Botox Treatments

In Billings & Bozeman

You deserve the best! Dr. Julie Reil has the high-certification of Master Injector for Botox and Juvederm. Over the past 15+ years, Shiloh Medical Clinic has performed more injections than any clinic in the state of Montana.

BOTOX® is the most popular injectable in the world, effective in the use of smoothing dynamic wrinkles and fine lines caused by repetitive muscle movement. Botox temporarily relaxes the facial muscles where it is applied blocking signals from the nerves to the muscles. 

BOTOX® has been proven effective with more than 16 years of cosmetic use, and 30 years meeting FDA quality and safety standards, since it was first introduced for therapeutic use in 1989. Over 100 million vials of BOTOX® have been distributed globally. 

Botox® is a subdermal injection that causes temporary muscle paralysis in the face, erasing wrinkles, lines, and crow’s feet.

It works by blocking the neurotransmitter acetylcholine, which is an organic chemical that acts as the messenger between the brain and the muscles of the body. Botox works by getting in between the signals sent by the brain and the muscles in the face, effectively blocking or greatly reducing the brain’s signals to that particular group of muscles. This means the lines normally created in the face by regular expressions, like smiling, frowning, squinting, or raising the eyebrows do not get made, since the expression is halted or diminished. 

Botox also relaxes the muscles into which it is injected, causing them to release all their held tension and erase the wrinkles those muscles were creating.

Botox treatments can last 4 to 6 months, but most people’s injections will last 3 to 4 months. In very rare cases, the injection lasts only two months. First-time treatments tend to last the longest.

Since Botox blocks neurotransmitters from the brain, it takes some time for the full effects of the first injections to take place: sometimes up to two weeks. Early results tend to be seen in the first two or three days, however. It is typical to schedule a follow-up appointment two weeks after the first so your medical provider can check the progress and touch-up any areas that may have resisted the effects of the Botox.

Botox will begin working, for some people, as early as 3 to 4 days after the injection. However, most people can expect to see the full impact of the treatment in 14 days. If you’ve just had your injections, it’s best to wait the full 14 days before judging the results.

Botox is most often used on the face to help treat:

  • Wrinkles
  • Crow's feet
  • Neck bands
  • Sagging eyebrows
  • Smoker's lines
  • Bunny lines
  • Frown lines


The manufacturer recommends a benchmark of 4 units of Botox for each injection. However, depending on the individual, their desired results and the treatment area, up to 100 total units can be used safely. 

Botox is a fast, easy procedure that only takes a few minutes in the doctor’s chair. In fact, the treatment is so efficient that you won’t even need to have any anesthesia. Instead, you simply sit in the doctor’s chair, they’ll inject the Botox, and you’ll be on your way shortly after. For most people, the entire process will take 20 minutes or less.

Like any medical procedure, getting a Botox injection starts with a conversation between doctor and patient. The medical professional in charge of the injections will discuss the desired objectives from the treatment, potential risks and side effects, and medical history and potential allergies. Before-and-after photos may be taken as well; and if your medical provider does not take them, it may be wise for you to do so yourself so you can compare the results of the treatment to make sure it is worth it for you to continue receiving it. After that, the process is simplicity itself.

The face is cleaned and made sterile, and then an approved medical provider injects the Botox into the muscle groups that are causing wrinkles in the face. 

The types of needles used by doctors and nurses during Botox injections are extraordinarily thin, and cause as little discomfort as possible. The low level of pain, coupled with the fact that the procedure itself can take less than ten minutes in the hands of an experienced professional, makes this a very common outpatient procedure. 

Wrinkles are often the result of your muscles contracting. Botox injections will help block the nerve signals going to the muscle that tenses up when you smile, laugh or make other facial expressions. The blocking of the nerve’s signal will allow the muscle to relax and wrinkles to soften. This can be done as a preventative measure or to improve the appearance of existing wrinkles. 

Treatments should be as often as your doctor recommends. However, most people will need to get injections every three to four months to maintain their results. Over time, fewer treatments may be necessary.

Depending on the reason for your treatment, you may need more or fewer treatments. For wrinkles and fine lines, you can expect to have three to four treatments per year to maintain your appearance.

Botox has been on the market since the 1990s and has been studied strenuously, because it does involve the botulinum toxin. However, study after study has shown that Botox is a safe and effective drug when administered by a properly trained medical professional. Side effects commonly experienced are bruising around the injection site, which can last for up to a week: uneven effectiveness across the face, which is treated with an additional microinjection, and swelling. 

Pregnant women, those who are breastfeeding, and those who may become pregnant should not receive a Botox injection, because the drug has not been adequately studied in those populations.

Botox has very minimal side effects, but some people will experience some or a combination of the following:

  • Headaches
  • Bruising
  • Swelling
  • Pain
  • Dry eyes

Adverse effects are very minimal and temporary, often only seen near the injection site shortly after treatment.

Botox is a very popular cosmetic injection that has been used worldwide for many years. Countless men and women choose this treatment for a more youthful, rejuvenated appearance. Botox is an injectable muscle relaxer that smooths out expression lines commonly formed on the forehead and around the eyes. It is safe, effective and FDA-approved.

Administering Botox is minimally uncomfortable, has low risk of bruising and requires no recovery time. The dose and distribution for Botox treatments at Shiloh Medical Clinic are always customized for you and performed by a physician or a trained RN under the direct supervision of a physician. 

Only a medical doctor has legal privilege to use Botox off-label. Off-label use of Botox includes injection around the lips, or into the masseter muscle to reduce jaw clenching and teeth grinding (Bruxism). Additional off-label uses include injection into the lower jaw muscles to slim a wide jaw and injection into the neck cords to reduce platysmal bands. All off-label uses of Botox carry risk and must be approached with caution and discussed with your physician as there are dangers associated.

Understanding how Botox works begins by understanding the types of wrinkles and fine lines that this treatment targets. Wrinkles are grooves in the skin caused by repetitive muscle movements such as smiling, frowning, and squinting. The dynamic wrinkles become much more noticeable as we age, starting in our 30s. They are most prominent on the forehead, brow area and around the eyes. 

Botox is a neuromodulator derived from Botulinum Toxin Type A. It works by blocking the signals telling a muscle to contract. The muscles then relax and elongate, causing overlying skin to smooth out. This significantly diminishes wrinkles, reflecting a more youthful appearance.  Young adults in their 20’s and 30’s may help prevent winkles from forming with regular Botox use. 

Improvements from Botox will vary per individual, but most patients see smoothing within 24-72-hours. Most enjoy the anti-aging results for 3-4 months after treatment.

Before & After Results

*Your results may be different than those pictured

Dr. Julie Reil

Dr. Julie Reil

Dr. Reil holds the high-level certification of Master Injector for both Botox and Juvederm, making her among the most experienced injectors in Montana. Over the past 15+ years, Shiloh Medical Clinic has performed more injections than any other clinic in the state!  

A Montana native from Miles City, Dr. Reil was born and raised in a small farm and ranch community. She graduated from The University of Montana and won the title of Miss Montana at age 19. After earning her medical degree at The University of Washington, Dr. Reil completed her residency and spent decades practicing primary care, obstetrics and gynecology in Billings. A passion for women's health led her to open Shiloh Medical Clinic in 2007. 

Billings Location

1655 Shiloh Rd Suite E, Billings, MT 59106

Bozeman Location

304 Gallatin Park Dr Suite 302, Bozeman, MT 59715

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