BOTOX.
Smooth fine lines and prevent the wrinkles that haven't formed yet — with Botox, Dysport, Xeomin, or Jeuveau. Trained injectors, conservative dosing, complimentary 2-week touch-up.
A purified protein, precisely placed.
Botox is a purified-protein botulinum toxin type A that temporarily relaxes the small facial muscles responsible for dynamic wrinkles — the lines that show up when you smile, frown, or raise your eyebrows. When the muscle relaxes, the overlying skin smooths.
It's not filler. Filler adds volume; Botox softens motion. The two often work together, but they solve different problems.
The treatment is a series of small injections taking 10–15 minutes. Results begin appearing 5–7 days after treatment, reach their full effect by day 14, and typically last 3–4 months. Botox has FDA approval for cosmetic use and is one of the most-studied aesthetic treatments in medicine — there are decades of safety data behind it.
Trained injection, conservative dosing.
At Reviv Med Spa in Millbrae, Botox is administered by our Medical Director Dr. Gayle Misle, MD, and our Aesthetic Nurse Megan Sosnick, RN — both with extensive training in neurotoxin injection technique. Every consultation starts with a face-to-face assessment — we look at how your face moves, where lines form, and what outcomes feel right for you. The difference between a great result and a frozen one is dosing and placement, not the product itself.
Reviv is an Allergan Platinum Plus Partner (2023) — the top tier of recognition from Allergan Aesthetics, the maker of Botox. The status reflects sustained treatment volume and ongoing injector training, and places Reviv among the higher-volume providers for the Allergan portfolio in the San Francisco Bay Area.
We carry the four major neurotoxin brands so we can match the product to the case:
- Botox by Allergan Aesthetics
- The original; widest indication coverage; predictable onset around day 7.
- Dysport by Galderma
- Onset slightly earlier (3–5 days); some patients prefer it for forehead and crow's feet.
- Xeomin by Merz Aesthetics
- The "naked" toxin (no accessory proteins); a strong choice for patients with prior resistance. Dedicated Xeomin page →
- Jeuveau by Evolus
- Newer; aesthetic-only indication; a competitive option for first-time treatment. Dedicated Jeuveau page →
After your consultation we map the injection points, mark the skin lightly, and place the injections. The full treatment takes 10–15 minutes. There's no anesthesia and no downtime — most patients drive themselves back to work or to the rest of their day. We recommend staying upright for 4 hours after treatment and skipping vigorous exercise for 24 hours.
You'll see initial smoothing within a week. We schedule a complimentary 2-week touch-up assessment so we can fine-tune dosing on follow-up visits.
Nine areas, one toolkit.
In your consultation we'll identify which areas would benefit most for your goals. Most first-time treatments cover 1–3 areas.
Glabellar lines
The "11s" between the eyebrows. The most-requested first area.
Forehead lines
Horizontal lines that appear when you raise your brows.
Crow's feet
Lines around the outer eyes that show with smiling.
Bunny lines
Diagonal creases across the nose bridge when you scrunch.
Lip lines
Vertical "smoker's" lines around the mouth — perioral softening.
Chin dimpling
Pebbled or "orange-peel" texture on the chin.
Masseter
Jawline slimming and TMJ / clenching relief.
Neck bands
Platysmal cords — vertical bands on the neck.
Underarm sweating
Hyperhidrosis — an FDA-approved medical indication.
Lines that move, lines that stay.
Dynamic expression lines
The lines that show up when you smile, frown, or raise your brows — the primary indication for neurotoxin.
Early static lines
Lines that have just begun to etch at rest. Consistent treatment can soften them over time.
Preventative ("baby Botox")
Lower-dose, less-frequent treatment in patients in their 20s and 30s — softens repetitive movement before it etches a wrinkle.
Masseter hypertrophy / TMJ
Jawline slimming and clenching relief through targeted masseter dosing.
Hyperhidrosis (underarm sweating)
FDA-approved medical indication. Lasts 6–9 months per treatment.
Forehead Crow's feet Bunny lines Lip lines Masseter Neck bands Brow lift Glabellar Forehead Crow's feet Bunny lines Lip lines Masseter Neck bands Brow lift Glabellar Forehead Crow's feet Bunny lines Lip lines Masseter Neck bands Brow lift What to know, in four lines.
- 01
Onset is gradual: you will not see anything for 3–7 days. The 2-week touch-up is the moment to assess, not day 3.
- 02
"Frozen" comes from over-dosing, not from the product. Conservative first-treatment dosing is our default — we add at the touch-up if you want more.
- 03
Botox softens motion; filler adds volume. They solve different problems and often work together. We carry both.
- 04
Pricing is per unit and quoted in writing at consultation. No surprise charges, no day-of upsells.
From day zero, to day fourteen.
Treatment day. 10–15 min of micro-injections. No anesthesia, no downtime — drive yourself back to work.
Tiny pinprick bumps fade within an hour. No visible signs of treatment. Avoid lying flat, vigorous exercise, and saunas for 24 hours.
First effects appear. Lines begin to soften. The product is binding to receptors and the muscle is starting to relax.
Full effect. Complimentary touch-up assessment — we fine-tune dosing if anything looks asymmetric or under-treated.
Before your visit, and the days after.
- Schedule a Consultation
- We will discuss your goals, medical history, and any concerns. Disclose any medications or supplements you are taking, as some can increase the risk of bruising.
- Avoid Blood-Thinning Medications
- For at least a week before the procedure, avoid medications that can thin your blood, such as aspirin, ibuprofen, and certain supplements like fish oil, vitamin E, and garlic.
- Refrain from Alcohol
- Avoid consuming alcohol for at least 24 hours before your appointment, as it can increase the risk of bruising and swelling.
- Stay Hydrated
- Drink plenty of water in the days leading up to your treatment to keep your skin hydrated and healthy.
- Plan Your Schedule
- Schedule your Botox appointment at least two weeks before any major events to allow time for any potential bruising or swelling to subside.
- Avoid Topical Treatments
- Refrain from using retinol, glycolic acid, or other exfoliating products on the treatment area for at least 48 hours before your appointment.
- Prepare Your Skin
- Arrive at your appointment with a clean face, free of makeup, lotion, or sunscreen.
- Stay Calm
- Try to relax and reduce stress before your appointment, as stress can affect your body’s response to the injections.
- Do Not Touch or Rub
- Avoid touching, rubbing, or applying pressure to the treated area for at least 24 hours to prevent the Botox from migrating to unintended areas.
- Stay Upright
- Remain upright for at least 4 hours after the treatment. Avoid lying down or bending over during this period.
- Avoid Strenuous Activity
- Refrain from vigorous exercise, heavy lifting, or any activities that cause excessive sweating for 24 hours post-treatment.
- Cold Compress
- Apply a cold compress to the treated area to reduce swelling and bruising, if necessary.
- No Alcohol or Blood Thinners
- Continue to avoid alcohol and blood-thinning medications for another 24 hours post-treatment to minimize bruising.
- Gentle Cleansing
- Cleanse your face gently with a mild cleanser and avoid using any harsh skincare products for at least 24 hours.
- Avoid Heat Exposure
- Stay away from direct sunlight, tanning beds, saunas, and hot tubs for at least 24-48 hours to prevent increased swelling and bruising.
- Avoid Facial Treatments
- Postpone any other facial treatments such as facials, microdermabrasion, or chemical peels for at least two weeks.
- Monitor for Side Effects
- Mild redness, swelling, or bruising at the injection site is normal. However, if you experience severe pain, allergic reactions, or other concerning symptoms, contact your medical provider immediately.
You'll receive these neurotoxin instructions in writing before your visit and we review them with you in person. Questions during recovery? Call (650) 697-3339 — we answer same-day. See the aftercare hub for the universal recovery principles and when to call us.
What it actually costs.
Botox pricing at Reviv is from $18.50 per unit, with most first-treatments using 20–40 units total across the upper face. Final cost depends on the areas treated and the dosing your face requires — which we quote in writing at consultation, before any treatment begins.
Who it's for — and who it isn't.
- Adults with dynamic expression lines that show with smiling, frowning, or raising the brows
- Patients in their 20s–30s exploring preventative ("baby") dosing
- Patients with masseter hypertrophy, jaw clenching, or TMJ discomfort
- Patients with axillary hyperhidrosis (underarm sweating)
- Pregnant or breastfeeding patients
- Patients with myasthenia gravis or other neuromuscular disorders
- Patients with a known allergy to any of the formulation's ingredients
- Patients seeking volume restoration — that's a filler conversation
Your Botox team.
Dr. Gayle Misle, MD
Founder of Reviv Med Spa & Laser Treatment. Leads our injectable program with extensive training in neurotoxin technique and a conservative-first dosing philosophy.
Megan Sosnick, RN
Aesthetic Nurse and Practice Manager. Runs your initial consultation, places injections alongside Dr. Misle, and manages your 2-week touch-up assessment.
Real Reviv patients. No retouching.
Two weeks post-treatment. Same lighting, same pose, same camera. Tap any pair to read the case study — areas treated, units placed, brand used.
Individual results vary. All photos are real Reviv patients, shared with consent. Lighting and pose are matched, no retouching.
Trained hands. Same studio.
Botox at Reviv is administered by our Medical Director Dr. Gayle Misle and our Aesthetic Nurse Megan Sosnick — both onsite at our Millbrae studio, both with extensive neurotoxin training. Same hands, same protocols, every visit.
What people say about Reviv.
I've been to quite a few places for Botox. This spa is by far the best I have ever experienced. The staff is warm & friendly. The Dr is so personal & friendly it took me a while to realize she is the Dr!! I told her how many units I usually get.…
…I usually see her for Botox injections but have had facials, sunspots removed with BBL laser, and fillers done for lip lines. She is an absolute artist with Botox injections, I receive many compliments from people saying I look much younger than my years (I am 66).…
I come here frequently for touch ups on my Botox and filler. I have to say that Dr Misle is the best doctor I have ever had for injections. I leave feeling flawless and get compliments on my lips and Botox all the time.…
Frequently asked.
How long does Botox last at Reviv?
Most patients see Botox results last 3–4 months. First-time patients often metabolize the product slightly faster as their muscles adapt — by your second or third treatment, the effect tends to last longer. We recommend treating every 3–4 months for the most consistent appearance.
Will I look frozen?
Not when it is done well. Modern aesthetic Botox aims for natural-looking softening — you should still be able to express emotion, just without the deep wrinkle. The "frozen" look comes from over-dosing or treating too many areas at once. At Reviv we err toward conservative first-treatment dosing and adjust at your 2-week touch-up.
How much does Botox cost?
Pricing starts at $18.50 per unit; most first-treatments use 20–40 units across the upper face. Final cost depends on the areas treated and the dosing required for your specific muscles. Request a consultation for an exact quote — we do not surprise patients with unexpected charges.
Does Botox hurt?
Most patients describe the injections as a 1–2 out of 10 — a series of brief pinches. We offer topical numbing cream beforehand if you prefer.
Is there downtime?
No. You can drive home or back to work. Avoid lying flat, facial massage, vigorous exercise, and saunas for 24 hours. Small bumps at the injection sites fade within an hour.
What is the difference between Botox and filler?
Botox softens muscle movement to reduce dynamic wrinkles (lines that appear with expression). Filler adds volume to areas that have lost it — like cheeks, lips, or under-eye hollows. They solve different problems and often work together. We carry both at Reviv and will recommend what is right for your goals.
Can I prevent wrinkles with Botox before they form?
Yes — preventative or "baby Botox" is a common approach in patients in their 20s and 30s. The idea is to soften repetitive muscle movement before it etches deep wrinkles into the skin. Treatments are typically lower-dose and less frequent than corrective Botox.
How soon will I see results?
First effects appear at day 5–7. Full effect is at day 14. We schedule complimentary 2-week touch-ups so we can fine-tune dosing if needed.
Are there side effects?
Botox has decades of safety data. The most common side effects are minor bruising or a small headache the day of treatment. Rare side effects (eyelid drooping, asymmetric brows) are dosing-related and almost always resolve as the product wears off — they are correctable on your touch-up.
Who should not get Botox?
Patients who are pregnant or breastfeeding, who have certain neuromuscular disorders (e.g., myasthenia gravis), or who are allergic to any of the ingredients. We screen at consultation. If you have questions about whether Botox is right for you, ask us.
Patients come to us from across the peninsula.
Reviv Med Spa is at 31 S El Camino Real in Millbrae, California — easy to reach from across the Bay Area peninsula. Patients come to us from Burlingame, San Mateo, Hillsborough, San Bruno, Foster City, and the broader peninsula including Atherton, Belmont, Brisbane, Daly City, Half Moon Bay, Menlo Park, Pacifica, Palo Alto, Portola Valley, Redwood City, San Carlos, and South San Francisco. Off the 101, just south of SFO. Free parking on site.