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Conveniently located to serve the areas of Maryland, Virginia and Washington, D.C.

Many people are not ready for surgical intervention for wrinkle treatment and prefer to have small treatments over time that allow them to return to work without anyone noticing they have had anything done. Botox has gotten a lot of press over the last several years for its effects and how quickly its benefits can be achieved. Its primary use in cosmetic surgery is to decrease wrinkles in the skin and provide a smooth, youthful appearance.

What Is Botox?

Botox is a naturally occurring protein that is purified in the laboratory. It binds to nerve endings preventing them from stimulating muscle contraction.

Certain muscles in the face are responsible for wrinkles that many find unattractive. Typical treatment areas include the forehead, frown lines at the root of the nose, and the so-called “laugh lines” around the eyes. When the muscles responsible for these lines cannot contract, the wrinkles in the skin disappear. Overtime (3-4 months in most individuals), Botox wears off and the wrinkles can return. With continued use, however, the muscles become weaker from prolonged inactivity and the lines are less noticeable when the Botox wears off.

Why Use Botox?

Seeking Botox as a solution for unwanted signs of facial aging? It is important to recognize that while this treatment was not designed as a means to replace plastic surgery, Botox is a quick, temporary procedure that helps to improve the most visible signs of aging. This facial injectable treatment consists of a botulinum toxin that paralyzes the muscles that cause facial wrinklings, such as forehead lines and crow’s feet (wrinkles along with the eyes.) A Bethesda Botox professional will inject Botox in the specified area, providing you with a smoother, younger-looking facial appearance. Results may last up to 4 months.

Who Should Get Botox?

Botox injections are ideal for patients who want to achieve a more youthful facial appearance, yet do not want to undergo a surgical procedure to obtain results. Patients with concerns regarding forehead lines, crow’s feet, frown lines, thick bands on the neck, a gummy smile, or excessive sweating can be good candidates.

Botox Treatments Available

Whether you are concerned about signs of aging in a particular part of your face or you would like to address a plethora of areas, Botox injections can bring back your plush and youthful appearance. Dr. Jabs, Dr. Magge, or Dr. Richards will help determine the options that are best suited for your needs.

Botox for Horizontal Forehead Lines

Forehead lines are caused by the muscles contracting to lift the brows, most commonly shown when expressing surprise. Some people also use these muscles over-exaggeratedly throughout the everyday conversation or when they are attempting to see something clearer. A low number of Botox units placed tactically across the forehead can soften the appearance of these lines without weakening the muscles or putting too much pressure on the brows. This can be used to improve both deep wrinkles and more shallow ones.

Botox for Crow’s Feet

Crow’s feet are caused by the orbicularis muscles, which are responsible for closing the eyelids. These muscles encircle the eyes with fibers spanning from the temples to the cheeks. When the muscles contract in either sleep, blinking, squinting, smiling or laughing, the skin from the temples, cheeks, and forehead pull towards each other, creating folds at the corners of the eyes. After time and with aging, these lines become permanent and create what we call “crow’s feet”. Injecting Botox into this area will soften the appearance. Using a lower number of units will give patients their desired effect while still keeping the warm and friendly appearance that is often associated with smiling.


Patient Reviews

Every single person in their office makes you feel so welcomed and comfortable the moment you step into the office. The day of my surgery the staff took amazing care of me and went above and beyond to calm my nerves, talk me through it and made it such a great experience. I highly recommend this office, I can’t thank them enough for all that they did for me!

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Botox for Frown Lines Between the Brows

Glabellar lines, more commonly known as frown lines, are the creases formed between the eyebrows. This is the most commonly treated area among Botox patients. The injections are placed slightly above the supraorbital ridge, the brow bone bordering the eye sockets. Patients’ complaints are often an “angry” appearance caused by repetitive frowning over an extended period of time. Getting Botox treatment in this area can create a more elegant and pleasant looking face.

Botox for Thick Bands on the Neck

Although the face is of most focus in relating to the appearance of aging, often another telltale sign is a pattern of creases or bands across the neck.

This is due to the overuse of the platysma muscle ranging from the jaw to the clavicles. Botox injections allow this muscle to finally relax, relieving the tension in your neck and leaving you with a smoother, younger-looking décolletage.

Botox for Appearance of Gums

Sometimes referred to as a gummy smile, patients who are concerned about their gums being unpleasantly exposed can greatly benefit from this treatment if a hypermobile upper lip, one that raises too high when smiling, is to blame. Most lips only retract to 5 millimeters from the inactive natural position. When the muscles in the upper lip are pulled beyond this point, the gums are bared and teeth appear smaller in comparison. Botox injections can release the extra strain and tautness in the upper lip and reduce the prominence of a gummy smile. The results of this treatment are dependent on the length of your lip and the amount of gum-line exposed.

Botox for Excessive Sweating

Sometimes deodorants just won’t do the trick. When you produce an excessive amount of sweat, also known as hyperhidrosis, your nerve signals are sending messages to your sweat glands to overproduce without any understandable cause such as heat or exercise. This can cause those embarrassing and unwanted sweat stains. Using Botox injections in the axillae, also known as the armpits, will decrease or halt the production of sweat. This treatment can be used as an alternative to an unsuccessful attempt at curing excessive sweating by using creams and medications.

What Are My Other Options?

The quest for a safe, reliable, long-lasting soft tissue filler has resulted in various substances being tried with differing results. The goal is to have an injectable substance that is virtually the same as the body’s natural soft tissue. It should be non-allergenicnon-colored, and not cause lumpiness when properly placed. In addition, it should last a long time between needing to be injected again.

Over the years various substances have been tried with various amounts of success. We are closer today than we have ever been in finding the “perfect” filler.

For some areas such as fat depressions and lips, using your own fat harvested from any area where you may have some extra, works well. This does require “harvesting” the fat (a small procedure done under local anesthesia using a special needle) and not being able to predict accurately how much of the fat will remain over time. The big plus is you are using your own, natural, soft tissue filler.

For most people who want to keep it simple, Juvederm and Restylane are good choices. These compounds are made up of the same molecules (hyaluronic acid) found in your skin that provide the “plumpness” that is associated with youth. They are crystal clear and can be injected with minimal discomfort using topical anesthetics. They last up to one year and give excellent results in reducing moderate to severe wrinkles and folds found on the face.

Botox Consultation

We understand that getting Botox treatment can be a big decision. Dr. Jabs, Dr. Magge, or Dr. Richards will provide an in-depth consultation to discuss all of your cosmetic concerns. Your doctor will then perform a thorough examination and evaluate if Botox injections will be the most beneficial procedure for you. If you are a good fit for receiving Botox, a personalized treatment plan will be put in place and your doctor can explain in detail the specifics of the process until you feel well informed and prepared to proceed.

Please feel free to ask us any questions you may have. We at Cosmetic Surgery Associates want to ensure a comfortable experience for you. You can set up a consultation online or call us at our Bethesda, Maryland office.

How Are Botox Treatments Done?

Commensurate with our philosophy of personalized care, all Botox treatments are performed by one of our Botox experts. We believe you deserve the care of a seasoned professional for even minor procedures such as this.

Small injections of Botox are placed using the smallest available needle. Your Botox specialist will expertly place the precise amount of Botox needed to treat the muscles, thus removing the wrinkles from your skin.

Recovery Process

The treated area may be slightly pink for one to two hours after injection. This typically settles down quickly. Massage of the area and exercise is restricted for 24 hours. Noticeable improvement begins in 2 to 5 days and usually lasts 3 to 4 months.


Prices vary based on the specifics of your treatment. Dr. Jabs, Dr. Magge, or Dr. Richards will determine this based on the units of Botox needed, how many desired areas there are, and the number of sessions required to complete your treatment. For an estimation of cost, please contact our Bethesda location.

We look forward to meeting you and discussing if Botox is right for you.

Our Plastic Surgery Associates team includes Dr. Franklin Richards, Dr. A. Dean Jabs, and Dr. Keshav Magge. Each of our plastic surgeons is board-certified, and together they have over 60 years of combined experience. Drs. Richards, Jabs, and Magge are all highly qualified in procedures for the face, breast, and body, and pride themselves in providing excellent results through our state-of-the-art, Quad A certified operating centers