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Botox in Los Angeles, Santa Monica, Beverly Hills, Pacific Palisades


Botox is a proprietary (trademark) name for a naturally-found chemical called Botulinum toxin.  Allergan, the parent company of Botox, discovered the utility of botulinum toxin for wrinkles many years ago.  Since then, it has become synonymous for cosmetic rejuvenation, cosmetic dermatology, and plastic surgery.  The safety of Botox is unquestionable if performed by a knowledgeable and conscientous plastic surgeon or dermatologist.  It has an extremely high safety profile given the fact that millions and millions of patients have it injected every year.


Botulinum toxin is naturally found in nature in a species of bacteria.  The medicine works by blocking the release of acetylcholine at the junction between the nerve and the muscle. In doing so, it blocks the release of the nerve impulse that translates what a nerve stimulates a muscle to do.  For example, if Botox is injected in the forehead, it prevents a patient from scrunching the forehead muscles, thereby preventing the muscles from creating so-called 'laugh lines' during facial animation.


The greatest thing about Botox is that it works effectively and it is only temporary.  There are very few, if any, long term complications associated with Botox.  As the Botox wears off, the patient's muscles return to their normal state of contraction.  In other words, if you don't like the effects of Botox, simply wait until the Botox wears off and you will be back to baseline. 


Dr. Karamanoukian performs a lot of Botox injections in his office in Los Angeles and Santa Monica.  Botox can be provided in doses measured in 'units.'  The amount of Botox is variable and depends on how many areas you would like treated. The more areas, namely the 'elevens,' crow's feet, forehead, and under eyes, the more Botox you will need.


Schedule a consultation to discuss your Botox options with Dr. Karamanoukian.  You will be amazed by the results and will find that Botox will expand your options for facial rejuvenation and wrinkle reduction.


Botox FAQ: Question and Answer


What is Botox Cosmetic? Botox is a cosmetic injectable that is used to smoothe out wrinkles on the face. Its primary use is for wrinkle reduction on the forehead, corners of the eyes, and neck. There is no downtime after injection, but patients will begin to see results within 5 days. In 2009, the FDA approved a second medication that works similarly to Botox, called Dysport. Both Botox and Dysport work by similar mechanisms.


How does Botox Cosmetic work? Botox Cosmetic works as a selective inhibitor of acetylcholine release at the neural synapse. In other words, it works to block the release of a small molecule at the junction between the nerve and facial muscle to block the contraction of the muscle. In this way, it stops us from having laugh lines by temporarily blocking the muscles that are responsible for wrinkles.


What areas can be treated with Botox Cosmetic? The best places to use Botox Cosmetic are on the forehead, the glabella (area between the eyebrows), the corners of the eyes (crow’s feet), the area around the mouth, and the neck.


What is a Botox Brow Lift?  In my Santa Monica office, I use Botox to decrease the muscle activity of the orbicularis oculi depressors that are located below the lateral eyebrow.  These muscle fibers lower the brow with facial expression and by blocking them, the eyebrows are heightened by a few millimeters.


Who is a good candidate for Botox Cosmetic? Put simply, almost everyone. Young men and women come in to my office in Santa Monica for preventative Botox treatments, while patients with wrinkles on their forehead, crow’s feet, and neck also benefit enormously by Botox. In Los Angeles and New York, Botox Botox is one of the most common cosmetic procedures.


Do I need a consultation before having Botox injected? Yes. It is in your best interest as a patient to have a qualified physician discuss the risks and benefits of Botox before injection. Dr. Karamanoukian will discuss all the details of Botox during your consultation.


Do I need anesthesia before Botox injection? No. Anesthesia is not required. Some patients, however, choose to numb the area of injection with a topical numbing medication.   Dr. Karamanoukian uses a tiny needle for injection.


How long does the Botox Cosmetic injection take to perform? Dr. Karamanoukian or Beth Donowho are experts in Botox Cosmetic injections and perform the procedure meticulously in about thirty minutes, including assessment and injection. We are certainly not the fastest injectors, but rest assured, that we are the best!


Are Botox injections painful? No. Most patients tolerate the injections very well. Even those that are scared of needles.   If you are timid about the injections, Beth Donowho and Dr. Karamanoukian provide anesthetic creams, freezing sprays, cool ice packs, tension squeezers, and even anxiolytics to calm the nerves.


How long is recovery with Botox injections? There is no real recovery after injection. However, there may be slight bruising around the eyes in some patients who are bruise-prone. In these patients, we recommend topical bruise creams and the BruisePak pills.


When can I return to work after Botox injection?  Work and social activities can generally be planned for the same day of injection. Minor bruising is generally coverable with makeup. 


Is Botox Cosmetic covered by my insurance plan? This is a frequent question, but it really depends on your insurance carrier and the medical necessity of the procedure. Botox Cosmetic is generally not covered, but we have seen some exceptions.


Does Botox injection have risks? The risks of Botox injection are rare, and include transient concerns such as temporary redness, bruising, and swelling. These subside within hours to days. Temporary eyelid droop may occur in rare cases. This should be discussed with your physician or nurse if you have concerns.


How long does Botox or Dysport last? After injection, patients see results within 3 to 5 days. Wrinkle reduction typically lasts 4 to 5 months.


How do I prepare for Botox injections? Do not take ibuprofen products for 2 weeks before treatment. Aspirin should be avoided for 3 weeks.   Do not wear makeup or foundation during your injection appointment.


Dr. Karamanoukian provides comprehensive plastic surgery and cosmetic dermatology services in the Los Angeles area.  Our office performs a full range of cosmetic procedures including liposuction, tummy tucks, breast surgery, weight loss surgery, facelifts, neck lifts, eyelid lifts, and brow lifts.

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Call our office to learn more about safe Botox injections.  Schedule an appointment today for affordable Botox injections in the Los Angeles area. Call (310) 998-5534 or email our office at

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