Myth

Patients only care about how much a neurotoxin brand costs.

Fact

Patients also consider
brand trust and natural-looking results to be among the most important attributes they look for in a neurotoxin brand.1,*

Real BOTOX® Cosmetic patient.

Treated for the appearance of moderate to severe platysma bands.
Results may vary.

Did you know?

Market research shows that when choosing a neurotoxin, women (n=187) rank a product's brand trust and natural-looking results as 2 of the top attributes they value.1,*

Women (n = 187) who
had received treatment
with a neurotoxin within
the last 2 years ranked
brand attributes in order
of priority1,*:

  • 50% of women chose natural-looking results
  • 47% of women chose trustworthiness in a brand

Men (n = 56) who had received treatment
with a neurotoxin within
the last 2 years ranked
brand attributes in order
of priority1,†:

  • 61% of men chose natural-looking results
  • 70% of men chose trustworthiness in a brand

*Based on a 2022 online survey of 187 women who had received treatment with a neurotoxin within the last 2 years. Women were asked to rank attributes in order of priority when considering which neurotoxin brand to use.1

†Based on a 2022 online survey of 56 men who had received treatment with a neurotoxin within the last 2 years. Men were asked to rank attributes in order of priority when considering which neurotoxin brand to use.1

Only BOTOX® Cosmetic.

BOTOX® Cosmetic is the only product of its kind studied in more than 870 publications,‡ the only one supported by 30 years of manufacturing,§ and the only one FDA approved to temporarily improve the appearance of moderate to severe platysma bands, forehead lines, lateral canthal lines, and glabellar lines in adults.2-10

‡As of July 2025, there were more than 870 publications featuring BOTOX® Cosmetic.2
§Over 30 years since the first FDA approval for therapeutic use in 1989.4

BOTOX® Cosmetic provides natural-looking results in upper facial lines.

Based on a clinical study of pooled subjects, 84% (n = 592) who received 20 Units
in forehead lines and glabellar lines, respectively, reported being “Very Satisfied”
or “Mostly Satisfied” with the natural-looking results of treatment compared to
5.8% (n = 241) with placebo at day 30. This item was part of the Facial Line Satisfaction Questionnaire Follow-Up Treatment Satisfaction domain. In addition, 96% of market research subjects (n = 134) treated for lateral canthal lines reported they “Completely Agree” or “Somewhat Agree” that BOTOX® Cosmetic provides natural-looking results.11,12



In 2 clinical trials, 90% and 82% (n = 260 each) of patients reported they were “Very Satisfied” or “Mostly Satisfied” (top 2 out of 5 responses) with their treatment results at day 60 vs 1% and 3%, respectively, for placebo (n = 6 total).5


In clinical trials, full results of treatment were seen at 30 days.5

Patients are interested in BOTOX® Cosmetic.13,¶

#1

requested neurotoxin by patients.14,||

82%

of patients ask for
BOTOX® Cosmetic
by name.14,||

91%

of patients who plan to receive neurotoxin treatment in the next year are specifically considering BOTOX® Cosmetic.1,#

¶Based on a 2020 online survey of providers (n = 241), in which respondents were asked to rate neurotoxin brands on attributes that determine their performance. Of providers polled, 77% said BOTOX® Cosmetic drives patients to their practice, the highest percentage of any brand.12

||Based on a 2024 online market research survey of 250 patients who had received treatment with a neurotoxin within the past 2 years. Of the 57% of patients (n = 114/188) who requested treatment with a specific brand, 82% requested BOTOX® Cosmetic.13
#Results from a 2022 online market research study of 243 patients aged 18 to 60 who have used a neurotoxin in the past 2 years.1

Satisfaction results for upper facial lines.

In 2 multicenter, double-blind, placebo-controlled studies of BOTOX® Cosmetic treatment, 90% and 82% (n = 260 each) of patients who received 20 Units in forehead lines and 20 Units in glabellar lines reported they were "Mostly or Very Satisfied" (top 2 out of 5 responses) with their treatment results at day 60 vs 1% and 3%, respectively, for placebo (n = 6 total).5

In addition, 88% (n = 313) of patients who received 20 Units in forehead lines, 24 Units in lateral canthal lines, and 20 Units in glabellar lines reported they were "Mostly or Very Satisfied" (top 2 out of 5 responses) with their treatment results at day 60 vs 3% (n = 156) placebo.5,15

These items were part of the Facial Line Satisfaction Questionnaire (FLSQ) Follow-up Treatment Satisfaction domain.

Real BOTOX® Cosmetic patient.

Treated for the appearance of moderate to severe forehead lines, lateral canthal lines, and glabellar lines.
Results may vary.

Patients consider brand trust and
natural-looking results to be among
the most important attributes they look for in a neurotoxin brand.1

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Real BOTOX® Cosmetic patient.

Treated for the appearance of moderate to severe forehead lines, lateral canthal lines, and glabellar lines. Results may vary.

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BOTOX® Cosmetic IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

Indications

BOTOX® Cosmetic (onabotulinumtoxinA) is indicated in adult patients for the temporary improvement in the appearance of:

- Moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity

- Moderate to severe lateral canthal lines associated with orbicularis oculi activity

- Moderate to severe forehead lines associated with frontalis activity

- Moderate to severe platysma bands associated with platysma muscle activity


BOTOX® Cosmetic IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING

WARNING: DISTANT SPREAD OF TOXIN EFFECT

Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses and approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and spasticity and at lower doses.

CONTRAINDICATIONS

BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.

WARNINGS AND PRECAUTIONS
Lack of Equivalency Between Botulinum Toxin Products
The potency Units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. BOTOX® Cosmetic is not equivalent to other preparations of botulinum toxin products, and therefore, Units of biological activity of BOTOX® Cosmetic cannot be compared to nor converted into Units of any other botulinum toxin products assessed with any other specific assay method.

Spread of Toxin Effect
Please refer to Boxed Warning for Distant Spread of Toxin Effect.

No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 40 Units (for forehead lines with glabellar lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines), and 64 Units (for simultaneous treatment of lateral canthal lines, glabellar lines, and forehead lines) have been reported. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech, or respiratory disorders occur.

Serious Adverse Reactions With Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX® injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX® to the site of injection and/or adjacent structures. In several of the cases, patients had preexisting dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of BOTOX®. The safety and effectiveness of BOTOX® for unapproved uses have not been established.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such a reaction occurs, discontinue further injection of BOTOX® Cosmetic and immediately institute appropriate medical therapy. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.

Cardiovascular System

There have been reports following administration of BOTOX® of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors, including preexisting cardiovascular disease. Use caution when administering to patients with preexisting cardiovascular disease.

Increased Risk of Clinically Significant Effects With Preexisting Neuromuscular Disorders

Patients with neuromuscular disorders may be at increased risk of clinically significant effects, including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise from onabotulinumtoxinA (see Warnings and Precautions). Monitor individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis or neuromuscular junction disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) when given botulinum toxin.

Dysphagia and Breathing Difficulties

Treatment with BOTOX® and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with preexisting swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing (see Boxed Warning). 

Preexisting Conditions at the Injection Site

Use caution when BOTOX® Cosmetic treatment is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s). 

Dry Eye in Patients Treated With BOTOX® Cosmetic

There have been reports of dry eye associated with BOTOX® Cosmetic injection in or near the orbicularis oculi muscle. If symptoms of dry eye (eg, eye irritation, photophobia, or visual changes) persist, consider referring patients to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries a remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), which would also be considered remote. No cases of transmission of viral diseases, CJD, or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.

ADVERSE REACTIONS

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for glabellar lines were eyelid ptosis (3%), facial pain (1%), facial paresis (1%), and muscular weakness (1%).


The most frequently reported adverse reaction following injection of BOTOX® Cosmetic for lateral canthal lines was eyelid edema (1%).


The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for forehead lines with glabellar lines were headache (9%), brow ptosis (2%), and eyelid ptosis (2%).


The safety profile of BOTOX® Cosmetic treatment of platysma bands is consistent with the known safety profile of BOTOX® Cosmetic for other indications.



DRUG INTERACTIONS

Coadministration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (eg, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX® Cosmetic may potentiate systemic anticholinergic effects.


The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.


Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX® Cosmetic.


USE IN SPECIFIC POPULATIONS

There are no studies or adequate data from postmarketing surveillance on the developmental risk associated with use of BOTOX® Cosmetic in pregnant women. There are no data on the presence of BOTOX® Cosmetic in human or animal milk, the effects on the breastfed child, or the effects on milk production.


Please see BOTOX® Cosmetic full Prescribing Information, including Boxed Warning and Medication Guide.

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

Indications

BOTOX® Cosmetic (onabotulinumtoxinA) is indicated in adult patients for the temporary improvement in the appearance of:

- Moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity

- Moderate to severe lateral canthal lines associated with orbicularis oculi activity

- Moderate to severe forehead lines associated with frontalis activity

- Moderate to severe platysma bands associated with platysma muscle activity


BOTOX® Cosmetic IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING

WARNING: DISTANT SPREAD OF TOXIN EFFECT

Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses and approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and spasticity and at lower doses.

CONTRAINDICATIONS

BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.

WARNINGS AND PRECAUTIONS
Lack of Equivalency Between Botulinum Toxin Products
The potency Units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. BOTOX® Cosmetic is not equivalent to other preparations of botulinum toxin products, and therefore, Units of biological activity of BOTOX® Cosmetic cannot be compared to nor converted into Units of any other botulinum toxin products assessed with any other specific assay method.

Spread of Toxin Effect
Please refer to Boxed Warning for Distant Spread of Toxin Effect.

No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 40 Units (for forehead lines with glabellar lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines), and 64 Units (for simultaneous treatment of lateral canthal lines, glabellar lines, and forehead lines) have been reported. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech, or respiratory disorders occur.

Serious Adverse Reactions With Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX® injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX® to the site of injection and/or adjacent structures. In several of the cases, patients had preexisting dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of BOTOX®. The safety and effectiveness of BOTOX® for unapproved uses have not been established.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such a reaction occurs, discontinue further injection of BOTOX® Cosmetic and immediately institute appropriate medical therapy. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.

Cardiovascular System

There have been reports following administration of BOTOX® of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors, including preexisting cardiovascular disease. Use caution when administering to patients with preexisting cardiovascular disease.

Increased Risk of Clinically Significant Effects With Preexisting Neuromuscular Disorders

Patients with neuromuscular disorders may be at increased risk of clinically significant effects, including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise from onabotulinumtoxinA (see Warnings and Precautions). Monitor individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis or neuromuscular junction disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) when given botulinum toxin.

Dysphagia and Breathing Difficulties

Treatment with BOTOX® and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with preexisting swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing (see Boxed Warning). 

Preexisting Conditions at the Injection Site

Use caution when BOTOX® Cosmetic treatment is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s). 

Dry Eye in Patients Treated With BOTOX® Cosmetic

There have been reports of dry eye associated with BOTOX® Cosmetic injection in or near the orbicularis oculi muscle. If symptoms of dry eye (eg, eye irritation, photophobia, or visual changes) persist, consider referring patients to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries a remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), which would also be considered remote. No cases of transmission of viral diseases, CJD, or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.

ADVERSE REACTIONS

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for glabellar lines were eyelid ptosis (3%), facial pain (1%), facial paresis (1%), and muscular weakness (1%).


The most frequently reported adverse reaction following injection of BOTOX® Cosmetic for lateral canthal lines was eyelid edema (1%).


The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for forehead lines with glabellar lines were headache (9%), brow ptosis (2%), and eyelid ptosis (2%).


The safety profile of BOTOX® Cosmetic treatment of platysma bands is consistent with the known safety profile of BOTOX® Cosmetic for other indications.



DRUG INTERACTIONS

Coadministration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (eg, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX® Cosmetic may potentiate systemic anticholinergic effects.


The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.


Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX® Cosmetic.


USE IN SPECIFIC POPULATIONS

There are no studies or adequate data from postmarketing surveillance on the developmental risk associated with use of BOTOX® Cosmetic in pregnant women. There are no data on the presence of BOTOX® Cosmetic in human or animal milk, the effects on the breastfed child, or the effects on milk production.


Please see BOTOX® Cosmetic full Prescribing Information, including Boxed Warning and Medication Guide.

References: 1. Data on file, Allergan Aesthetics, March 2022; Consumer NTX ATU. 2. Data on file, Allergan Aesthetics, July 2025; Botulinum Toxin Peer-Reviewed Publications. 3. Data on file, Allergan Aesthetics, October 29, 2020; Westport Manufacturing Process. 4. BOTOX® Prescribing Information, November 2023. 5. BOTOX® Cosmetic Prescribing Information, October 2024.
6. Dysport Prescribing Information, September 2023. 7. Xeomin Prescribing Information, July 2024.
8. Jeuveau Prescribing Information, April 2023. 
9. Daxxify Prescribing Information, November 2023. 10. Letybo Prescribing Information, February 2024.
11. Ogilvie P, Rivkin AZ, Dayan S, et al. Pooled subject-reported outcomes from 2 phase 3 studies of onabotulinumtoxinA for simultaneous treatment of forehead and glabellar lines. Dermatol Surg. 2020;46:950-957. 12. Data on file, Allergan Aesthetics, February 14, 2023; Consumer NTX A&U. 13. Data on file, Allergan Aesthetics, April 10, 2020; Facial Injectables ATU: Neurotoxins Final Report. 14. Data on file, Allergan Aesthetics, December 2024; NTX Consumer A&U.
15. Data
on file, Allergan, 2016; Clinical Study Report Satisfaction Table.

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