Dynamic wrinkles, or lines that develop as a result of repetitive movement from facial expressions, are a common occurrence that comes with aging. These fine lines and wrinkles can make patients feel that they look older than they are. Thankfully, effective and minimally invasive treatment using Botox injections can reduce the appearance of these fine lines and wrinkles, helping patients in Lone Tree and Denver, CO look and feel more youthful. At FacesFirst, our Denver Botox® patients benefit from the expertise of plastic surgeons to make sure they achieve the best possible results.

What is Botox® Cosmetic?

Botox® Cosmetic is a prescribed medicine that is a simple, nonsurgical treatment administered by professionals on the forehead, in between the eyebrows, and into the crow’s feet around the eyes to relax the underlying muscles and smooth wrinkles with no downtime. Botox is made using a purified form of botulinum toxin and is classified as a neurotoxin injectable.

How Does Botox Work?

When injected, Botox® Cosmetic blocks the chemical signs from the nerve to the muscle and temporarily prohibits the muscle’s capacity to contract and create wrinkles. This relaxes and smooths the underlying muscles and wrinkles with no downtime, beginning within four to seven days of the injection. Repeat injections are necessary every three to five months to maintain the wrinkle-free appearance, as the body naturally and safely metabolizes the product over time. Many Botox patients report that their results last longer each time they receive injections as they continue with the treatment. Botox® Cosmetic has one of the highest patient satisfaction rates of all of the non-invasive procedures available in our Denver, CO practice.


from our patients

I got a rhinoplasty done by Dr. Cote and I’m so happy with my results! He definitely paid attention to what I wanted and was also so kind throughout the entire process. The whole FacesFirst team was so nice and made it very stress free! I can’t recommend him & his team enough!

-Martha Zellmann

After reading about Dr. Picerno, from a man’s point of view, I can only add my absolute agreement to the multitude of five star reviews she and her staff have received. Professional, competent, friendly and caring only begin to scratch the surface when describing she and her staff. Suffice it to say, the procedure performed produced an amazing result and I couldn’t be more pleased. I would recommend her services to anyone who wishes to have facial surgery of any type. Thank you Dr. P for your caring way.

– Terry Allard

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Where can Botox® Cosmetic Be Used?

Botox has several uses. Primarily, Botox is used to reduce wrinkles and fine lines that develop as a result of repeatedly making facial expressions, such as frowning, squinting, or smiling. The most common injection sites for Botox include:

  • The forehead
  • Between the eyebrows (“11 lines” or “frown lines”)
  • In the crow’s feet

In addition to these uses, patients in Denver can use Botox for several other cosmetic purposes. First, Botox can be strategically placed to reduce marionette lines, which are vertical lines or folds that run from the corners of the mouth down, causing the lips to have a downturned appearance. Around the lips, Botox can also be used to reduce smoker’s lines. When injected in the chin, Botox can reduce excessive dimpling. Some patients have also received Botox injections below the nose to fix a “gummy” smile. Finally, Botox can be injected in the neck area to reduce bands or ridges commonly found in the neck as we age.

Aside from these cosmetic uses, Botox treatment can be used as a non-surgical and minimally invasive option for various medical issues. Some physicians have used Botox to reduce excessive sweating by injecting the product into the hands and/or feet. It is also useful in relieving TMJ pain when injected into the masseter muscle, which can also narrow the lower face for a positive cosmetic side-effect. Finally, Botox injections in the head or neck can reduce migraine headaches and may even ease depression.

Who is a Candidate for Botox?

Most people in Denver who have wrinkles, folds, or fine lines that are worsened when they make certain facial expressions are good candidates for Botox treatment. In addition, those with other concerns, such as a gummy smile, dimpling in the chin, or marionette lines, may be good candidates for Botox in Denver. Not all signs of aging are effectively treated using Botox, however. Your plastic surgeon may recommend an alternative treatment plan such as the use of dermal fillers to address your fine lines or wrinkles instead. Botox candidates should also be generally healthy and have realistic expectations for their treatment and results. Your Denver, CO plastic surgeon will explain whether Botox or another treatment is correct for you after a consultation. Typically, Botox injections can take place immediately after a consultation during the same appointment in our Denver office.

Read Our Blog

for more information

7 Surprising Uses for Botox


Benefits of Botox Around the Eyes


What is the Botox Procedure Like?

During your Botox appointment, the first step is to thoroughly cleanse the injection site, and your injector may apply a numbing cream to the area as well. The appropriate number of injections to achieve your goal results will then be administered. Immediately following your injections, you will likely see some redness and slight swelling, which quickly dissipates. Botox patients are usually advised to avoid strenuous activity such as exercise for about 24 hours after their procedure, but can otherwise return to work or their routine as normal immediately following their Botox injections if they choose.

If you have questions about Botox® Cosmetic or would like to set up a consultation to discuss your options, call our Denver office today at 303-744-2300.


Before and After

Neurotoxins like Botox and Dysport temporarily smooth fine lines and wrinkles caused by repeated facial expressions. These injectables offer a non-surgical treatment for frown lines, crow’s feet, fine lines on the chin, gummy smiles, and neck bands.


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*actual patient of Botox® Cosmetic Surgery

Frequently Asked Questions

Can Botox age you?

Botox should not cause you to look older, even after the results fade. Many patients also use Botox to prevent wrinkles from getting worse over time.

Can Botox cause weight gain?

Botox does not cause weight gain.

Can I go for a walk after Botox?

You can go for a walk after Botox injections. However, it is best to avoid strenuous exercise for about 24 hours to prevent bruising or other complications.

Can I have wine after Botox?

It is best to avoid drinking alcohol for about 24 hours after receiving Botox injections, as this can increase your risk of bruising or bleeding.

Can you drink coffee after Botox?

There are no restrictions on drinking coffee after receiving your Botox injections.

How long until I will see the results of the Botox?

When you are given Botox, it may take one to two weeks to start seeing the full effect. Botox lasts on average 2 to 4 months and the duration can depend on a number of factors including the amount, the muscle characteristics of your face and how expressive the treated muscles are, and how often they are used. For example, it is important to receive the full dosage as a lower dose will not last as long. In addition, some people have larger muscles or increased activity that require higher doses and Botox effect may wear off faster.

Can I wear makeup after Botox?

In the first few hours after receiving Botox it is important not to put excessive pressure or irritation on the treated areas. Beyond that there's no problem with your usual skin treatments, including makeup.

Do I have any restrictions with bending over or working out after Botox?

For the first few hours after receiving a Botox treatment you need to be careful about a few things so that the Botox does not spread away from the muscle being treated. This includes avoiding bending over, excessive exercise, or placing direct pressure such as by wearing a hat or goggles in the treated area.


ASPS – Botox
AAD – Botox

Nicolette Picerno, M.D.

Dr. Nicolette Picerno is a double-board-certified facial cosmetic surgeon certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. She received her medical degree from Hahnemann University, School of Medicine in Philadelphia, and completed her fellowship for the American Academy of Facial Plastic and Reconstructive Surgery at the Beeson Aesthetic Surgery Institute in Carmel, IN. She also completed the Cenegenics Physician Training and Certification in Age Management Medicine program in 2012 and became a certified BioTE provider in 2014. When not in the office, Dr. Picerno enjoys spending time with her family, hiking, skiing, playing tennis, and running her doggie daycare with her husband.

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