I thought I would condense the top 10 questions I usually get during a Botox® /Xeomin®/Dysport®/Jeuveau® consultation into a blog post for everyone! Note: whenever I use “Botox®” I’ll generally mean any of these brands. Hope this helps!
I. Does it hurt?
A. Well, it depends on your pain threshold and how anxious you are. You will feel something, but the vast majority of patients are completely fine without needing a numbing cream or anything! I use a very small needle and have been told I have a gentle touch. If you are extremely anxious around needles, that may be a different story, but usually I just remind you to breathe through it, hold the squeezy ball, and you’ll be fine. And then a few minutes later we’re done and you’ll say incredulously, “That was it?”
II. Will I have to do it forever? I’ve heard that I’ll look worse after/if I stop?
A. In a word, no. Botox will gradually soften fine lines and wrinkles. However, if you love your results, you will have to keep up with regular treatments! If you stop, you’ll just commence aging where you left off. Patients could possibly feel like they look worse because they forget how they looked before treatment began and thus why they started treatment in the first place.
III. How long does it last?
A. On average, about 3-4 months, though it depends a little bit on your own body’s chemistry. I have some very lucky patients where it lasts for 5-6 months! But they are more rare. You’ll feel it starting about 1-2 weeks after the injection. I highly recommend a complimentary follow up for first time patients at the 2 week mark to make sure you are happy and to make sure I am happy with your results. After 2 weeks, you’ll have the strongest “hold” (think like a hairspray), which will gradually diminish over time. How much time depends on your body and body chemistry. In general, you return when you feel like you have too much movement and are creating wrinkles again. I always say it’s like maintenance for a car – you don’t want to get to Empty as you’ll have to refill a full tank. So we schedule the usual Botox treatment every 4 months.
IV. Will I look unnatural after Botox®?
A. My goal with every patient is for a natural look and so I am very conservative – especially if I am seeing you as a patient for Botox® for the first time. As I always say – I can always add more, but I can’t take any out. I would rather you be comfortable with your look at the outset. Because everybody’s anatomy is different, some people may require a few more injections after the initial estimate to make sure everything looks perfect. My goal is for you to look like yourself (but better). Some patients worry that if they treat one area, that part of the face will look younger than the rest of the face. I would say this is not likely, as it’s not as if the Botox will completely erase all wrinkles – they will generally make them softer. We also don’t always have to do all areas (the FDA-approved areas are the forehead, crow’s feet, and lines between the eyebrows), though it is generally highly recommended by most injectors to keep the areas aging at the same rate. On the other hand, some people show wrinkles in some areas a lot sooner than other areas! So I keep this option flexible for patients and it’s why I like to see patients in person, talk with you, and give personalized quotations. Anatomically, if patients request the forehead to be treated, I will generally recommend treating the area between the eyebrows as well because otherwise you can end up with an angry look. It’s because if you weaken some muscles in the forehead, the naturally opposing muscles can seem stronger and pull the eyebrows down. Other areas where people can get treated (off-label) are: gummy smile, downturned mouth, cheeks/masseters for jawline slimming, under the eyes for squinting, the neck for a slight neck lift, underarms for hyperhidrosis (increased sweating) and much more!
V. How long should I get it before my special event?
A. I generally recommend 4 weeks before your special event, as it gives adequate time to see the results of the initial treatment and for any additional treatment that may be necessary to tweak towards perfection.
VI. Is there downtime?
A. For most patients, there isn’t much downtime. You may get some bumps immediately after (that’s the Botox® that needs to absorb) and you may get a little red, see the needle marks, and some possible bruising. First time patients may experience a headache. There are a whole slew of other things that could happen that are listed in my informed consent forms, but these are the most common.
VII. What are the differences between the injectable products?
A. There are a few studied differences in the injectable products. Each has their own marketing team and their own message. I’d rather talk to patients to see what their goals are and choose one with them. With that said, Botox is generally the most popular as of right now.
VIII. What can I expect after?
A. You’ll leave thinking nothing happened except a few tiny injections. Then in a few days, you’ll notice it’s a little harder to move your muscles. The lines will generally start to soften. Then at the two week mark, you’ll come in for your “after” photos and we’ll see how much progress we made and determine whether you may need some more.
IX. How long does the procedure take?
A. We schedule 20-30 minutes, but that takes into account the time to talk with you about your goals, answer any questions, the time to prepare the product, clean the room for the next patient, etc. The actual procedure only takes a few minutes. For first time patients, it may take closer to the full 20 minutes; for regulars it takes maybe 5-10!
X. Should I start Botox now?
A. This depends on your skin and your own individual aging process. Take a look at your biological relatives (parents and siblings are usually the best indicator) to see how they are aging and to get an idea of how you will age. Age as a number doesn’t really matter – it’s about your own individual process of aging. I have patients who are starting to see (or already see) etched-in lines in their late twenties and are starting Botox to treat these lines. I also have patients in their thirties with no etched lines, but can see where the lines will form and so are doing it preventatively. I have patients in their forties-sixties who have now started Botox as part of their regular skincare routine to preserve what they have now. It’s easier to treat and prevent softer lines than treat etched-in lines, as you will likely need a higher dose the deeper the lines are. If you’re still not sure, schedule a consultation so that I can evaluate in person!