Everything You Always Wanted to Know About Botox…

But, were afraid to ask.  I’m Dr. Lisa Jenks, owner and medical director of Genesis MedSpa in Colorado Springs.  I have been administering cosmetic Botox treatments since 2006 and currently perform more Botox injections than anyone in Southern Colorado.  I pride myself on using cosmetic Botox in a way that allows both men and women to look younger and more refreshed, while still looking like themselves, just with fewer lines.

What Does Botox Do?

Botox is used to soften and improve lines on the face that are caused by underlying muscle movements.  These include the lines between our eyebrows, across the forehead, around the eyes and around the mouth.  If lines are visible when the face is at rest, it will take 3-4 Botox treatments before they are no longer able to be seen. The best time to begin Botox treatments is before a person develops lines at rest because Botox will prevent them forming.  In other words, Botox temporarily gets rid of existing lines, but permanently stops new lines from forming.

Why Should I Consider Botox?

Botox is a purified form of the botulinum bacteria.  When small amounts are injected into facial muscles, the communication between the nerves and the muscle is disrupted, so that the muscle stops receiving signals from the nerve to contract.  Therefore, the muscle stays relaxed and smooth.  Over approximately 4 months, the nerve repairs itself and begins sending signals to the muscle again, causing movement to return.   As we age and continually use our facial muscles, lines at rest become permanent.  So, for example, if a person scowls whenever they are concentrating or staring at their computer, they will form permanent “11’s” in between their brows.  People who are very expressive and are always raising their eyebrows eventually form permanent lines across their foreheads.  Botox injections will relax those muscles so that the person cannot scowl as easily and thus those lines will soften, improve and eventually even disappear.

Lines on our face tend to make us look angry and tired.  Cosmetic Botox, when injected by a trained professional, still allows men and women to have facial movements and look like themselves, but a more refreshed and happier version of themselves.  Botox can be used to make the eyes look more open and to give women a subtle, but pretty, brow lift.  The corners of our mouths often develop a permanent droop as we get older, making us look as though we are always frowning.  Botox can be used to lift those corners.  Other fun uses of Botox include a “lip flip”, which gives a subtle upturn to the lip and treatment of the chin, which improves the appearance of the jawline.  Botox can also be injected into the bands in the neck that give a “turkey-neck” appearance, resulting in a tighter, younger-looking neck.  Injecting Botox into the muscles of the lower face can slenderize and sculpt the low face and jaw line.  This is also a good treatment for reducing tension caused by grinding of the teeth at night. Good injectors always start off conservatively, with the philosophy that it is better to add a little more once the full effects are seen than it is to start with too much.

When Will I Notice the Effects of My Botox?

The full effects of Botox are usually seen 7 – 10 days after the treatment.  Botox treatments need to be done 3 – 4 times a year for best results.  If a person redoes their Botox within a few weeks of noticing the results starting to wear off, but before they return to baseline, then the effects are better with each treatment and tend to last a bit longer.  However, if the Botox completely wears off in between treatments, then each treatment starts all over and the results don’t accumulate. 

Is There Any Thing I Should or Shouldn’t Do After Receiving My Botox?

After being treated with Botox, patients should not heavily rub or massage the area for about 4 hours.  If the forehead was injected, tight hats or headbands should be avoided as well.  Normal, gentle touch is fine, and make-up can be reapplied immediately.  Most people have small, red bumps at each injection site.  These usually disappear with 10 – 15 minutes as the fluid gets absorbed.  Some studies recommend moving the injected muscles in an exaggerated way several times an hour for 3-4 hours after the treatment to allow the Botox to get more thoroughly absorbed.  So, for example, if the crow’s feet were injected, the patient should squint repeatedly.  Normal activity can be resumed immediately.

Possible Side Effects

Cosmetic Botox has been used safely for over two decades.  Botox is used for medical purposes in doses up to 1500 units.  It is uncommon to use more than 80 – 100 units for cosmetic purposes, so doses in the aesthetic industry and much lower than in the medical field.  While serious side effects have been reported at the higher medical doses, none have ever been reported at cosmetic doses.

The most common side effect is bruising and tenderness, which is not due to the Botox, but rather to the fact that a needle is used for the treatment.  At Genesis MedSpa, we use very small needles, so our incidence of bruising is minimal. 

A small percentage of people get a low-grade headache for 3-4 days after their Botox injections.  Most people notice a reduction in severity and frequency of headaches and Botox is FDA approved to treat migraine headaches.  If a person does develop a headache after treatment, it usually resolves with some Tylenol.

When Botox is injected into the forehead, an over-arched brow or a flattened brow can occur.  Skilled injectors can almost always fix either of these issues.   A lopsided smile is possible after Botox is used around the mouth and, again, this can usually be fixed.  When Botox is placed into the “smoker’s lines” above the lip, people sometimes feel as though they are talking funny after the effects kick in.  Usually nobody else notices this and, after about a week, talking no longer feels different. 

Botox should not be injected into pregnant woman.  People who have neuromuscular diseases need to be treated cautiously.  People who take blood-thinning medication can be treated but need to recognize that they will very likely bruise.

How Much Botox Will I Need?

Botox is measured in “units”.  Most facilities charge per unit, which is what Genesis does.  In my opinion, this is the fairest way to charge, because each person needs different amounts of Botox.  Other places charge per area treated.  However, the average man needs more Botox than the average woman and younger clients usually need less than older ones.  When price is per area, these differences are averaged out so that younger clients could end up paying more than they would if they were only charged for the amount that was put into their muscles. 

The amount of Botox needed can only be determined once the injector looks at a person’s facial movements and takes into account their age and sex, as well as medical history.  On average, though, women need 12 – 20 units in their foreheads, 16 – 24 units in between their eyebrows and 16 – 24 units in the crow’s feet.  Men, on average, need 1.5 – 2.0 X the amount women do.  At Genesis, Botox is $12 per unit if 26 or fewer units are injected and $11 per unit if more than 26 is used.  Genesis offers “frequent buyer” programs which further reduce the cost of treatments.

What Else Should I “Know” Before Considering Botox?

In addition to Botox, there are three other FDA approved neurotoxins on the market in the United States.  These are Dysport, Jeauveau and Xeomin.  Studies show they are equal in efficacy and their safety profile.  Each, however, does have a slightly different “personality”.  Experienced injectors can help each patient determine which product is best for their face.  At Genesis, we do offer alternatives to Botox which we are happy to discuss in our client consultations. Genesis offers free consultations with our physician or nurse injectors.  This allows each patient to meet the providers and to find out exactly how many units they will need and how much that will cost.  It also allows all questions to be answered prior to treatment.  We are happy to do the treatment on the same day as the consultation or to schedule them for two separate days. 

Unfortunately, “Black Market” Botox does exist.  In the United States, the only company that is authorized to produce and sell Botox is Allergan.  Allergan production of Botox is tightly regulated and follows strict quality guidelines.  Using Botox that is made by anyone other than Allergan is potentially very dangerous.  “Black Market” Botox is usually sold for a very cheap price, which is one clue that it is not “real”.  Allergan determines the price at which providers can sell Botox and so, if you see an advertisement for extremely inexpensive treatments, be very wary.  Since unauthorized Botox is not regulated, it can contain anything, which is not safe.  Several years ago, there were two cases of unauthorized Botox causing death because the purification process was so inexact. 

Genesis recommends that you only get Botox treatments from medical spas that have on-site physician oversight and that have excellent reputations and have been in business for several years.  As with many things in life, you get what you pay for.  Paying a bit more, but knowing you are getting safe injections is well worth it!

Botox is a beautiful adjunct to any anti-aging regiment.  It is a safe and effective way to look relaxed and happy and to slow down the aging process.  Skilled, experienced injectors will help you look and feel your best version of you!  

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