick pinch or pressure rather than pain. We can apply ice or a topical numbing cream if you are needle-shy. Start to finish, a focused treatment runs about 15 to 20 minutes, which is why so many of our patients book it on a lunch break or between RTP meetings. You walk out and go back to your day. The main aftercare rules are simple, and we cover them below.
You will usually notice movement softening around day three, with full results by about two weeks — so if you have an event, book two to three weeks ahead, not the week of. Results then hold for roughly three to four months before the muscle gradually regains movement and lines return. People who treat consistently often find the effect lasts a little longer over time, because the trained muscle stays weaker between visits. Most patients settle into a rhythm of three to four visits a year. There is no harm in letting it wear off completely; you simply return to your baseline, never worse than you started.
All three are botulinum toxin type A and all three relax muscles to smooth lines — the differences are in the details. Botox is the most studied and the name most people know. Dysport tends to spread a little more, which some injectors prefer for broad areas like the forehead, and it can feel like it kicks in slightly faster. Xeomin is a “naked” formulation with no added carrier protein, which is why some long-term patients choose it. The right one is the one that fits your anatomy and history, and we carry options so the product serves you rather than the other way around. For a side-by-side, see our dedicated Dysport and Xeomin pages, or just ask at your consult.
It is one of the most common questions we hear from younger Holly Springs professionals, and the honest answer is: it depends on your lines. Botox cannot prevent aging, but used in small, conservative doses on muscles that are starting to etch lines into the skin, it can slow how deep those lines become — you are training the muscle to crease less, so the skin has less reason to fold. It is not for everyone or every face, and good practice means starting light and treating the lines you actually have, not selling a subscription to a 28-year-old who does not need it yet. We will give you a straight read at your consultation.
To lower the small chance of bruising, it helps to avoid alcohol and, where medically appropriate, blood-thinning supplements like fish oil for a day or two beforehand — never stop a prescribed medication without asking us first. Afterward, the guidance is short and worth following: stay upright for about four hours, skip the gym and strenuous exercise that day, and do not rub, massage, or apply firm pressure to the treated areas, since that can move the product where you do not want it. Hold off on facials, saunas, and hot yoga for a day or so. That is essentially it — minimal downtime is one of the reasons Botox fits a busy schedule so well.
Skynn MD is a physician-led medspa, founded and led by Dr. Raghav Gotur, board-certified in Internal Medicine (ABIM, trained at the Mount Sinai School of Medicine) and in Aesthetic Medicine (AAAM), with more than 20 years in medicine. That background changes what a Botox visit looks like. Choosing the right product and dose for your facial anatomy, screening the medications and conditions that affect how Botox behaves, telling cosmetic concerns apart from medical ones like TMJ or chronic migraine, and managing the way muscles regrow over time are clinical judgments, not a menu.
It also means straight talk. You will get a plan built around your face and your goals — never a membership you must join or a flat package that bills you for units you do not need — and a physician’s honest read on whether Botox is even the right tool for what is bothering you.
Holly Springs has grown into one of the Triangle’s youngest, fastest-growing towns — a community of busy professionals and families, many of them commuting the 25 or so minutes up to Raleigh and Research Triangle Park and back. That pace is the whole point of Botox: a treatment that takes under 20 minutes, needs no recovery time, and fits between a school drop-off and a meeting. It is also why we see so much interest in the jaw-and-clenching side of Botox — desk work, screens, and deadline stress have a way of settling into a tight jaw.
The seasonal rhythm here lends itself to planning, too. If you want to look refreshed and rested for a First Friday downtown, a fall photo session, the holidays, or a HollyFest weekend at Sugg Farm, book your visit two to three weeks ahead so results have time to settle. Skynn MD serves clients across Holly Springs and the surrounding communities — Apex, Cary, Fuquay-Varina, Morrisville, Garner, Willow Spring, and the wider Raleigh metro and Wake County — and you can find directions and details on our Wake County location page. Wherever in the Triangle you are coming from, the goal is the same: results that look like a well-rested version of you, from a practice that will tell you the truth about what you need.
Botox is priced per unit, so your total reflects how many areas are treated and how strong those muscles are rather than a flat fee — a light, single-area first treatment costs less than treating the forehead, frown lines, and crow’s feet together. Because dosing is matched to your anatomy and goals, the most accurate number comes from a quick consultation rather than a generic price list. Call our front desk for a current quote built around your plan.
Many first-time forehead treatments use roughly 10 to 20 units, but the strong frown-line muscles between the brows often need 20 or more. The right number depends on your muscle strength, how expressive you are, your goals, and your history with Botox. We start conservatively and fine-tune at a two-week follow-up.
Most people feel only a quick pinch or light pressure with each injection, since the needle is very fine. Numbing cream or ice is available if you would like it. The appointment takes about 15 to 20 minutes with no real downtime.
Results generally last three to four months. You will start to see lines soften around day three, with full results by about two weeks. Many patients maintain their results with three to four visits a year.
Masseter Botox relaxes the large jaw muscle used for chewing and clenching. It can slim a square jawline over time and, for many people, relieve the soreness, tension headaches, and tooth grinding (bruxism) tied to clenching. Because jaw pain has several possible causes, a physician first confirms the muscle is the source before treating.
Book two to three weeks ahead. Botox takes about three to seven days to begin working and up to two weeks for full results, so the week-of is too late for a wedding, reunion, or photo session.
Stay upright for about four hours, skip strenuous exercise that day, and avoid rubbing or massaging the treated areas so the product stays where it was placed. Hold off on facials, saunas, and hot yoga for a day. These steps lower the small chance of bruising or product spread.
Botox has been used cosmetically and medically for decades and has a well-established safety profile when administered by a qualified, properly trained provider. Side effects are usually mild and temporary, such as minor bruising or tenderness. A physician-led screening of your health history and medications is part of keeping it safe.
Most healthy adults who want to soften dynamic lines — or ease jaw clenching, migraines, or excessive sweating — are good candidates, especially when those lines are still forming rather than deeply set. Botox is generally not recommended during pregnancy or breastfeeding, for anyone with a known allergy to it, or alongside certain neuromuscular conditions such as myasthenia gravis. A brief review of your health history and medications at your visit confirms it is safe and appropriate before treatment.
Botox can soften fine vertical lip lines by relaxing the muscle that purses the mouth, using just a few carefully placed units. It is different from a lip flip, which rolls the lip outward; here the aim is smoother skin above the lip without limiting normal movement. Deeper, set-in lines often respond best to Botox combined with a little filler or a resurfacing treatment.
Yes. Relaxing the vertical platysmal bands in the neck can soften those cords and ease the downward pull on the jawline — an effect sometimes called a Nefertiti lift. It pairs well with treating the lower face but is not a substitute for addressing loose, heavy skin, which needs a different approach.
Board Certified in Internal Medicine(ABIM) – Mt. Sinai School of Medicine
Board Certified in Aesthetic Medicine (AAAM)
With 20+ yrs of working in the field of MEDICINE across various disciplines, Dr. G(Gotur) perceived there was a need for more personalized wellness and aesthetic services that catered to the unique health, skin, and beauty concerns of people with diverse backgrounds, this led to the conception of SKYNN MD Medspa and Aesthetics.
Looking to get even more out of your SKYNN MD experience? Explore our exclusive membership plans. With a SKYNN MD membership, beauty and wellness treatments aren’t a one-time luxury. They’re a part of your regular routine. Learn more about our SKYNN MD membership options, benefits, and exclusive promotions.
