Your first Botox appointment in Dubai: exactly what happens, step by step

Almost everyone who sits down for their first Botox appointment asks me the same two questions. Will it hurt? And will I still look like me?

Fair questions, and you deserve a proper answer to both. So here is the whole appointment, from the moment you walk in to the day it wears off, with nothing left out and nothing dressed up.

First, I watch your face move

Before I pick up a needle, I ask you to do a few slightly silly things.

Frown. Lift your eyebrows. Squeeze your eyes shut. Give me a big smile.

I am watching which muscles pull hardest. This matters far more than most people expect, because two people can walk in asking for exactly the same thing and need completely opposite treatment.

Here is a real example. Some people have a strong muscle across the forehead that is quietly holding their eyebrows up all day. If I relax that muscle too much, the eyebrows drop and the eyes look heavier than before. Other people have the opposite situation: the muscles between the eyebrows are pulling everything down, and relaxing those actually opens the eyes up.

Same request. Opposite plan. Reading that difference correctly is the entire job.

Then a few questions about your health

Quick and simple ones:

• Have you had this treatment before, and when?
• Do you have any muscle or nerve condition?
• What medicines are you taking?
• Are you pregnant or breastfeeding?
• Any allergies?
• Any spot, cut or infection on the skin where I would inject?

Sometimes an answer means I will not treat you that day. I would much rather tell you that than treat you anyway and hope for the best.

The injections themselves

I clean your skin and mark the points with a pencil. Then a very fine needle goes into specific muscles.

What does it feel like? A quick sting, roughly like plucking a hair, and then it is done. Each point takes a second or two. We can use ice or numbing cream if you want, but most people find they do not need it.

You will be walking out within the hour. You can go straight back to work, straight to a meeting, straight to lunch. Nobody will know unless you tell them.

Now you wait, and this part surprises people

You will look exactly the same in the mirror when you leave. That is completely normal and it is not a sign that anything went wrong.

The timeline

• Day 1 to 2 — the muscle starts to feel a little weaker
• Day 3 to 7 — the change becomes clearly visible
• Day 14 — this is your real result

Those small red bumps at the injection points disappear in about twenty minutes. You may get a small bruise, especially around the eyes, and concealer covers it easily.

I always see you again at two weeks. That is the right moment to adjust anything, not on day three when it is only half working.

How long does it last? The honest answer.

Around three to four months for the frown lines between your eyebrows.

It does not switch off one morning. Movement comes back slowly, and one day you catch yourself frowning in the mirror and the line is back.

Some people go through it faster than others. If you train hard, or you are young with strong muscles, you may be closer to three months than four. That is your body, not a bad treatment.

What can go wrong

I am not going to pretend nothing can. Here are the real numbers from the studies used to license this medicine:

• A drooping eyelid happened to about 3 in every 100 people treated between the eyebrows
• Some puffiness of the eyelid in about 1 in every 100 treated for crow's feet
• A headache in about 9 in every 100, and slightly lower eyebrows in about 2 in every 100, when the forehead was treated

Almost all of this is temporary and settles as the product wears off. But it is exactly why this is a prescription medicine that belongs with a licensed doctor in a licensed clinic, and not something to buy at a salon, a hotel room or a house visit.

How I do things

Three rules I keep to.

I start low. Especially on the forehead. I would rather give you a little less and add more at your two-week review. I can always add. I cannot take it out.

I take photos. With your face relaxed and with your face moving, before I treat you. At your review we look at real pictures instead of trying to remember what you looked like.

I say no when the answer is no. If what you are asking for will not give you a good result, I will tell you, explain why, and suggest what would actually work instead.

It is easy to add a little more. It is impossible to take it out. So I start low, always. — Dr. Hossam Mohammed

Questions I get asked every week

Will I look frozen?

Not if the dose and the placement are right. Frozen faces come from too much product in the wrong place. Starting low and reviewing at two weeks is exactly how you avoid it.

I have a wedding coming up. When should I have it?

Two to three weeks before, at the very least. That gives the result time to settle and any bruise time to fade completely.

Can I go to the gym after?

Not the same day. Skip heavy exercise, sauna and lying face down until the next morning.

Is it bad to keep having it for years?

People have been having this treatment for decades and it is very well studied. Over time the treated muscle becomes a little lazier, which is mostly the point of it.

Am I too young? Too old?

Neither is really the question. What matters is whether your lines only appear when you move your face, or whether they are already there when your face is completely still. That is what we look at together.

What if I do not like it?

Come back at two weeks and tell me. Most of the time what people dislike is a small imbalance that a tiny adjustment fixes. And unlike filler, this one fades on its own.

Where to read more

If you want the detail on the treatment itself, doses and areas, that lives on the botulinum toxin treatment page. If you are weighing this against something else, the Journal covers the other treatments people ask about most.

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Sources

• BOTOX Cosmetic (onabotulinumtoxinA) prescribing information, US FDA / DailyMed
• Skorochod R et al. Ophthalmic adverse events following facial injections of botulinum toxin A: a systematic literature review. Journal of Cosmetic Dermatology, 2021
• Kroumpouzos G et al. Complications of botulinum toxin A: an update review. Journal of Cosmetic Dermatology, 2021