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Botox in Fresno, CA

Botox Cosmetic is a prescription injectable, FDA approved for the temporary improvement of moderate to severe frown lines, forehead lines, crow’s feet, and vertical neck bands in adults. At Savage Serenity MedSpa in Fresno, your treatment is performed by Angela Hash, BSN, RN, or by one of the injectors she trains, after a consultation that sets the dose for each area. Botox Cosmetic is $14 per unit here, and you are quoted by the unit, per area, before anything is injected. Most people see results within three to seven days, and for frown lines the effect lasts approximately three to four months.

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Botox at a glance

Product

Botox Cosmetic (onabotulinumtoxinA), made by AbbVie.

Areas treated here

frown lines, forehead lines, crow’s feet, vertical neck bands, lip flip, bunny lines, and the masseter.

Reference dose

20 Units for frown lines; 20 Units for forehead lines, given together with the frown line dose; 24 Units for crow’s feet, 12 per side; 26 to 36 Units for neck bands, depending on how many bands are treated. Your dose is set at your consultation.

Time to results

most people within three to seven days.

How long it lasts

about three to four months for frown lines. Timing varies from person to person.

Retreatment

no sooner than three months.

Injectors

Angela Hash, BSN, RN; Michelle Perkins, RN; Candice Brantley, NP. Angela trains the team. Medical director: Dr. Luis Lee.

Pricing

Botox Cosmetic $14 per unit as of September 2026, quoted by the unit and per area at your consultation, before treatment. No charge for the two week follow up visit.

Financing

Cherry and CareCredit.

What Botox does, and what it does not do

Botox Cosmetic relaxes the small muscles that fold the skin when you frown, raise your brows, or squint. It blocks the signal between the nerve and the muscle at the injection site, so the muscle stays quieter and the line it creates softens. If you want the mechanism in more depth, read how Botox works.

Because it works on movement, Botox is a treatment for dynamic lines, the ones that appear when your face is in motion. A line that has been etched into the skin at rest for years may soften, and it may not disappear. Volume loss in the cheeks or under the eyes, and changes in skin texture, are different problems with different treatments; see dermal fillers and Sculptra. At your consultation your injector will tell you plainly which of your concerns Botox will address and which it will not.

Angela Hash, who leads and trains the injector team, describes the approach this way: “I look at the face as a whole and create a treatment plan that restores balance, supports the way you’re naturally aging, and still keeps you looking like you. My goal is never to change someone’s face.” The aim is for people to notice that you look healthy and refreshed, smoother and more like yourself, without being able to say what you had done.

Botox, Daxxify, and Jeuveau

Savage Serenity carries three neurotoxins: Botox Cosmetic, Daxxify, and Jeuveau. All three are botulinum toxin type A products, FDA approved for frown lines; Botox Cosmetic is also approved for forehead lines, crow’s feet, and neck bands. The three are made by different companies, are formulated differently, and are dosed in units that cannot be compared across products.

Which one you receive is a clinical decision made with you at your consultation, based on the areas you are treating and how you have responded to a product before. Your injector will explain the reasoning.

What happens at your Botox appointment

Your first visit starts with a conversation. Your injector looks at your face at rest and while you make expressions, asks what bothers you, and asks what you are hoping for. If Botox is not the right answer for a concern, you will hear that plainly.

If you choose to go ahead the same day, the injections themselves take about ten to fifteen minutes. The needle is very fine. Most people describe each injection as a quick pinch, and the area between the brows tends to pinch a little more than the forehead or the eyes. Numbing cream is available if you want it, though most people find they do not need it.

Your injector sees you again at about two weeks to look at the result together and record how your face responded, which shapes the plan for your next visit. For a fuller walkthrough, read what happens at a Botox appointment and how to prepare for wrinkle relaxer injections.

How many units of Botox you will need

The number of units decides the price, so it is worth understanding how the number is set. The reference doses above are the starting point. From there, your injector adjusts to your face, watching the muscles move, judging their strength and the depth of the lines, and asking what you want to keep. Someone with a strong frontalis may need more in the forehead; someone who wants to keep a lot of expression may want less.

In practice at Savage Serenity, forehead lines take 12 to 20 units, frown lines 20 units, and crow’s feet 12 units per side.

A quote made without watching your face move is a guess. You will have your unit count for each area, and the total, before you decide.

Areas we treat with Botox in Fresno

The three upper face areas and the neck come first. The other areas we treat follow.

Frown lines, the 11s

The two vertical lines between your brows come from the corrugator and procerus muscles, which pull the brows together and down. They can read as anger or fatigue on a face that feels neither. This is the most requested area at the practice. The reference dose is 20 Units.

Forehead lines

The horizontal lines across the forehead come from the frontalis, the muscle that lifts your brows. Forehead lines are treated together with frown lines, because relaxing the forehead on its own can let the brow drop, and your injector plans the two doses as one map. The reference dose is 20 Units for the forehead, given with 20 Units for the frown lines. In the clinical studies, about 2 in 100 people treated for forehead lines had some brow drooping, which is one reason a conservative first dose makes sense.

Crow’s feet

The lines that fan from the outer corners of the eyes when you smile come from the orbicularis oculi, the muscle that closes the eye. The clinical name is lateral canthal lines. The reference dose is 24 Units, 12 on each side.

Vertical neck bands

The cords that stand out on the front of the neck when you grimace or strain come from the platysma, the thin sheet of muscle that runs from the jawline down the neck. The clinical name is platysma bands. The injections are placed shallowly along each band and along the jawline. The reference dose runs from 26 Units, for one band on each side of the neck, to 36 Units for two bands on each side. The neck muscles also help with swallowing and breathing, so tell your injector about any history of trouble with either before this area is treated; the risks section below applies here as everywhere else.

We also treat three more areas with Botox Cosmetic, each planned from your anatomy at your consultation. Your injector sets the dose from training and from how your muscles move, and will tell you whether each area is a good fit for you. The risks described on this page apply to every injection of the product, wherever it is placed.

Lip flip. A few units along the border of the upper lip, aimed at the muscle that rolls the lip inward. It adds no volume. If fuller lips are the goal, lip filler is the treatment for that.

Bunny lines. The lines that appear on the sides of the nose when you scrunch it. A small dose in the nasalis muscle is aimed at softening them.

Masseter. The large chewing muscle at the angle of the jaw. Some patients ask about it for a softer lower face contour. The dose is higher than in the upper face, and your injector will explain how the dose and the visits are planned before you decide.

When you will see results, and how long they last

Botox does not work the day you receive it. Most people see results within three to seven days. In the clinical studies for frown lines, the share of patients with a visible response was highest around day 30, so the result you see at the end of the first week is not yet the final one. If one side seems to be responding ahead of the other in that first week, wait for the two week check before judging it.

For frown lines, the effect lasts about three to four months. The effect fades gradually as muscle movement returns, and lines return with it. The timing varies from person to person and from area to area. Retreatment is not done sooner than three months, so a maintenance visit is planned for the three to four month mark at the earliest.

Botox is temporary. If you are new to it, that is a reassurance: a result you do not love will wear off.

Risks and side effects

Botox Cosmetic is a prescription medicine with real risks, and you should know them before you book.

Expected side effects: pain or bruising where the needle went in; headache (9 percent of patients in the forehead line studies); drooping of an eyelid (3 percent in the frown line studies) or of the brow (2 percent in the forehead line studies); swelling of the eyelid (1 percent in the crow’s feet studies). Most of these appear within the first week. Most are temporary; some can last several months or longer.

Serious risks. Every botulinum toxin product carries the same boxed warning. In the words of the FDA Medication Guide, Botox Cosmetic “may cause serious side effects that can be life threatening, including: Problems breathing or swallowing” and “Spread of toxin effects,” and “These problems can happen hours, days, to weeks after an injection.” The Medication Guide also names allergic reactions (itching, rash, red itchy welts, wheezing, asthma symptoms, dizziness or feeling faint) and eye problems (double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of the eyelids, dry eyes).

Call the clinic or get medical help right away if you have any of these after treatment, in the Medication Guide’s words: problems swallowing, speaking, or breathing; loss of strength and muscle weakness all over the body; double vision, blurred vision, and drooping eyelids; hoarseness or change or loss of voice; trouble saying words clearly; loss of bladder control; trouble breathing; trouble swallowing. If any of these happen, do not drive a car, operate machinery, or do other dangerous activities.

Botox Cosmetic is not for you if you are allergic to any botulinum toxin product or any ingredient in it, or if you have a skin infection where you would be injected. Tell your injector about any muscle or nerve condition, any history of trouble breathing or swallowing, and every medication and supplement you take. Treatment is deferred during pregnancy and breastfeeding.

The full Medication Guide is here: Medication Guide, Botox and Botox Cosmetic.

Before and After Care

Before

The American Academy of Dermatology’s preparation guidance is a list of what to tell the person treating you: “All medicines you take,” including pain relievers, blood thinners, and anything bought without a prescription; “All herbs, vitamins, and minerals you take”; “If you are pregnant or plan to become pregnant”; and “All surgeries and cosmetic treatments you have had.” Bring that list to your consultation and leave nothing off it.

Our own instructions for the week before go a little further. If your doctor agrees it is safe, stop aspirin, ibuprofen, and naproxen five to seven days ahead; Tylenol is fine. Skip fish oil, vitamin E, ginkgo, and high dose vitamin C for about a week. Never stop a prescribed blood thinner without asking the prescriber. Skip alcohol and hard workouts for the 24 hours before. Arrive with clean skin and little or no makeup, and eat something first so you are not lightheaded.

After

The American Academy of Dermatology’s guidance after botulinum toxin injections is short: “Do not rub or massage the areas where you received the injections,” and “Wait two hours before you engage in strenuous physical activity.” Most people return to their everyday activities immediately.

Our own instructions for the first day go a little further. Stay upright for four hours after treatment; plan a morning appointment if that is easier. Skip hard workouts for 24 hours. Keep hats, headbands, and tight goggles off the injection sites for the day. Skip alcohol for 24 hours if you can.

Botox pricing in Fresno

Botox is priced by the unit. As of September 2026, Botox Cosmetic is $14 per unit at Savage Serenity. What you pay depends on how many units your plan calls for and how many areas you treat; there is no flat price for a face. At your consultation your injector recommends a unit count for each area, and you receive the total before treatment.

At the unit counts the practice typically uses, that works out to $168 to $280 for forehead lines (12 to 20 units), $280 for frown lines (20 units), and $336 for crow’s feet (12 units per side). Forehead and frown lines treated together come to $448 to $560. Your own unit counts are set at your consultation and can fall outside these figures.

There is no charge for the two week follow up visit.

The practice also carries Jeuveau at $12 per unit and Daxxify at $18 per unit. Units of one product cannot be converted into units of another, so a lower price per unit does not mean a lower total, and a higher one does not mean a higher total. When you compare prices around Fresno, compare the quoted total for your plan.

Financing is available through Cherry and CareCredit.

Why patients in Fresno choose Savage Serenity for Botox

Your injector is Angela Hash, BSN, RN, or one of the two injectors she trains, Michelle Perkins, RN and Candice Brantley, NP. The practice operates under the medical direction of Dr. Luis Lee.

Angela is conservative by default, and she trains her team the same way. The first dose leans toward keeping your expression: more can be added at a later visit, while too much can only be waited out. You are quoted in units, per area, before treatment, and you are told which of your concerns Botox will not fix.

Savage Serenity sits on East Champlain Drive in northeast Fresno, near Highway 41, and treats patients from Fresno, Clovis, and across the Central Valley.

Frequently asked questions about Botox in Fresno

Does Botox hurt?

Most people describe each injection as a quick pinch. The needle is very fine and the injections take about ten to fifteen minutes in total. Numbing cream is available if you would like it.

Will I look frozen?

Not if the dose and placement are right for your face. The frozen look comes from too much product or product in the wrong place. The first dose here is deliberately conservative so that you keep your expression, and your injector reviews the result with you at two weeks. Results vary from person to person, and no injector can promise a particular look.

How much does Botox cost in Fresno at Savage Serenity?

Botox Cosmetic is $14 per unit as of September 2026. At the practice’s typical unit counts, frown lines (20 units) come to $280, forehead lines (12 to 20 units) to $168 to $280, and crow’s feet (12 units per side) to $336. Your unit count is set at your consultation, and you receive the total before treatment. There is no charge for the two week follow up visit.

Can I have Botox and dermal filler at the same visit?

Yes. Many patients treat frown lines or crow’s feet with Botox and add lip or cheek filler in the same visit. Your injector plans the order and placement so the two work together. Read more about dermal fillers in Fresno.

What should I tell my injector before treatment?

Tell your injector if you have ever reacted to a botulinum toxin product, if you have any skin infection near the treatment area, if you have a muscle or nerve condition, or if you have had trouble breathing or swallowing. List every medication and supplement you take. Your injector will tell you which ones, such as aspirin, ibuprofen, fish oil, and vitamin E, can make bruising more likely. Do not stop a prescribed medication on your own; tell us, and talk to the prescriber. Tell us if you are pregnant or breastfeeding.

How should I prepare for my first Botox appointment?

Arrive with a clean face and no makeup on the areas you want treated. Write your questions down and bring them. If you are treating before an event, book at least two weeks ahead so the result has settled and the two week check has happened. The full preparation guide is here: how to prepare for wrinkle relaxer injections.

What if one side looks different from the other in the first week?

Muscles respond at slightly different rates, and the result is still developing during the first week. Wait for the two week check, where your injector looks at both sides with you.

Book a Botox consultation in Fresno

Book online and choose a consultation. You will leave with a plan, a unit count per area, and the total, and you decide from there.

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Keep reading

View Links

Injectables at Savage Serenity

Dermal fillers in Fresno

Sculptra in Fresno

How Botox works

What happens at a Botox appointment

How to prepare for wrinkle relaxer injections

Avoiding the frozen look: dosing for natural results

About Angela Hash, BSN, RN

About Michelle Perkins, RN

About Candice Brantley, NP

Sources

View Sources

U.S. Food and Drug Administration. BOTOX Cosmetic (onabotulinumtoxinA) Prescribing Information (BLA 103000). Revised 10/2024. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/103000s5316s5319s5323s5326s5331lbl.pdf

U.S. Food and Drug Administration. Medication Guide, BOTOX and BOTOX Cosmetic (onabotulinumtoxinA). DailyMed. Revised 10/2024. https://dailymed.nlm.nih.gov/dailymed/medguide.cfm?setid=485d9b71-6881-42c5-a620-a4360c7192ab

American Academy of Dermatology. Botulinum toxin therapy: FAQs. Accessed 09/21/2026 (page undated). https://www.aad.org/public/cosmetic/wrinkles/botulinum-toxin-faqs

American Academy of Dermatology. Botulinum toxin therapy: Overview. Accessed 09/21/2026 (page undated). https://www.aad.org/public/cosmetic/wrinkles/botulinum-toxin-overview

American Society for Dermatologic Surgery. Neuromodulators. Accessed 09/21/2026 (page undated). https://www.asds.net/skin-experts/skin-treatments/neuromodulators

Medically reviewed by Angela Hash, BSN, RN. Reviewed October 31, 2026.