The Injectables Vol. II: Botox Q&A

I get a lot of questions about Botox - both about my own experience and the treatment in general so a good Q&A post was needed. Throughout my Botox journey I have developed a great friendship with my nurse injector Marg and she kindly agreed to sit down with me and answer some more in depth questions about the treatment, its possibilities, and what to look for in a practitioner if you are looking to have injections done!

I’ll start by answering some questions about my own experience:

Does it Hurt?

No, the Botox needles are so small the pain is very mild, similar to a tiny pinch at each injection point and lasts a fraction of a second.

How long does it take?

My forehead, frown lines, and crow’s feet were done in about 20 minutes. With a consultation and treatment the appointment was one hour.

How much does it cost?

The price varies clinic to clinic, mine was $10 a unit. Beware of offices offering Botox at ridiculously low prices, Marg discusses why a little later on in this article.

Do you bleed? Can you go back to work after?

I had minimal bleeding at the injection points that subsided immediately. I am currently on maternity leave, but absolutely could have gone back to work following the procedure.

How long do results take?

Some people see results as early as 2 days, Marg told me I would start to see results in about 5 days with maximum effect in two weeks. Turns out I’m a slow responder, and I didn’t see any effect until about 10 days. At two weeks, my forehead was perfect but my frown lines needed additional touch ups. This is important to know because if you are planning Botox for a special event, I would go about a month ahead to make sure everything has set correctly and no touch ups are needed!

What does it feel like afterwards?

Nothing. As it starts to take effect I had a mild heavy feeling in my forehead that lasted for a day or two. It wasn’t painful, but felt odd, almost like my forehead was sleepy.

Are your lines gone?

For the most part, my lines are invisible. If my skin is fairly dehydrated I will be able to see them, but they are slowly fading and will continue to fade as I have more Botox treatments. With my facial muscles not being able to contract, the lines aren’t being formed hundreds of times a day, and this is giving my skincare products a chance to really work on the lines without my muscles getting in the way

Now onto the harder questions, graciously answered by my dear friend Marg!

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Margaret is a Board Certified Nurse Injector working at Skinjectables downtown Toronto. She used to work at The Hospital for Sick Children in the Neonatal Intensive Care Unit and the Pediatric Intensive Care Unit (so I knew I was in good hands) before finding a love for injectables and deciding to make a career switch. I did a lot of research to find the right injector for me and wouldn’t hesitate to recommend Marg. Lucky for you Toronto/GTA/Ontario ladies who are looking to start or continue your injectable journey, Skinjectables has an amazing referral program detailed at the bottom of this article.

When is the "right" time to come in for Botox? Once static lines begin to appear? If expression lines are deep?

There is no set age when someone needs to come in to get botox. I tell my patients that the “right time” is whenever the lines start bothering you. Wrinkles are caused by dynamic muscle action and what Botox does is relax the muscle so the dynamic motions can’t be made. Botox can therefore be used as  prevention to stop deeper wrinkles from forming. Once the wrinkle has been formed, especially deep ones, it will never fully go away. Botox can only smooth out the skin so much, so in my opinion it is best to start injections when the wrinkles are not yet deep and formed.

Is it too late for Botox if static lines are already quite deep?

It is not too late, Botox will help the lines that are deep but it will take some time and might need several treatments (3-4 months apart) to be somewhat corrected. It took time for that wrinkle to be created so it will take some time for the wrinkle to smooth out. If the wrinkle is very deep most practitioners will do several botox treatments first, spaced 3-4 months apart, and then attempt to use filler in order to fill in the depression caused by the wrinkle

How do you decide how many units to inject? Is there a range that is pretty common for someone with mild to moderate static lines who wants forehead and frown lines done?

Allergan does have set standards for their botox dosing according to each muscle group. How we decide how much goes into each muscle is dependent on the strength of the muscle. In each consultation I ask my patients to “frown, smile and raise your forehead” in order to see how strong their muscle is. (Laura: For reference, I had about 40 units in my forehead, frown lines, and crow’s feet on my first visit, but the forehead obviously needed more help)

Aside from expression lines, what are other uses for cosmetic Botox? What about Therapeutic Botox?

Botox is one of the most widely studied drugs out there and has many great cosmetic applications. Botox can be used in the masseters to slim the face and above the top lip to correct a gummy smile among other things. Botox began as a therapeutic treatment and was first introduced in the 1970s for the treatment of strabismus (crossed eyes) and it was finally approved for cosmetic use in 2001. Time magazine just recently published an article on Botox and listed all the different uses for the drug. These include migraines, excessive sweating in the underarms, hands and feet, twitchy eyes, overactive bladders and even depression. The article can be found here.

How long does Botox last?

The duration of botox is dependent on several factors; the individual, how much they use the muscle,  how fast their metabolism processes the product, the quality of the skin, and how many units were injected. (Laura: Marg told me that people who exercise can sometimes burn through Botox faster, so I’ve officially stopped exercising to preserve my smooth forehead). Botox is dose dependent, more units injected mean the more it’s going to last. Common botox areas and times they last:

What should I do before and after my injections?

Prior to your treatment avoid any alcohol, omegas, or Advil for 3-5 days (Laura: this was hard for me for obvious reasons). Following treatment refrain from exercise for 4 hours (Laura: this was not hard for me for obvious reasons), and no laying down or rubbing the area. No retinols or acids for three days following the procedure and no massages, lasers, or saunas for two weeks.

Why do some places seem to offer such inexpensive Botox?

Some clinics use another product similar to Botox called Dysport or Xeomin. They are cheaper to buy and cheaper to sell. These two products are similar to Botox in that they relax the muscle but they may not last as long and the concentration to actual Botox is different. Botox has a wealth of studies behind it and these do not have as much research at all. It’s important to remember that it is your face and you do not want to get a discount on your face.

What should I look for when selecting an injector in my area?

I would always go to a Nurse working under a Plastic Surgeon or Dermatologist. These places are credible and if complications do arise you have help. You need to ask the individual doing your Botox injection their years of experience, their credentials, and what product they are using (Botox or Dysport/Xeomin). Always go for a consultation, and if something doesn’t feel right, go with your gut.

I am sure there are more questions but these were a lot of the ones I’ve received since sharing my Botox results. I’ve learned a lot from Marg over the past couple months and I hope this has been helpful for you. If you are looking to start or continue your journey into Botox or Injectables and are in the Toronto/GTA area, I can’t recommend Marg or the team at Skinjectables enough. Luckily for you, if you are in the area and head to Skinjectables, you can mention my name (Laura or Lather to Lashes) and receive 10 FREE UNITS of Botox, which is worth $100. I’m not sure of any other clinics that offer as nice of a welcoming as Skinjectables does, and I feel confident that you’ll love their clinic as much as I do. As always, I love talking about all things skincare and that includes Botox and injectables, please never be afraid to reach out on IG if you have any questions and hopefully I can guide you in the right direction!

I wish you all super smooth days ahead,

Laura

*Disclaimer: This post is not sponsored in any way, shape, or form by Skinjectables. I have not received any free Botox or injectables for this post and the questions answered by Marg were done graciously on her own time at no charge. In full transparency, as per their referral policy, if you do mention my name at Skinjectables to redeem the 10 free units of Botox, I will also be given 10 free units to use at a later time. Images used with permission from Skinjectables.