(828) 627-2711 46 Haywood St #11, Asheville, NC 28801


The average treatment time is 10 - 15 minutes. Many people get it on lunch break or even coffee break and are back to work. Mountain Radiance Medical Spa, conveniently located in Downtown Asheville provides the opportunity to stop by during the work day for treatment!


With over 4 million Botox treatments per year in the United States, Botox has an extremely low incidence of complications. While complications with Cosmetic Botox are possible they are extremely rare.


Botox gives reliable results that are significant but subtle when treatment is by an experienced doctor like Dr. Zacher. Dr. Zacher's most common Botox review is that "it looks so natural!"

Non-Surgical Botox in Asheville North Carolina

What is Botox?

Use of Botox brand of botulism toxin (Bot. Tox. A) for cosmetic improvement is the most frequently performed medical procedure in the United States and likely the world. Over 4 million visits for Botox injection in the US occurred in 2014 and the number has been steadily rising since 1979 when this medication was introduced.

So, what is Botox? In lay terms it is the toxin - now used as a medication - produced by Clostridium botulinum. "Botox" is the original brand and is composed of the active ingredient: botulinum toxin A. There are 3 versions of Botox A, two other brands include Dysport and Xeomin.

Why do we use Botox at Mountain Radiance instead of the other brands (Dysport and Xeomin)? Because like Coke, I feel "Botox is the real thing". It has been used for cosmetic purposes since 1979. The other two are arrivals within the past couple of years. So, first, Botox has been used longer than any other version for so much longer with so much clinical history, it would seem to be the safest one! Certainly Botox in Asheville has been the most commonly used "wrinkle relaxer" even though Dysport and Xeomin have been recently introduced.

A research study published in Biologics  in 2014 and available online shows that the 3 brands which are slightly different versions of Bot. Tox A are not interchangeable.  This paper demonstrates that the different brands have different strength per unit and different lengths of activity.

The bottom line is that Botox brand by Allergan has been around literally decades longer than the other two, they are not interchangeable, they have variable lengths of activity. If you want the best result you want to be treated by a doctor who has an extensive knowledge and experience with a specific version or brand of this medication (e.g. Botox brand) - because the results are variable when you switch from one product to another.

What are the benefits of Botox?

Botox, of course, is primarily used to relax the muscles that cause wrinkles on the face. This cosmetic effect is the most frequently targeted use, though it has been used medically to treat a wide variety of additional medical problems such as migraine headaches and muscle spasms, hands-down the most common use for Botox is cosmetic.

At Mountain Radiance Medical Spa we have been using Botox to treat cosmetic concerns of wrinkles since 2008 and have treated many hundreds of satisfied clients. Areas we have treated successfully include the forehead (frontalis muscle), between the eyebrows (glabellar area, or glabella), the wrinkles around the corners of the eyes ("crows feet" or periorbital rhytids) and occasionally "orange skin" appearance on the chin and the vertical lines ("kissing lines" or sometimes, "cigarette lines") above the upper lip (though treating this area may require filler such as Volbella, as well).

We have also been one of the only places in Asheville to use Botox to treat hyperactive sweating under the arms (hyperhidrosis) and in the hands and feet. This is an extraordinarily effective treatment.

How Does Botox Work?

It's important to remember Botox is a medicine. It works on the "neuromuscular junction". Let me explain.

Signals through the nerves and end at a microscopic junction "plate" by the muscle. A neurotransmitter (a chemical) is released, jumps a very short gap and attaches to a receptor site. This reaction is commonly called the "key and lock" the chemical exactly fits into the shape of the receptor site - like a key fits into a lock.

Botox and a variety of other medications some of which are used in anesthesiology, almost fit into the lock but not quite. This blocks the action of the neurotransmitter. This "blocks" the neurotransmitter - much like sticking gum into a lock prevents the key from fitting and therefore, blocks the contraction of the muscle.

The neuromuscular blocking agents used in anesthesiology are short acting and last hours at the longest. Botox (botulinum toxin) takes up to two weeks to create it's effect but blocks neuromuscular junction for months not hours - though it works exactly the same way in it's blocking mechanism.

Understanding how and why this potent medication works, the medical science behind it, interactions with other medications and medical conditions is essential for safe use of this technique.

Dr. Zacher has been treating patients with neuromuscular blocking agents since the 1980's, understands their use very well and has had years of experience treating patients with Botox.

Botox for Underarm Sweating

Botox can be used to eliminate excessive underarm sweating! Dr. Zacher has performed this procedure quite a few times and finds it is exceptional in it's effectiveness!


Botox Before and After

How Much Does Botox Cost Per Unit?

At Mountain Radiance Medical Spa, PLLC, we charge $11 / unit.

Botox is measured in "units of activity" rather than micrograms or volume. A single unit will not do much. Typically it takes from a very low 4 units to do anything (like arch an eyebrow) to 35 units to treat a strong glabellar area.

Treating the entire face for a new client with strong "wrinkle muscles" on the face can take as much as 65 units (sometimes 70) but the average dose is going to be about 55 for the whole face.

Over time and with maintenance I have seen this go down to a low of 30 to 35 units for the whole face but that's after maintenance.

Just treating certain areas is always an option. The forehead may take only 10 - 12 units and is where there'd the "biggest bang for the buck" or most noticeable improvement for the amount spent

Botox Treatment

$ 11
per Unit
Units Required for Treatment will vary based on area treated

Botox for an eyebrow lift: 2-5 Units

Botox for Crows feet (each side): 5-15 Units

Botox for Forehead Lines: 10-30 Units

Botox for frown lines: 10-25 units

Botox for Smile lift: 3-6 units

Neck/Platysmal Lines: 25-50 units

We treat other areas besides the ones listed. For an accurate quote, be sure to schedule a free consultation with Dr. Zacher.

How Long Does Botox Take to Work?

In about 5 days you will start to see changes in the areas treated, however, it takes approximately 2 full weeks for Botox to reach its full effectiveness.

always counsel patience especially for new patients to wait the FULL TWO WEEKS before requesting further enhancement of the treatment.

This wait can wear one's patience, but it's worth the wait.

Another important point is to be certain to maintain your investment in this treatment - regular maintenance of Botox will result in lower dosage (therefore lower cost) and more importantly - improved appearance.

How Long Does Botox Last?

Botox generally lasts 3 - 4 months before requiring a maintenance dose. Dr. Zacher highly recommends maintaining your investment by returning about 3 1/2 months for follow up dosing. This will enhance the beneficial effects over a period and result in lower dose needed to maintain. The first treatment almost always requires more units of dosing than maintenance doses.

Letting the botox wear completely off takes 6 - 12 months. Then it would require the full dosing to be repeated.

Difference Between Botox and Fillers?

Botox is a medication that takes about 2 week to have it's effect. Fillers (Juvederm, Voluma, Volbella, Vollure) are clear gels that fill crevices, the results can be seen immediately.

While we're on the topic of injectables, Kybella is different from both Botox and filler. Kybella is an enzyme that destroys fat and is currenty only FDA approved for the fat pad that some people can have under the skin. It works a completely different way, dissolving the fat under the chin and over time this contracts to sharpen the jaw line.

Botox Side Effects

Botox usually has very few side effects. There are adverse effects that can happen to a small percentage of clients. These are rare when Dr. Zacher uses this medication.

I like to explain that treating the face with Botox is something like painting with a blindfold on - you cannot see the results of your work for 2 weeks. This is why it's important to have an experienced, seasoned and knowledgeable injector perform your Botox treatment! 

Dr. Zacher has performed thousands of Botox treatments for patients over the years and has superb experience and control of the medication. His results speak for themselves with satisfied customers.

Dr. Zacher's patients also frequently note his treatment is almost painless compared to other providers.

Botox For Migranes

Some of our patients do note that cosmetic Botox can help with chronic migraines. I should note though that Mountain Radiance and Dr. Zacher only use Botox for cosmetic purposes which is not covered by insurance. If this happens to help a client's migraines we love hearing that and frequently do!

Can You Workout After Botox? What are the post procedure instructions?

These are the post procedure instructions I give clients:

  • Exaggerate your facial muscles for about 1 hr after the procedure to work the medication into the muscle.
  • DO NOT PRESS ON THE AREAS INJECTED for 24 to 48 hours - such as wear a hat that presses on the forehead. Do not press on the injections sites. YOU MAY touch gently as in wash the face and apply makeup.
  • Allergan, the manufacturer of Botox says not to work out or lie down for 4 hours after treatment.
  • Expect full results in 2 weeks, do not re-treat or "enhance" the botox until after the waiting period
  • You may have a facial treatment BEFORE Botox but not AFTER for 48 hours because we don't want to press on these areas.
  • We do not perform laser procedures on the face on the same day as a Botox treatment.
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