Botox Nation: Which State Gets Injected Most?

No public registry counts injections state by state, so we measured the supply side: of the 7,475 aesthetic doctors in the NavMDs directory, 1,513 list neuromodulator injections (Botox, Dysport, Xeomin, Jeuveau or Daxxify) on their service menus. Normalize that for population and a clear geography emerges — Louisiana is America's Botox capital per capita, at 0.83 listed injectors per 100,000 residents, ahead of New York (0.77) and Washington, DC (0.71). Coastal, urban and Southern states dominate; the Upper Midwest and rural Mountain West barely register.

Across 743 listed prices on provider menus, the national median is $440 per session — almost exactly ASPS's $435 national average. But geography moves the needle by 3x: Massachusetts medians hit $600 and Florida $550, while North Carolina ($260) and Wisconsin-to-Indiana territory sit under $300. Remember these are per-session list prices — actual bills scale with units injected, and a masseter treatment can cost double a glabella touch-up. To compare listed prices from providers in your area, search Botox near me.

Count heads instead of rates and the giants reclaim the podium: California fields 264 listed injectors — more than the bottom 30 states combined — with Florida (159), New York (153) and Texas (121) behind it. But look at the density and price columns: New Jersey and Virginia punch far above their size, and the same appointment that runs $550 in Florida is $370 in Texas. Every injector counted here has a NavMDs profile with credentials and ratings — find Botox near you.

The American Society of Plastic Surgeons doesn't publish state-level injection counts, but its 2024 regional data settles the volume question. The South Atlantic region — Florida through Maryland — performed 3.01 million neuromodulator injections, 30% of the national total with just 20.5% of the population. Per 1,000 residents it injects at more than twice the Midwest's rate. The Northeast, despite Manhattan's med-spa density, ranks fourth — its rate is dragged down by everything outside the big metros.

Neuromodulator injections have nearly doubled since 2019 — from 5.04 million to 9.88 million a year — making Botox not just America's most popular cosmetic procedure but bigger than every surgical procedure combined, six times over. The Zoom-boom years did the heavy lifting (+73% by 2022); growth has since settled into a steady +4% a year. Nothing else in aesthetics comes close: HA fillers, the #2 injectable, sit at 5.3 million.

For all the talk of “preventative Botox” and twenty-somethings at the med spa, the data says otherwise: patients aged 40–54 receive 57% of all injections — 5.6 million in 2024 — and the 55–69 group takes another 23%. Patients under 30 account for less than 2% of national volume. The gender split barely moves: 94% of injections go to women, though the male share — 594,000 injections — grew 4.3% last year.

The FDA-approved cosmetic targets are the upper face — frown lines between the brows (approved 2002), crow's feet (2013) and forehead lines (2017). But injector menus tell you where the market is heading. Among the 1,513 injectors in our directory, the most common named uses beyond the standard upper face are chin and jawline work (including masseter slimming for jaw tension and facial contouring), therapeutic migraine treatment (FDA-approved for chronic migraine since 2010), neck bands, the “Botox brow lift,” and hyperhidrosis — excessive-sweating treatment that predates most cosmetic uses.

Five FDA-approved neuromodulators now compete for the American forehead, but the original owns the shelf: 88% of injector menus list Botox by name. Dysport — faster onset, wider spread — appears on 14%, while the newer entrants (Xeomin's “naked” formulation, Jeuveau's #NewTox marketing, Daxxify's six-month duration claim) remain niche. Menus can list multiple brands, so shares sum past 100%.