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10 Things I Wish I Knew Before I Got Botox

10 Things I Wish I  knew before I got Botox

I’ve been getting Botox injections regularly for the past 4 years.  To my surprise, there’s been a lot more trial and error in finding the right doctor, paying the right prices and knowing what to look for and ask for.

My first experience was 4 years ago when I turned 40.   I went to a widely known (and expensive) doctor who gave me just a touch between my brows on my forehead (the area known as the “11s”).   Within a week I looked fantastic.  My eyebrows were lifted ever so slightly and I looked natural, rested and a lot less bitchy.

5 months later, after my first injection began to wear off, I began to think more was better.  A stylist I was working with recommended a plastic surgeon that reportedly did excellent Botox (along with Kate Hudson’s new nose).  Armed with a false sense of security in the hands of celebrity plastic surgeon, I went one step further and had my crows’ feet and more of my forehead injected to get an even stronger brow lift.

Hmmm.  The results were a little harsher than I wanted, but I still liked my glamorous lifted new look.  Botox was creating a new normal for me.

6 months later, my first Botox party (more on that later). Despite the doctor’s excellent credentials, I had too much Pinot Grigio and didn’t tell him about my earlier Botox injections, so wound up with more than I needed.  My eyebrows were now so high and arched it looked like they were going to fly off my forehead.

My hairdresser whispered the name of yet another famous doctor (also with a skin care line), but when I learned he treated Madonna, I cancelled my appointment.

So I went back my original doctor who must have had a bad day.  I told him to repeat what he did the very first time.  He suggested more, I said yes wanting to trust and believe.  A week later, my eyebrows were unnaturally arched and disturbingly uneven.

Bad botox

I looked like the sinister love child of Dr. Spock and Dr. Evil.

Flash forward to a year of letting it wear off and finally finding a new doctor in Manhattan who I love.  Now , I only get Botox twice a year in very small doses.

If you’re a a Botox virgin or just getting your feet wet, I thought sharing my story and lessons learned would help avoid some of the pitfalls I encountered in my quest for a wrinkle free face.

1. Understand what Botox can and can’t do. Botox is a neurotoxin that relaxes the muscles underneath the skin that cause the wrinkle in the first place. Botox is only FDA approved to treat the 11s– those lines that form between your brows.  Off label it can also be used to treat horizontal forehead lines, crows feet, tiny bunny lines on the side of the nose and can give a gentle lift to the brows.   While most doctors prefer to keep Botox to the upper third of the face, some also use it to lessen the bands around the neck, reduce some lip lines and in some cases give a more youthful decollete.

This is where Botox can get injected

2. Find the best doctor “injector” you can afford.    There is a difference between knowing who CAN inject, and who SHOULD inject because the laws vary by state.  I’m going start off with a blanket statement that in most states, you should only get injections by an actively board certified (ABMS, ASPS, ASAPS, AAD) dermatologist or plastic surgeon at a medical facility.  Their logos look like this:

The board certifications your cosmetic plastic surgeon (middle two) or dermatologist should have (far right)

Where things get a little confusing, is that in the US, there are some states that allow a nurse practitioner or physicians assistant to prescribe and inject Botox (for example New York, Florida, Texas, California and Oklahoma).  In most cases this means under the direct supervision of the doctor, but again in some states, such as New York the nurse practitioner can do this independently (you have to call your state’s medical board to find this out).

Second to being with the right health care provider, is making sure you’re seeing a cosmetic dermatologist or cosmetic plastic surgeon who has an active practice cosmetic practice beyond Botox (think lasers, chemical peels, upper/lower eyelid surgery, face-lift, etc).   Once you’ve narrowed down from that criteria, make sure they’re a  “high volume” injector meaning they’ve been injecting for over 5 years and come up close to the top in Allergan’s website doctor search engine (Allergan is the parent company of Botox).  Also, don’t underestimate the innate talent of the injector; meaning a plastic surgeon isn’t necessarily better than a dermatologist at injecting, nor are either of them necessarily any better than a licensed nurse practitioner with many years of experience.

The important take away here is that just because your dermatologist saved you from that melanoma or you know a plastic surgeon that does brilliant reconstruction on accident victims, none of this is a guarantee that they’ll be any good at Botox.  In fact, I have two dermatologists; one who does the serious mole check melanoma stuff, and another who specializes in all things cosmetic.

As you narrow your choice, resist the temptation to think that a widely recognized name guarantees great results.  Publicity, advertising and having a skin care line does not mean the doctor is genius injector.  Rather it means they have good marketing instincts, a crack publicist and social media guru with a good understanding of SEO.  By all means don’t rule them out because of this, but you will likely pay a premium to see these guys (and believe me, I have).

Finally don’t be shy to ask ask ask ask ask.  Ask your facialist.  Ask your hairdresser.  Ask your eyebrow plucker.  Ask your OB/GYN.  And ask your friends who you suspect have had it done.  I’m fortunate to work in an industry where I have a lot of contact with actresses, stylists, photographers and agents, and I’m always asking.

But whatever you do, no med spa without a doctor on premises, no aestheticians and certainty not your dentist who up until now just checked your teeth.  I have a firm stance on this because it’s incredibly easy to become trained and licensed to inject Botox in little over a weekend.  There’s a lot of financial incentive for doctors to hang their Botox shingle out and because it’s so easy to get licensed, it’s equally easy to find yourself in the wrong hands.

3. It’s your job to brief your doctor on the outcome you want. It’s your doctor’s job to figure out how to get there, and Botox may not be the only solution, so keep an open mind.  That said, a lot gets lost in translation because one woman’s frozen forehead nightmare may be another’s definition of awesome.  Often doctors will ask you questions like “what is bothering you about the way you look” and do a quick assessment based on your age, your style and lifestyle. If you say I’m just a busy working mom who wants to look refreshed and natural, they’ll err on the conservative side.  On the flip side, if you say “I’m recently divorced, jumping into the dating pool and want to look a little sexier” that may signal you want more than you really do.  My fail-safe method is to use pictures.  Bring them a few pictures of women you don’t want to end up looking like (for instance, Jennifer Aniston versus Nicole Kidman).

4. Schedule your Botox appointment 6 weeks prior to any big event.  It takes about 5 days for the Botox to take full effect, but should there be any issues, you want enough time for any swelling or bruising to go down, and have the doctor do any touch ups.

5. Stop taking all fish oils and ibuprofen 2 weeks prior to your appointment.   I’m stunned at how many doctors’ offices don’t say this when making an appointment.   This will limit the potential for bruising and swelling.  Some women take extra measures by taking Arnica and or eating pineapple, which contains bromelian, a natural anti-inflammatory agent.

6. Understand the cost and make sure you’re getting what you’re paying for.  Doctors charge for Botox one of two ways:

Per unit.  This is my preferred way to pay for Botox because it’s very clear what you’re getting.  Allergan sells Botox in units of 50, 100 and 200 vial bottles.  The average cost can be anywhere from $9 to $20 per unit, depending on where you live.   To give some perspective, the average person needs about 20 units to treat horizontal forehead lines, 2 to 10 units to treat crows feet around the eyes and 25 units to treat the glabella (men need more).  So if I wanted all three of these regions treated (assuming I’m paying Manhattan prices), my total cost would be somewhere around $960.   Lastly, always make sure the vial is opened in front of you so you can be sure it’s fresh.

Per area. What this means is that a doctor might charge anywhere from $250 to $500 (again, depending on where you live) for each area they inject.  However, places like the forehead can have multiple areas.   For example, if I wanted my  “11s”, horizontal forehead lines and crows feet treated and my doctor charged $500 per area (again Manhattan prices), I would walk out with a bill of $1500.  Ouch.   Just because a doctor approaches his pricing this way doesn’t mean he/she is a bad injector, but I’ve always found I pay for more than I need.   Further, there is the possibility of cross contamination because you didn’t just “buy” a vial of Botox, of your very own so there is a small risk of cross contamination.

7. More is more, not better!  Nor is it more cost efficient (one of the main reasons women get too much).  Remember, Botox is a strong neurotoxin that has the potential to dramatically alter the planes of your face.  And smoother doesn’t always equal prettier.

 

8. Make sure you stay upright for at least 2-4 hours post Botox.  This helps ensure the Botox doesn’t migrate to someplace it shouldn’t and means don’t go to sleep or hit the yoga mat.

9. Botox builds up over time.   I was cheating on all my Botox doctors, meaning I switched doctors, didn’t share my injection history and had less than 6 months between each one, I was getting more Botox than I needed.  So while you may have needed 5 units of Botox in your crows feet initially, over time you may need only 2 units.]

10. Mistakes happen, even with the best doctors.  The most common worry is the droopy eyelid, which can happen if the doctor goes to deep or hits a nerve.  Fortunately, this doesn’t happen that often and it does wear off in a few months.  Your doctor will want to know about it though and in many cases, can inject additional Botox elsewhere to counteract the issue.

Have you been Botoxed?  If so, what was your experience?

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191 Comments

  • Reply
    healthehelen
    July 23, 2012 at 2:59 PM

    I’ve been having mine done for nearly 10 years and I’d add ‘interview your injector as if they were going to take a scalpel to your face on you.’ Because I move countries a lot I’ve had to choose three different docs – and each time I interviewed and googled three or four before I chose them. One didn’t even touch my face (and he charged me $100 for the consultation), one got vetoed when I saw pics of him with a celeb I really didn’t want to look like! Touch wood, I’ve not had a bad experience yet.

    • Reply
      narcissista1
      July 23, 2012 at 11:17 PM

      Great build on interviewing your doctor. So many assume you’ll get injected right then and there. Thanks for taking a read!

      Becca

  • Reply
    Daniela
    July 25, 2012 at 7:13 AM

    I never had any but I really like this post as it is informative and honest! And yes … I might consider some now -:)!

    Kind Regards,
    Daniela

  • Reply
    Debbie
    July 27, 2012 at 2:34 PM

    I’m lucky to have an excellent doctor who is an expert at injections. I wish I had found him 10 years earlier!

    • Reply
      narcissista1
      July 27, 2012 at 2:37 PM

      It’s great to find a good doctor. I’ve found it’s a lot of trial and error!

      • Reply
        Birtha
        July 28, 2013 at 5:06 PM

        Do you have a few favorites that you like in NYC? I moved here 3 years ago from Chicago. I have frequently been flying back over this time and while there having all my maintenance done as it’s hard to beat the prices. I’ve begun weening myself of and would like to find a NYC replacement for Dr Geldner’s practice in Chicago.

        Thanks

        • Reply
          narcissista1
          July 30, 2013 at 6:52 AM

          I have a few suggestions that I can share privately, but I don’t like to broadly broadcast them on the site because the truth is, I haven’t been injected enough to be a Zagats for needles:) I’ve seen only 4 different injectors – only one of which I would give a hearty thumbs up to – but there are so many others in the city who I haven’t tried, so I don’t want my opinion to imply that who I’ve tried is the only solution.

          I’ll send a private email.

          Becca

          • Holly
            July 31, 2013 at 6:53 AM

            Many thanks for the reply. I missed the private email. Could you kindly resend it?

            Thank you

          • Natasha
            May 11, 2016 at 10:14 AM

            Would you be willing to share your doctors with me too? Im a newbie and am looking for someone reasonable and good in NYC. Thanks becca!

          • Becca
            May 24, 2016 at 7:08 PM

            Dr. Ellen Gender. Keeps it real

          • Jen
            May 14, 2016 at 4:27 PM

            Same here! New to NYC and would love some suggestions of where to go. 🙂

          • JJ
            May 24, 2016 at 3:57 PM

            HI Narcissita,
            Would you share the name?

          • Ellie
            July 14, 2016 at 10:40 PM

            I don’t know if this post is too old to be replied to, but I am in NYC as well and would really appreciate some recommendations. I’ve been reading and asking, but I’m still nervous about selecting someone.

            Thanks in advance!

        • Reply
          Eva
          August 20, 2013 at 7:08 PM

          Hi,Im from Chicago.I would like to ask you, where are you going for Botox here?Thank you

        • Reply
          Frances
          October 24, 2013 at 10:10 AM

          Love Dr. Geldner in Chicago. That’s the only one I trust to do anything on me 🙂

    • Reply
      Anonymous
      May 31, 2013 at 7:04 AM

      Hi Debbie , is it possible for me to have your doctor’s details ?
      Thanks

    • Reply
      Flower
      December 5, 2015 at 11:30 PM

      Can you send me your doctor’s in formation?

    • Reply
      Dee
      May 16, 2016 at 11:39 AM

      Can you share who it is?

    • Reply
      JJ
      May 24, 2016 at 3:56 PM

      HI Debbie,
      Would you share the name?

  • Reply
    Gigi
    July 27, 2012 at 4:28 PM

    Sorry to burst your bubble. I’ve been a nurse practitioner for 39 years and have been injecting Botox for over 10. I’m the best injector I know. I have had numerous patients come to me over the years (many of them from doctor’s offices) having had negative experiences. They prefer my injection techniques hands down. Moral of the story, there are good and bad injectors in all classifications of professionals. But I don’t think being a doctor is the only criteria to use when looking for someone to help impove your appearance.

    • Reply
      narcissista1
      July 27, 2012 at 5:54 PM

      I knew when I wrote this post, it would irritate some of the nurses and PAs who are licensed to inject Botox under the supervision of a doctor, and to your point, in those circumstances it’s all about the talent of the injector. However, in this day and age of women getting irreversible damage due to illegal injectors, I stand firm in my view that injections should be done only a cosmetic dermatologist or cosmetic plastic surgeon, especially because there is too much inconsistency between states a licensing and the qualifications.

      All that said, to your point Gigi (and for those reading this), I want to clarify that in the US, each state governs who can and who can’t inject Botox and there are a handful that allow a NP or PA to inject Botox (for instance New York, Florida, Texas, California and Oklahoma among others). However, this is only under the direct supervision of a doctor. Meaning the doctor is there in person, not in theory. Tying this back to my point in the post, for the best results possible, this doctor should be a cosmetic plastic surgeon or cosmetic dermatologist – not your dentist, not your OBGYN, not your internet, not your vet:)

      • Reply
        Gigi
        August 9, 2012 at 5:23 PM

        California State Law:

        “Is a nurse practitioner practicing illegally when the physician supervisor is more than 50 miles away?

        The mileage between the nurse practitioner and the supervising physician is not specifically addressed in the NPA. However, the physician should be within a geographical distance, which enables her/him to effectively supervise the nurse practitioner in the performance of the standardized procedure functions.”

      • Reply
        Maria
        October 2, 2012 at 2:08 AM

        In NY state NPs are independent practitioners. That means they are not working under direct supervision of MD, they work in collaboration with physician which is a huge difference. So please, before you post anything on the internet make sure you familiarize yourself with the subject (otherwise your statements are missleading to others). Also, maybe if you didn’t lie to those who injected Botox for you (before you found your perfect physician), your results would be much better. So instead of saying someone was incompetent, maybe you should say: “I lied and this is the reason why my results were not what I expected.” Just think about this: who in their career do you think gives more injections: a docot or a nurse? MDs, NPs, PAs, RNs all have to take Anatomy and Physiology classes, but who injects the most? During my certification I saw many MDs whos hands were shaking while holding the syringe (one client even said:”I don’t want him to touch my face”), nurses had no problem…

        • Reply
          narcissista1
          October 2, 2012 at 11:26 PM

          Hi Maria, thanks for responding and I stand corrected. I called the New York State Medical Licensing board and they confirmed that a NP can write inject themselves in New York. None of this was available online though (about the NP not needing direct supervision of the MD in NY); I called the NY state medical licensing board, and after being passed around to about 5 people, finally reached someone who could help. But even then, there was pause and reflection before confirming their answer because the way it’s written isn’t straightforward (and the woman answering my question was in fact a nurse).

          I think the bigger issue is the lack of clarity and guidelines available for the patient, which is the spirit of this post. It is horrifying to me that it’s this difficult for patients to understand the difference between who CAN and who SHOULD inject Botox. It’s compounded by the variability on licensing state to state. Even worse that a health care provider can take a weekend course and then offer Botox.

          Thanks again for the clarification and I made appropriate revisions to the post above.

          Becca

      • Reply
        Yasmine
        February 11, 2013 at 9:53 AM

        This is a little OT, but I once almost had my face ruined by a PA who unnecessarily injected a steroid into my face for a mild case of adult acne. I wound up with terrible dents that took over a year to go away. She works for a very popular and respected dermatologist in my area. I decided then and there that I would never have my face injected by anyone other than a board certified PS or dermatologist. I go to an ocular plastic surgeon for my Botox . He is also a very experienced injector, and that has worked well for me.

        • Reply
          narcissista1
          February 12, 2013 at 8:52 PM

          I’m so glad you found a good injector at last, it is so much trial and error. Do you know whether or not your first injector was board certified? I’ve found that many doctors have a “name”, but once you dig beneath the surface, you don’t have all the credentials.

          Becca

    • Reply
      Christne
      December 1, 2012 at 9:13 AM

      Gigi, it’s a shame that some nurses are cheating patients out of the true Botox. TOO much saline and no results.

    • Reply
      Saleem
      February 4, 2013 at 10:02 PM

      Are you in the New York area .. If so what’s your address …

      • Reply
        narcissista1
        February 7, 2013 at 12:19 AM

        Saleem, were you asking me or the prior commenter?

    • Reply
      Anonymous
      September 10, 2013 at 12:12 PM

      Hi there, I know it’s been a while since your post, but I would like to know if you wouldn’t mind sharing what you charge and what area you are in? I am from Canada but have a lot of family in the U.S. I am visiting quite often. If you wouldnt mind your information, what area you are in and your price and if are able to reccomend anyone in in Niagara Falls , buffalo area , the erie Pennsylvania and if you would know their price range? I am just starting to find out about this , I would really appreciate your help! Thank you!

      • Reply
        narcissista1
        September 10, 2013 at 9:21 PM

        Hi – I am not a doctor, just a very experienced patient:) I don’t know the rules and regulations in Canada, but I always tell my friends to see a board certified COSMETIC plastic surgeon or dermatologist. Make sure they have an active cosmetic practice and didn’t just learn how to inject over the weekend. Check for at least 5 years of Botox injection experience and ask for pictures. Good luck

      • Reply
        Celia
        September 29, 2013 at 8:16 PM

        I would strongly recommend you arrange treatment in the country in which you are a resident and have health coverage in. Neuromodulator injections are medical treatments not without risk. In addition, the health care provider you receive treatment from should ensure you have a follow up appointment two weeks post injection to assess results. You should be able to access your provider quickly if there is a complication.

        • Reply
          narcissista1
          October 1, 2013 at 9:05 AM

          Amen

      • Reply
        Anonymous
        November 24, 2013 at 11:55 AM

        I’m also in Ontario, Canada and I have my Botox injections done in Oakville, for several years, by a very skilled injector who actually trains doctors to do injections. If you provide your email address, I can provide you with her contact information.

        • Reply
          Hk101
          November 27, 2013 at 4:12 PM

          Can you please supply me the doctor’s name in Oakville. Thanks kindly

          • narcissista1
            December 30, 2013 at 7:45 AM

            Sorry, I don’t know any doctors in Oakville:?

        • Reply
          Anonymous
          June 11, 2015 at 5:01 PM

          Hi. I know this was a long time ago. But can you tell me who does your injections in Oakville?

    • Reply
      Anonymous
      October 11, 2013 at 6:21 PM

      Hello, where can I go to have u botox me 🙂 please.

      • Reply
        narcissista1
        October 12, 2013 at 11:43 AM

        I am the farthest thing from a doctor, just a well informed patient. What I would tell you is to see a board COSMETIC certified dermatologist or plastic surgeon. Make sure they’ve been injecting for at least 5 years (you can get trained in little over a weekend and you don’t want to be the Monday patient, believe me) and ask to see pictures. Injector “eye” and experience are critical, and not everyone great doctor is good with a needle.

      • Reply
        JB Goodman
        December 31, 2015 at 12:48 PM

        Go to dr Lisa Kellett. http://Www.dlkonavenue.com

    • Reply
      Kamala
      March 20, 2015 at 9:52 AM

      I agree with you. One of my daughter is the best nurse pediatric practiciones, some times with better diagnostic skills that some doctors. Where do you practice or have your office? Thanks, I would love a consultation with you, Never had Botox but I am considering now. Have a great week end.

    • Reply
      Anonymous
      February 14, 2016 at 9:19 PM

      Hehe! Moral of the story is that formal eduction makes the senses go dull…….I would trust a nurse, NP, or PA over a physician for my Botox injections.

    • Reply
      Madelyne Lazaro
      August 21, 2016 at 11:28 AM

      Hi, would a nurse practitioner charged the same amount as an MD ?

  • Reply
    jeannie
    July 27, 2012 at 5:45 PM

    I have a physician assist do my injections and she does a fine job

  • Reply
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  • Reply
    hoping4astory
    September 6, 2012 at 2:21 AM

    I know somebody who is using botox to get rid of migraine headaches. They put it in her scalp. It’s the only thing that’s worked, so it has many other practical uses!

    • Reply
      narcissista1
      September 6, 2012 at 7:27 AM

      That’s true, it does. It also helps underarm sweating.

    • Reply
      Marlene
      October 7, 2013 at 6:18 PM

      I just got my first treatment for migraines a couple of weeks ago and don’t like what it did to my eyebrows and eyelids, hopefully they will go back to normal. It has helped my headaches, have been suffering for over 60 years, and have tried everything. My neurologist gives me the injections in the forehead and scalp and shoulders, etc.

      • Reply
        narcissista1
        October 12, 2013 at 12:12 PM

        Hi Marlene – sorry to hear you’re not happy with the results. I’ve never had Botox for anything medicinal, just aesthetic so I don’t know the ups and downs of using Botox in that way. It’s amazing what Botox can do. Did you want Botox in your forehead to treat wrinkles, or did it migrate from where you were injected for the migraines? I’ve heard of a lot of people getting wrinkles treated at the same time they get medical issues treated with Botox, but it’s important to remember that if you’re looking for an aesthetic result, you’ll want to see an aesthetic doctor (cosmetic board certified plastic surgeon or derm). I wish I could help, but the best person to speak to is your doctor. You can try asking the question of the docs on Real Self, they’re pretty good with situations like this.

        Becca

  • Reply
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  • Reply
    clara54
    October 5, 2012 at 9:22 AM

    Great and informative article on botox. As a nuse of 30 plus years, I can tell you doctors also us Botox for various other reasons, most popular for muscle relaxers in severe arthritic conditions. and extreme cases of headache…its good to do research in every med usage and you have. Thanks for the follow at ‘liking’ my post and follow. As Arnold says “I’ll be back” here as well

    • Reply
      narcissista1
      October 7, 2012 at 9:16 AM

      Ha ha “Ahnold”…thanks Clara.

      Becca

    • Reply
      Anonymous
      August 26, 2015 at 3:54 PM

      My daughter has just had botox to relax her larynx as she was slowly dieing from her airways closing down happy to say it’s saved her life she is forty ,it was all caused by an accident when she was born premature and has spent her life fighting to live now she can live

  • Reply
    marshaw60
    October 5, 2012 at 6:10 PM

    Your honesty shall serve as a road map for others…

    • Reply
      narcissista1
      October 5, 2012 at 11:22 PM

      I hope so, its a more confusing path that it seems on the surface

      Becca

  • Reply
    chrystalovevintage
    October 10, 2012 at 8:53 AM

    Great info and great timing- I’m about to lose my Botox virginity very soon!!

    • Reply
      narcissista1
      October 10, 2012 at 8:55 AM

      Glad it helped! Let us know how it goes. Good luck (and it doesn’t hurt that much at all)

      Becca

    • Reply
      Tammy McCoy
      December 30, 2012 at 9:45 PM

      I am 43 & went to a board certified plastic surgeon. I told him I a considering botox. He told me I absolutely didn’t need it! Wow, I have always taken care of my skin, but I soon will be 44yrs old & I feel like my face is looking tired! He said, if you don’t need it the longer you wait the better ! I then went to a medspa for a facial & at this spa, the nurse practioner was all ready to “Botox me up”. Like I said,” I want my skin to look refreshed.” I really just wanted to try it between my eyes! I have no lines on my face or neck, nor do I have crows feet! Who should I listen too? Confused Tammy!

      • Reply
        narcissista1
        December 30, 2012 at 11:10 PM

        Tammy, I totally get your confusion, but it’s also possible you don’t need a thing done:) Anyway, the hardest part is getting an honest opinion about what you need because doctors tend to be a bit biased based on what their area of expertise (PS more surgery, derms less so) and what they offer (for example who has what laser). All that said, your plastic surgeon’s selfless opinion seems worth listening too. Did he/she suggest any other advice or procedures? If not, what may help is asking your PS more broadly what you should be thinking about in terms of your anti-aging action plan, thinking 5-10 years out. So for instance, what might you consider in the next year? It may not be Botox, could be a peel, a laser or simply some Rx Retinol. For the long term, are there some target areas that your PS might see as treating in the future? For example, they can often project which areas may become more problematic, like the neck or eyes. procedures instead? Regarding the med spa, how did you hear about it? Buyer beware here; if you walk into a less sophisticated practice saying you want Botox (which is very common these days), it’s rare they’ll turn you away. It might also help to get an opinion from a dermatologist since they come at anti-aging from a different perspective. Just be sure you’re speaking to a derm and PS that are board certified and have an active cosmetic practice.

        Becca

  • Reply
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  • Reply
    Name
    January 1, 2013 at 6:09 PM

    I had my forehead done 3 months ago and the effects were fab, i loved it. But 2 months after botox i’ve started loosing my Hair, so far i’ve Lost half of my Hair volume within a month!!!! I’m devastated, depressed, loosing over 200 Hair a day! The blood tests are fine, so i’m not ill! Nobody mention this side effect to me so be aware, I feel like killing myself …

    • Reply
      narcissista1
      January 1, 2013 at 7:11 PM

      I am so sorry to hear about your hair loss:( First, did you see your injector or visit your regular doctor for the blood work? The latter would likely take a more holistic view of the cause. I haven’t heard of hair loss being a Botox side effect, in fact there’s “internet buzz” that it may actually help some forms of hair loss, instead of cause it. But I do know hair loss can be a symptom of all sorts of things, like hypothyroidism, iron deficiency and just some wacked hormones. What might help is finding a board certified dermatologist that specializes in hair loss – they exist, they’re wonderful and they have answers. Often, they’ll run a big panel of blood work, checking hormone levels, etc, but then they’ll often do a scalp biopsy which gets to the root of the problem. Best of luck to you!

      Becca

    • Reply
      David
      June 17, 2013 at 9:35 AM

      Hi, I too have experienced significant hairloss three times after using botox and each time around 3 months after the injections. Before Id made the connection my hair started to recover somewhat, its only after it happened the third time I made the connection. Its not genetic male pattern baldness, its patchy and inconsistent at and behind the hairline. I went to see a trichologist in January who went through all possibilities and strongly believes it was botox. Last year, it was 12 months before my hair had recovered quite a bit before my next top up in December. Im now 6 months in again and my hair has shed significantly and is only just slowing down. Needless to say I wont

      • Reply
        narcissista1
        June 18, 2013 at 7:03 AM

        I’m sorry about your hair loss, that must be rough. I’ve done a cursory look at the connection and on the surface there doesn’t seem to be a lot out there on the subject, but this is worth investigating further. Did you get Botox for cosmetic reasons or for treating migraines?

    • Reply
      losing it also
      October 19, 2013 at 9:19 PM

      I just made the connection also. I’ve been to three doctors including a dermatologist. I’m completely healthy and all the blood work came back fine. I am losing so much hair it’s making me depressed. So I decided to wait for the next treatment and see if there’s any difference in my hair. I’ve tried every shampoo even Wen thinking that it was my shampoo. Then I had a lightbulb moment and made the connection that that was the only thing that I’ve done different since last November and that’s when I started losing my hair. Its to the point where it’s noticeable and I’m very self conscious. I switched from Botox to Dysport and now deciding to wait at least 6 months to see if there is any difference in my hair.

  • Reply
    Jonesie
    January 20, 2013 at 5:36 PM

    I appreciate the direct and informed comments of all here. Having had a pituitary tumor removed 7 yrs ago… followed by a hysterectomy, with many hormone changes, living at a high altitude with dry climate, I decided on the eve of turning the big Five-O this coming August… just before Thanksgiving I enlisted a cosmetic dermatologist (having great reviews) to get rid of the 11’s in my forehead. I love the results, and would like to erase the crows feet around my eyes, but am concerned about the toxicidity it leaves in the body. I had flu like symptoms and a pressure in my forehead that lasted for weeks. Just wondering if there is a way to check for such a thing? Labs maybe? I usually have regular pituitary functions and liver, but is there something specific I should be watching for?

    • Reply
      narcissista1
      January 21, 2013 at 2:17 PM

      First of all, CONGRATULATIONS on turning 50 and being healthy! I’ve gotten my crows feet injected before and if there’s one thing I’ve learned, it’s to use only a tiny amount of Botox in that area, otherwise it’s easy to look ironed instead of rested:) Regarding your more important questions about toxicity and Botox, I am not a doctor but I am a cancer survivor, so before I got Botox, the first person I spoke to was my oncologist. Her response? A light hearted “You’re nuts, I wouldn’t put that crap in my body but there isn’t any clinical evidence to date to suggest it does harm in small doses, so enjoy”. So as your virtual friend, I would say first talk to your internal medicine doctor and if they say OK, then go for it. I would also talk to your derm about the side effects you had last time because you shouldn’t have that type of response, although you’ll see things like that pop up now and then on the internet. You might also ask your derm about other options, like lasers or chemical peels.

      Stay well!
      Becca

  • Reply
    Robin B
    February 7, 2013 at 9:39 PM

    My dentist currently inject sme an dis hands down, the best so far. My first two experiences were with well known doctors.
    1. Very well known PS (horrible job, horrible results and second most expensive.
    2. Well known dermatologist. SO-so reult but way over priced and didn’t last. Barely made 3 mos.
    3. Really well know cosmetic derm (also treated Madonna. Twice the price and same results as #2.
    4. ARNP at a Med Spa-loved her but she left and I couldn’t find her. The Med Spa never even told me she was gone.
    5. Dermatologic ARNP. Good, but over priced and when her eMatrix treatment turned out to be an epic fail, I stopped going to her.
    6. Enter dentist. Cosmetic DMD. LOVE him! Have had him 3 times. He does charge by the area but I’ve been happy.

    • Reply
      narcissista1
      February 7, 2013 at 10:37 PM

      Hey Robin, so sorry you had to go thru so much trial and error. Kind of similar to my story. Glad you finally found someone you like. While the board certification and having a cosmetic practice are tablestakes, after that it’s all in the eye and hand in the injector. Its a different skill set all together.

      Becca

      • Reply
        Nora
        June 28, 2013 at 3:58 PM

        Hello plzi need some one answer iam rel scard iam 32 years old and I went to a very bad Dr I will never ever forget what she did to my face she injected me with dysport and it turn on my life up side down it’s changed my face I had lovely face pretty and now I don’t even like to look to my self I don’t need it what she was telling me if you do it when you young you will not have wringals latter on stupid to believe her.other dr told me she injected you overdose iam in my 5 month and half and it is still strong the told me it will wear off if plz some one can answer me it could stay more than 6 month?? Even if it was my first time?dose overdose means it will stay longer I will be very thankful if some one help me

        • Reply
          narcissista1
          June 29, 2013 at 7:30 AM

          Hi Nora – I’m so sorry you had a terrible experience. Botox/Dysport in the wrong hands can go very wrong. Here’s the good news though: it will wear off. Depending on how much was in injected, it may take 9 months, but it will wear off. In the meantime, since I’m not a doctor, nurse or PA, it may help to see a BOARD CERTIFIED cosmetic dermatologist or plastic surgeon. There may be things they can do to help.

  • Reply
    http://yahoo.com
    February 9, 2013 at 8:15 AM

    Whatever honestly encouraged you to write “10 Things
    I Wish I Knew Before I Got Botox – NARCISSISTA.
    ME | NARCISSISTA.ME”? Ireally appreciated the post!

    I appreciate it ,Jack

    • Reply
      narcissista1
      February 10, 2013 at 9:39 AM

      I’m glad you found it helpful Jack. And as far as why I wrote the post, well you know what Gandhi says, “Be the change…”:)

      Becca

      • Reply
        Nora
        June 29, 2013 at 4:53 PM

        Thx narcissista and thx so much for your post abou 10 things ….. I wish to wear off soon sooner than 9 momt iam not sure if I can handl it I want to be stronger than dysport and let it go but it rely a painful period iam going throw wish it is end now thx god for every thing and thang you for reply me wish the luck for all people will get this treatment

  • Reply
    Lynn
    February 13, 2013 at 6:23 PM

    I’m having my first botox tomorrow morning and have been searching the Internet for stories on how others handled the experience. I’m very excited…but also very nervous. Mainly I’m nervous about how much it’s going to hurt, lol. Thanks for sharing your experience and tips. I feel confident that the doctor I am going to is very well qualified. 🙂

    • Reply
      jeannie
      February 13, 2013 at 7:01 PM

      it really doesn’t hurt at all and believe me I hate needles !

  • Reply
    Elle
    February 27, 2013 at 3:54 PM

    Hi there ! First, thank you for all the informative info. Its so nice to have legit, honest comments and shared experiences and have these questions answered without feeling as though you’re being given a sales pitch. Almost 12 months ago, I had a reconstructive rhinoplasty and septoplasty and since I was already ‘going under the knife’, I decided that I would also like to have the little lines around my mouth done as well as my jaw line under the chin area and my horizontal forehead lines. I’m 41 and didn’t need a great deal done but since I would be looking better after the nose job healed, I figured it would be the perfect time to be able to do it with it being less obvious as opposed to simply just looking ‘so great’ after the main surgery had healed. I knew the mouth and jaw area would likely need filler based on what I had researched, but when I inquired about doing botox for the forehead, my plastic surgeon told me he only liked to work with Radiesse and would need to use that instead and of course, since I was already there…well, you know the drill. The mouth and jaw area did look pretty good after about 2-3 weeks, but was really not nearly as improved as I had hoped even though I did want to look more natural and when I told the doc at my 3 week follow up appt that I felt like I needed a bit more to make it appear a bit more even, he told me that he had used 2 full syringes as though he felt that amount to be quite a lot and he seemed surprised that anyone would want more than that (even though it was pretty obvious that it was not as symetrical as it should have been). It lasted about 8-9 months which was a nice bonus given that I was expecting 6 months max. The forehead filler did little to improve the lines even though they were not deep and the result lasted barely 3 months. My doc is the head of the Facial Plastics and Reconstrutive Surgery Dept for a major hospital here and is highly recommended and well respected (I did ask more than a couple other physicians and was given his name each time). I am ready for a re-do now and want to revisit the botox option instead of the fillers. I’m wondering if the use of the fillers instead of the botox is considered a better , albeit, more expensive treatment and is the direction this type of work is heading or if it was simply the dr’s personal preference? The vast majority of the botox before and after pics are really more the results I’m looking for but if the filler is truely better and can get the same, if not better result given a really good pracitioner/injector, do you have an opinion as to which path to follow ? Thanks in advance , E.

  • Reply
    Tray
    February 28, 2013 at 6:23 PM

    Hi, Can you give me the name of a good Botox dr. in north jersey? I have gone to a couple of dr’s and was not happy. Thank you, tray

  • Reply
    Diane
    March 12, 2013 at 8:55 PM

    The botox I got last week looks great except I look like I have Dr. Spock eyebrows. Can this be fixed? I’ve never had Botox before.

    • Reply
      narcissista1
      March 18, 2013 at 10:08 AM

      Some of the time yes, this can be fixed although the fixing comes with trade-offs. First thing to do is go back to your doctor and let them know you’re not happy. They can put Botox in other places to compensate for the Dr. Spock look, BUT you should ask what the look will be afterwards as you might look over injected since more is being used (for instance it could lower your brows more than you want). It might help to bring a friend you trust with you to the appointment – maybe your Dr. Spocks are only visible to you and worth waiting out?? We’re very sensitive after our first time with Botox. Good luck!

      Becca

  • Reply
    Annoyed DMD
    March 22, 2013 at 9:03 PM

    I’d like to thank Robin for her comment, who after trying several “highly qualified” doctors ended up extremely happy with the treatment done by her dentist. I find it quite ignorant that you suggest that a dentist is not qualified to provide Botox injections. Dentists spend years studying the anatomy of the head and neck and are more than just familiar with the muscles of the face that are treated with Botox. They are also injecting this area on a daily basis already. A cosmetic dentist is trained to have an eye for detail and esthetics. These few factors alone make a dentist a qualified practitioner. When I did my training, I found it quite amusing that the dentists were the only ones that knew how to give a block and properly anesthetize when it came to prepping for dermal fillers. The dentists were much more confident in their injecting techniques than any other practitioner, at least in my experience. Of course any injector needs hands on training and significant experience in order to refine their technique and develop a good “eye” and be considered a “great” injector, but that goes for any type of practitioner, including the plastic surgeons and dermatologists. So educate yourself a bit better next time, before you make assumptions and generalizations about a particular field. Like one of the previous posters said, your poor experience was most likely your own fault. You lied and withheld important information from your injector that probably would have made all the difference in your treatments.

    • Reply
      narcissista1
      March 25, 2013 at 11:00 PM

      I’m never short of amazed at what a cosmetic dentist (and Maxillofacial surgeon) can do to transform the structure of a person’s face and their smile. And when it comes to Botox, I’m sure there are some cosmetic dentists who have been giving Botox for over 5 years and have happy patients like Robin. These dentists will likely have a book of before/after photos to demonstrate their work as well, and know how to handle it when something goes wrong.

      But the fact is dentists as Botox injectors are in the minority, because most states do not allow general dentists to inject Botox unless they hold a dual MD and DMD degree.

      In my post I say “if the dentist who cleaned your teeth last week just started offering Botox, run”. I absolutely stand by that, because it’s too easy to become “certified” after only a weekend course of training. I doubt you would want to be that first Monday morning patient. Too many medical specialties are doing this because facial aesthetics is a highly lucrative revenue stream (not insurance, $500 per area, pretty tasty).

      I’m sure you won’t be the last dentist to be irked by my post, but that’s OK. This wasn’t written in service of the medical community. It was written in service of the patients (like me, who was guilty of not knowing, not lying as you said) who have too little education at their fingertips to distinguish who CAN and who SHOULD be handling their injectables. After all, it’s just a millimeter of difference that can turn you into a fox or a Spock.

      • Reply
        Anonymous
        July 30, 2013 at 12:25 AM

        My dentist does my botox….best injections ever. Do you know what dentists spend their medical years focusing on?? How about plastic surgeons? I will take the dentists whos main focus is above the shoulders…if I get my boobs done I will look at the plastic surgeons. Thank you!

      • Reply
        AJ
        December 28, 2013 at 1:17 PM

        I agree with some of what Annoyed DMD is saying (not about dentists though, as I’ve absolutely no experience there and it’s rather rare where I am to have folks going to the dentist for that – I personally have never known anyone to be injected by a dentist – mind you, not that there isn’t a good one for that. I just don’t know.). What I do know is that here in California, I know almost no one who receives Botox from a doctor. Those who inject most here are nurses with doctor on premises, both Norcal and Socal. I have never had a dr inject me either. I’ve done my research and been injected over ten years by solidly competent nurses with only the best results, and that includes not ending up with that insane eyebrow lift that is so witchy-looking. Here’s the bottom line, if you do not do your due diligence, then you increase your chances of a terrible experience. Also, the lying that was mentioned by Annoyed was, I believe, in reference to you switching your practitioners and not letting them know your Botox history. Of course, that is not a smart thing to do, no matter how much you know or do not know about anything, in that, for example, in a totally different field, if I went to a mechanic about my car, I would tell him the car’s history truthfully so as to be able to rely on his professional opinion as to what is wrong with my car, same with any professional in any field. I get that you thought more might be good, but if you follow your own advice on safety, seems you should have been honest and trusted the professionals to treat you appropriately. I’m too lazy to go back and reread all the posts, but seems that is what I got out of what you wrote.

  • Reply
    Rose
    May 20, 2013 at 5:48 PM

    Thanks for your information. I am looking for a good doctor also. So can you tel me your doctor’s name in Manhattan. Thanks!

    • Reply
      narcissista1
      May 20, 2013 at 8:48 PM

      Hi Rose – I don’t share that information in this forum because there are a ton of great doctors in NYC who I haven’t used, so my opinion would be narrow. Also, it wouldn’t help those outside of the city. I will be posting later in June about how to find a great injector, because it is SO HARD to tell if a doctor (or nurse practitioner or PA) is going to be as magical with a needle as they are other things. Everyone has their strengths.

  • Reply
    Annie
    May 24, 2013 at 10:38 PM

    I would like to know what doctor you know who gives more shots than a dentist?? Also dentists spend MUCH more time on the head and neck region in school than doctors in med school, and definitely WAY more time than NP’s or PA’s on just about everything else.

  • Reply
    10 Things I Wish I Knew Before I Got Botox - Project Eve
    May 27, 2013 at 8:54 AM

    […] **Originally posted on Narcissista.me** […]

  • Reply
    Matt LaFever
    May 28, 2013 at 10:53 PM

    As an experienced RN injector in MA with a plastic surgeon who serves as my medical director, I wanted to respond to a few things in this article: “However, in this day and age of women getting irreversible damage due to illegal injectors, I stand firm in my view that injections should be done only a cosmetic dermatologist or cosmetic plastic surgeon, especially because there is too much inconsistency between states a licensing and the qualifications.” -Botox does not cause “irreversible damage”. At worst, undesirable results take 4 months to wear off. States’ practice acts do spell out who can inject. I work with 80 RN injectors whom many do this all day and every day and are experts in the technique.

    “Schedule your Botox appointment 6 weeks prior to any big event. It takes about 5 days for the Botox to take full effect.” -2 weeks is sufficient.

    “The most common worry is the droopy eyelid, which can happen if the doctor goes to deep or hits a nerve.” -This isn’t caused by going deep or hitting a nerve. It’s caused by injecting too much into the lateral orbicularis oculi or too low on the frontalis muscle. It can also just happen if the Botox spreads or the patient does not follow post injection instructions. Or, it doesn’t have to be anyone’s fault, sometimes it just happens.

    • Reply
      anne
      August 18, 2013 at 7:51 PM

      If you really work with that many injectors and do that many injections you should be well aware this is a complete marketing lie. I would not have tried neurotoxins at all if I had been made aware of the possibility of permanent damage, which is very real. I have had severe and lasting damage to both my health and my face, lasting two years now.

      Considering I was previously very healthy, I have been sicker this past two years than I have ever been in my life. I lost half the volume of my hair during this time. I have had persistent muscle weakness, joint pain and debilitating headaches that were more excruciating than anything else I have ever felt. I was specifically told there was -no- risk of permanent damage, and yet, the truth is that my face has not returned to normal after two years, and neither has my overall health. My muscles still move abnormally and there are many more wrinkles than there were before, very abnormal ones. The dr I saw was past president of the American Association of Aesthetic Plastic Surgeons.

      When I reported how sick I was and the ongoing deformity to my face, and asked him what he could do to fix the damage, he terminated me as a patient and told me he could not help me and there was no cure. I was not informed of this either, when he was happily taking my money.

      Now that there has been permanent damage, suddenly no doctor I see will tell me ‘dont worry, it always goes away’. Suddenly every dr I see looks like a deer in headlights and doesnt know what to say. When they were taking my money, it was easy to say ‘all effects always go away in a few months’ now when doctors see my damaged face, they suddenly will not say that. Funny huh.

      Permanent and lasting damage to both health and face, is very real and happens a lot more than injectors want to believe. You are living in a dream world and blinded by making $400 for ten minutes of work. Noone should have these injections without being warned that sometimes the effects -are- permanent or very long lasting and that there is no cure when this happens.

      • Reply
        narcissista1
        August 19, 2013 at 9:05 AM

        Thank you for sharing your story Anne. Sending you well wishes on getting better soon.

  • Reply
    Laser, Needle, Knife or Nothing: The Eyes, Part One - NARCISSISTA.ME | NARCISSISTA.ME
    July 15, 2013 at 6:39 AM

    […] Botox has been a slippery slope. The first time I did it, I looked beautiful.  My brows were arched and lifted just enough to perfectly frame my eyes.  But later injections by the same dermatologist (who’s practice became more like Grand Central) left me looking like Dr. Spock. Or sometimes, like someone pulled a shade over my forehead, leveling the eyebrows flat. […]

  • Reply
    dermatology portland oregon
    July 26, 2013 at 9:28 AM

    It’s very straightforward to find out any topic on net as compared to books, as I found this piece of writing at this website.

  • Reply
    Laser, Needle, Knife or Nothing: The Eyes, Part One - NARCISSISTA.ME | NARCISSISTA.ME
    August 6, 2013 at 11:37 PM

    […] Botox has been a slippery slope. The first time I did it, I looked beautiful.  My brows were arched and lifted just enough to perfectly frame my eyes.  But later injections by the same dermatologist (who’s practice became more like Grand Central) left me looking like Dr. Spock. Or sometimes, like someone pulled a shade over my forehead, leveling the eyebrows flat. […]

  • Reply
    Sheena
    August 9, 2013 at 10:31 PM

    Thank you for your very informative post. Since I live in the tri-state area, I would appreciate the name of the doctor you would give a “hearty thumbs up to” via a private e-mail. Your willingness to share your experiences and candid assessments of your discoveries is incredibly helpful.

  • Reply
    sara
    August 23, 2013 at 2:26 AM

    I have been to many doctors even plastic surgeons but i’ve been most satisfied by Dr. Darush in Los Angeles. My take is that a surgeon would be good at surgery, he is not going to waist his time to learn about the exact doses and units to inject. usually they have a NPs injecting. Therefore, finding an honest doctor (whom he has prevented me from certain injection) and providing the best care for long term client, Dr. Darush has been my doctor of choice and my friends as well. Try him and let me know. you wont be disappointed. He has not let me down.

  • Reply
    Luna
    August 29, 2013 at 5:00 PM

    Hi, Can anyone recommend a $ reasonable Botox specialist within Toronto, Ontario, and/or surrounding area?

  • Reply
    Cece
    September 13, 2013 at 2:04 PM

    I’m from Ottawa Canada and recently went for my first Botox consultation with a popular medispa in the area. I was looking to have my 11’s done, and basically wanted a quote. I’m 29 and I’ve always taken very good care of my skin, and my 11 is really just a 1, but it’s pretty faint. So i was thinking maybe 10 units, maybe 15 since it’s my first time, right? WRONG! This lady wanted to put 25 units in there (at $10/unit, might I add. So $250!!!), and I got scared right away. A good friend of mine who is 50 doesnt even get 25 units in her entire forehead!!! I couldnt believe how money hungry this lady was, and I’ll NEVER go there to have Botox done. Plus she looked like the cat lady which scared me a bit. LOL!
    Can anyone recommend a good place to have Botox done in Ottawa?

    • Reply
      narcissista1
      September 19, 2013 at 6:38 AM

      I’m so glad you ran Cece. And don’t get me started on medispas. They are tricky places to have anything done beyond getting facials, a spray tan or your eyebrows waxed (unless your derm or plastic surgeon calls his place a medispa, which is rare). For the most part they have lose medical oversight and their staff isn’t always well trained. One of the dermatologists I interviewed told me he had panicked staff at a popular chain call him about how to use Fraxel right before a patient procedure. Yikes.

      Back to the Botox, yes that sounds like waayyyy to much. i don’t the Candadian market at all, so can’t help you with a doctor, but make sure whoever injects you has been doing so for at least 5 years, you can see their before/after pictures and my preference, that they’re a board certified PS or derm with a thriving cosmetic practice.

      Good luck!

    • Reply
      Ottawa
      October 13, 2013 at 8:50 PM

      Hi Cece. I’m in Ottawa, had a consultation + my first injections last week to get rid of my 41-year-old 11’s and I’m thrilled with the results. He charges per area, not per unit, which might be more expensive but I trust him implicitly. If you google Ottawa Botox Doctor he’s the first hit.

  • Reply
    Jess
    September 28, 2013 at 12:55 PM

    Hi Becca,

    Could you send me the information of the doctor you like in NYC?

    Thanks!

  • Reply
    snoopygirl
    September 28, 2013 at 7:25 PM

    I had $350 worth of botox for the first time ever, in my forehead,..initially all I wanted was some filler in my one line between my brows but I was told that the filler would not work and it was botox that would prevent the line through , obviously..paralysis of the brow muscles.
    Well 2 weeks on & I still have the line plus a constant heavy, tired feeling on my forehead..plus drooping eyelids…so basically I paid $350 to feel like crap & look older ??.
    I’m just grateful it wears off and is not permanent.
    When I go back in 3 months, I’ll go with the…..” Cheaper ” filler.

    • Reply
      Anonymous
      June 18, 2015 at 7:42 PM

      I had Botox injected for first time 10 days ago today. I did the 11’s area, some forehead and a little for crows feet around outer eyes. 44 units total which is a minimal amount. Day three I had very heavy feeling in brow area as well as tight forehead. From there my right eye started to feel achey and heavier than left eye to the point where I had to take Advil to relieve. Kids felt heavy and was so fearful was developing droopy lids. Contacted my Aesthetic RN injector who asked me to send a pic so she could compare to before pic she took. To my surprise, my lids did not look any heavier than before and as she had said I felt as such because i had never experienced the weird tight Botox feeling before and had to give myself time to adjust and let muscles do so as well. Day 10, no more achey eye, much less tight feeling and very natural looking and feeling. Bottom line….don’t panic, trust your injector if reputable and relax and enjoy results. I spent last 10 days stressed out for nothing!!!!!

  • Reply
    Sweet
    October 7, 2013 at 10:22 PM

    I live in NYC and I too would love to know which doctor you recommend. Thanks in advance!

    • Reply
      narcissista1
      October 8, 2013 at 7:32 AM

      Hi Sweet, I generally don’t like to recommend doctors on my site because there are too many good ones that would get left off the list (I’ve only tried about 5 after all), but if you email me directly I’ll share the names.

      • Reply
        Sweet
        October 21, 2013 at 10:45 PM

        I did email you directly after I wrote the comment, but got no response 🙁 Still looking forward to your response!

        • Reply
          narcissista1
          October 22, 2013 at 8:30 AM

          Hi Sweet – give me until tonight. Been buried at my day job:((((

        • Reply
          narcissista1
          October 23, 2013 at 6:02 AM

          It’s in there now, check your in box:)

  • Reply
    Uma
    October 8, 2013 at 11:36 AM

    Hello, thank you for this informative and compassionate share. Have not had botox yet but am considering, as an upcoming trip overseas in a humid climate is looming in a little under a month. Have had forehead lines since a teen and so now in early 40’s with pale skin and living in a dry climate, they are deep. Have been noticing in my research there is caution in receiving botox if you already naturally have droppy eyelids. I have somewhat attractive deep-set heavy lidded eyes. Am wondering if botox can lift a heavy lid with the intent to smooth an active lined forehead or there is another alternative? Is botox off limits for this kind of client? Also if anyone would Recommend a good skilled botox injector (that fill requirements of author Becca’s suggestions) in the Phoenix/Scottsdale area…that would be a huge blessing. Thank you

    • Reply
      narcissista1
      October 12, 2013 at 11:53 AM

      You ask a terrific question, but only a cosmetic board certified derm or plastic surgeon can tell you for sure. One thing that your question brings to the forefront is that not everyone is a simple Botox case. I am actually quite difficult to inject because I have slightly asymmetrical brows which leaves little margin for error (and I’ve had lots of errors). If you want a quick medical answer, the doctors who frequent Real Self often give good directional advice. Better if you include a picture.

      Good luck and keep asking those great questions.

      Becca

  • Reply
    mark
    October 18, 2013 at 12:44 PM

    I heard that the cream used for piles (heamoroids) can be used to treat areas that Botox could have

    • Reply
      narcissista1
      October 20, 2013 at 3:03 PM

      Completely untrue. Everyone, put down the Preparation H.

  • Reply
    losing it also
    October 20, 2013 at 4:45 AM

    I just made the connection also. I’ve been to three doctors including a dermatologist. I’m completely healthy and all the blood work came back fine. I am losing so much hair it’s making me depressed. So I decided to wait for the next treatment and see if there’s any difference in my hair. I’ve tried every shampoo even Wen thinking that it was my shampoo. Then I had a lightbulb moment and made the connection that Botox was the only thing that I’ve done different since last November and that’s when I started losing my hair. Its to the point where it’s noticeable and I’m very self conscious. I switched from Botox to Dysport and now deciding to wait at least 6 months to see if there is any difference in my hair.

  • Reply
    Jolie Brooks
    October 26, 2013 at 11:06 AM

    Your post was very informative. I had doubts over the years about Botox but reading this made me want to give it a try. Thanks for all of your research and knowledge. I only wish you were knowledgable with Maryland doctors so you could E-fer me to one 🙂

    • Reply
      narcissista1
      October 29, 2013 at 7:39 AM

      Well, I don’t know Maryland well, but hope this will help.

      I wish I could say this was easy, but it’s hard to find a good injector because while a lot of doctors may be good at one thing, they’re not good at everything. Famous doctors are hit or miss (I had a bad experience with a famous one years ago), sometimes a nurse practitioner is good (although I’ve never done that) and sometimes you find a gem in the making.

      A few guidelines:
      1) Do you know how complicated your case is? What I mean is, do you just have some straightforward “11s” you need taken care of? I don’t have a lot of wrinkles, BUT great Botox lifts my brows beautifully and gets rid of my crows feet. On the other hand, I’m slightly asymmetrical, so it’s easy to go wrong with Botox on my face. So for me, I’ll pay a premium for the best injector I can get.
      2) Make sure they’ve been injecting for more than 5 years and ask to see their before/after photos. If you find yourself with an unknown doctor, this is a good question to ask (you can get trained in Botox over a weekend and you do not want to be that Monday morning patient).
      3) Make sure the doctor is a COSMETIC derm or PS that specializes in the face. Also, that they’re certified by the ASPS and ASAPS (for plastic surgery). They must have a thriving cosmetic injectable practice; sometimes your skin cancer derm and cosmetic derm are one in the same. I have two different demrs; one for cosmetic, one for skin cancer (I’m high risk for melanoma). I urge you to think twice before letting your GP, OB.GYN, or dentist inject you (unless they’ve been doing it for 5 years and have a book for before/after to show you – who knows, they could be a neurotoxin Rembrant).
      4) The doctor should make a recommendation about where and what you need. If the doctor just comes at you with a needle without thoughtfulness and says “where do you want it”, then run. Fast. They need to be skilled enough to look at your face and recommend.
      5) If you can, pay for a consult with 3 different doctors. The money usually goes to product or the procedure itself. It’s a pain, but if you have the budget to do it, I would.

      Good luck!

      • Reply
        Jason
        November 13, 2013 at 10:53 AM

        narcissista1 – thank you so much for this very informative and honest post. I have a question for you – how young do you think is too young to get botox? I am 29 and have ’11’ lines forming, as well as horizontal lines across my forehead, and lines under my eyes. I guess it’s all relevant and depends on the individual case.

        I have yet to have any consultations about this. But I am new to NYC, so if you have any recommendations on who to see for some guidance, I’d love to know 🙂

        • Reply
          narcissista1
          November 25, 2013 at 7:47 AM

          Hi Jason – I don’t think it’s about age as much as it is what you’re trying to address. If you have deep 11s that make you look angry when you’re not, then why not give it a shot? Just be sure you see a cosmetic board certified derm or PS for consult. And don’t over think every little imperfection, take your bigger picture into account:)

  • Reply
    Laura
    November 4, 2013 at 7:44 AM

    I have had my crows feet done twice this year and have scheduled my third appointment. My doctor is great. Last time I went to him I asked about getting my forehead done and he advised against it as he thought I didn’t need it. First time I have heard of a doctor doing this and it has made me really trust him. I’m looking at doing the bunny lines and smokers lines but will of course be asking his opinion first!

  • Reply
    carolyn
    November 15, 2013 at 10:22 AM

    i just received my 1st botox on weds from a very highly known dermatolgst. i did the horizontal lines on my nose. i got 20 units and paid $150 which seems great (out on li).. i dont see a change yet but its only been 48 hours. I made another appt to do the lines by my mouth (frown lines) since i have a wedding to attend in a month. hope i see some changes 🙂

    • Reply
      narcissista1
      November 25, 2013 at 8:07 AM

      It will take about a week for the results to show up, but be very careful about the lower third of your face. There is a high margin of error, especially around the mouth so make sure your injector has at least 5 years of experience in a an active cosmetic practice.

    • Reply
      Anonymous
      February 13, 2015 at 12:57 AM

      Hi, where on LI and what is the do toes name if you don’t mind me asking? Considering treating myself to losing my frown lines for my 30th birthday and am on the hunt for someone reputable. Thank you!!

  • Reply
    Rose
    November 20, 2013 at 7:28 PM

    I get Botox and fillers injected by a nurse practitioner at a med spa and am thrilled with the results. She has 13 years of experience and previously worked with a high profile plastic surgeon doing all of his injections. A doctor isn’t necessary IF your injector is highly skilled and experienced. In fact, I much prefer her work to the surgeon I used previously!!!

    Great tips overall tho, always best to err on the side of caution, especially when it comes to your face!! Don’t be scared of a nurse practitioner though…just be sure to look for experience and happy patients!

  • Reply
    Dave
    November 21, 2013 at 7:39 PM

    Some of this is just bad information. NPs, PAs and RNs can give Botox in any state, it does not have to be a doctor. In 19 states it can be done independently without a physician, in the others under a physicians orders. The doctor does not have to be onsite. Think about it nurses give more shots on a daily basis than any doctor every does, and this procedure is usually with a 30 gauge needle or smaller. A simple one day site injection class is common, and usually given by the Botox manufactures and sellers.

  • Reply
    Sparksie
    November 23, 2013 at 6:15 PM

    You mention to stop taking Fish oils 2 weeks prior to Botox but don’t say why? Fish oils are a natural anti-inflammatory. I would have thought this would be a good thing if you’re were having botox.

    • Reply
      narcissista1
      November 25, 2013 at 7:58 AM

      Fish oil is amazing, but it thins your blood which means you can get a more spectacular bruise at the injection site.

  • Reply
    Alm33
    December 3, 2013 at 9:28 PM

    Great article! I learned a lot and appreciated your candidness.

    Do you have any experience with chemical peels compared to a botox? I do not have the 11s, rather somewhat deep forehead wrinkles. But I still think botox could work ?

    Any chance you know of anyone in the metro detroit are who’s name you would share?

    Thanks again for a great read .

    • Reply
      narcissista1
      December 30, 2013 at 8:26 AM

      Thanks Alm. I have experience with both (as a patient), but they treat different things. A superficial to medium depth chemical peel can improve skin tone, sun spots, some fine lines, sometimes melasma and give you a beautiful glow, but it cannot get rid of “11s”. It works purely in a superficial level. Botox is a completely different animal in that it’s a neurotoxin that gets injected into muscle around the wrinkle to relax it from the inside out. It’s indicated by the FDA for the 11s and just recently for around the crows feet around the outer eye. It’s used elsewhere, but mostly used in the upper 1/3 of the face.

      I don’t know any derms of PS in Detroit, but be sure you see a board certified derm or plastic surgeon with a thriving COSMETIC practice.

      Good luck to you!

  • Reply
    Mata
    December 21, 2013 at 4:39 PM

    Perhaps if you have “11s” showing up between your brows, the real concern is how often you’re making that face. Remember how your mom warned you that if you kept making that face it would stick that way? Well, she was right.

    A knit brow is an expression of worry, sadness, frustration, anxiety, or anger. So confront those things.

    Study meditation. Learn to breathe and center yourself on your breath. Discover our inner beauty and gifts and focus on developing those for the benefit of both yourself and others. Find your inner peace and center yourself in that place at the start of each day… then you won’t need botox, fillers, or any of these other toxic procedures.

    You are beautiful and perfect **just as you are** — each and every one of you. If only you could see yourselves through the eyes of one who loves you…

    May you be safe. May you be well. May you come to know the joy of your inner beauty. And may you be at peace.

    “Body and wealth shall return to dust – hardly anyone realizes this. Pleasure, beauty, and delicious tastes are useless. What are you doing, O mortal?” ~ Sri Guru Granth Sahib

    • Reply
      narcissista1
      December 30, 2013 at 7:20 AM

      Haha, if ONLY I could sit still long enough to meditate. I keep trying, but the last time all I got was Katy Perry’s “Last Friday Night” playing in my spastic brain. I would love to be able to calm myself into less wrinkles:)

      • Reply
        Mata
        December 30, 2013 at 12:47 PM

        Not to worry dear — it is a problem common to all of us. Even Buddhist nun Pema Chodron has talked at some length about how “busy” her mind is most of the time and how she has struggled to master it over the years for the purpose of “meditating well.”

        I figure if a Buddhist nun who has studied for decades under some of the greatest masters of meditation has trouble with this, the rest of us probably need to go easy on ourselves. 😉

        If it really is something you wish to explore, I recommend starting with baby steps — just 5 minutes of meditation a day. Let it be the first thing you do upon waking, when your mind is calm and fresh.

        Using a guided meditation can be really helpful in the beginning. There is an iPhone app I use (also available for Android) called Insight Timer that offers a wide variety of guided meditations from a wide variety of practitioners. Most of them are really good, though there are some that could really use the assistance of a qualified sound technician with a mult box to filter out the extranous background noises.

        The important thing is to find a way to just breathe… and *be*. Here. Now. In this moment. With gentleness. Without judging yourself.

        Think of your noisy mind as a chattering little dog on a leash. And you are Cesar Millan… gently pulling the excited little dog to you and resting your hand on it to calm it. You will likely have to do this over and over again. I have ADD, so it’s just a regular part of my practice to say, “Okay, busy-brain, back to the breath now…”

        Realize that, in this moment, you are perfect. There is nothing you need to do. Nowhere you need to be. No one you need to answer to.

        You are safe. You are good. You are at ease. And therefore you are happy.

        When you first settle into it, this meditation may bring such an overflow of peace and joy to your heart that tears come to your eyes. We are all so busy running around, proving ourselves, trying please others, etc. that we forget there is a core being… a pure, bright spirit inside us that has no connection to this world beyond that it exists in this body. And this body will turn to dust. The spirit is eternal. And even your wrinkles are beautiful — especially those “crows feet” around the eyes, because they are the pathways that delight has etched into your face.

        Recognizing this fact can be tremendously freeing and bring an astonishing sense of relief. Thus… the tears. Don’t worry — that’s normal too. 🙂

        Be safe. Be well. Be happy. Be at peace.

        ~ Namaste ~

        • Reply
          Jess
          December 21, 2015 at 4:35 PM

          Mata. Wonderful – I feel as though you typed this just for me, Cesar Milan reference and all. I know I found myself on this page simply because it’s all too easy to stray into the less resistant – and not as genuinely fulfilling in the long run – path. Thank you for gently guiding me back and reminding me that the damn line between my eyebrows is 100% a physical manifestation of my sometimes-inability to live in the Now: of my allowance to let stress rather than awareness drive me.

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      Becca
      February 12, 2015 at 11:05 AM

      Wish I could tell you:) I’m a NYC girl so I don’t know, but there’s a good website called SkinTour that offers recos and also try Real Self/ Good luck

  • Reply
    Meena
    February 19, 2015 at 1:49 PM

    Thank you for this information. I am about to take the plunge and was trying to find a high volume physician. Unfortunately Allergan’s doctor search is sorted by distance or name.

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    Robert H.
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    Interesting article, and comments are helpful. Unfortunately, I’ve been having Botox and Restylayne injections by my Dentist for about 3 years. I look much younger than when I started, seems that the dosage/ placement has always been “right on.” , When I look my face and before/after photos, it’s hard to believe the process could have been done any better.

    Now, I’m faced with hunting for a “new injector,” since dentists are not qualified to do this type of treatment. Not looking forward to that, and also am wondering where the information came from, (i.e., that being a dentist makes you unable to inject botox)

    • Reply
      Anonymous
      May 3, 2015 at 8:58 AM

      I say if you are happy with your injector I don’t see why you should look for someone else. Anyone can inject Botox, they just take an 8 hour course and work under a supervision of a doctor and Bam! you are qualified. Here is my thing, I wouldn’t go to a dentist if I had problems with my heart. I would go to a cardiologist. So why would I let my dentist inject me, especially on my face. I recommend going to a board certified plastic surgeon or dermatologist. They have studied they’re whole life the formation of skin and facial structure. This is just my advice and what I would do but I know plenty of people who buy Groupons and go to any doctor who is having a sale. I don’t like anyone messing with my face so I am very weary of this.

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    Laurel
    April 26, 2015 at 9:31 PM

    Hello, I’m very stressed and few years back I had skin cancer, which was right smack on top of my nose and up into inner part of eyebrows, had bad health ins and my scares are awful I don’t like to go outside to parties, any suggestions? HELP

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      Laurel
      April 26, 2015 at 9:38 PM

      Does Any think Botox would help or fillers??

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    Lynne
    May 12, 2015 at 2:58 PM

    I look at my face and can see that it is in need of help, but I am embarrassed that people might think of me as being, well you know, vain. Did any of you feel that way, and how did you deal with it, especially with friends and family?

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    Lynne
    May 12, 2015 at 3:02 PM

    I have another question: I have two large pours (deep) on my nose. Is there anything that can be done about?

  • Reply
    Soloist
    May 16, 2015 at 1:53 AM

    CONSIDERING RECEIVING BOTOX OR DYSPORT INJECTIONS? Please read this first.

    I do not have a personal agenda. I am not a member of PETA or any other activist organization. I am an intelligent, educated, responsible and rational person. I do not have anything against anyone who wants to use injectables or any other treatment for anti-aging. I used to be one of those people.

    I have had plastic surgery, fillers and, yes, botulinum toxin injections (ie Botox). I was not a “junkie”….just a normal person that wanted to try and slow the age clock….just a little. I was scared to get my first injection, we perhaps all were just a little. And…..my first experience with an botulinum toxin product was fine. I actually loved the result. But….when it came time for the next….even though my injector was an experienced, very well-known board certified physician and a leader in the field…..something went terribly wrong. And I am here to tell you…..THIS CAN HAPPEN TO YOU.

    I am not unique. There are THOUSANDS of others who have suffered horribly from these side effects and from the spread of the botulinum toxin. It doesn’t seem to matter if you have had injections in the past with no effects or if you are receiving them for the first time….it doesn’t seem to matter if you receive 4 units or 100 units…..it doesn’t matter if you are 16 years old or 50 years old…..you are at risk. The risks are REAL and the symptoms that you can suffer are some so horrific…..they are beyond what you can even possibly imagine. I urge you to continue reading before making your decision to take this risk.

    Let me first assure you that before my injections…..I was a healthy, vibrant, active, athletic, and hard-working female who loved life. Since the ill-fated injection of botulinum toxin that I had now almost 5 years years ago, my life has completely and totally changed.

    Over the past 5 years since my injection….I have been hospitalized twice, been to the ER 8 times….have had 3 MRIs, CT scans, EEG, autonomic nervous system testing, every single imaginable blood and autoimmune test possible…even tests for things that are so rare you have never even heard of them. I do not have any other disease, psychological or medical problem. The botulinum toxin symptoms, which began 3 days after my injection and ramped up to full effect 30 days later…. rendered me non-functional. I had to take medical leave from work twice…..the first time for 2 months and the second time for 4 months (symptoms are known to come/go and relapse)…..and could only work part time for 8 months after that.

    My symptoms ran the gamut of head pressure, headache, ear pressure, ears ringing, muscle spasms, naseau, incontinence, nerve pain, inability to have a bowel movement, nerve sensations down my neck/spine, severe head tremors, slurred speech, convulsions, seizures, extreme sensitivity to noise/light/sound, blurred vision, dry mouth, dry eyes, muscle twitches, muscle weakness, abnormal gait, heart racing, difficulty breathing, difficulty swallowing, trouble moving my jaw, tingling and numbness in extremities, acid-burning feeling throughout my body, fatigue, hot flashes, cold sweats.

    We are not talking about 2-3 weeks of symptoms…..nor are we talking about symptoms that necessarily subside once you regain movement of your muscles that were injected. We are talking about MONTHS and in my case, YEARS of symptoms. We are talking about close to over $120K in medical bills. We are talking about not being able to drive, go outside, eat, work, live alone…..we are talking about a complete life-altering nightmare.

    The botulinum toxin can spread beyond the site of injection and into both the peripheral and central nervous system. This is a scientific fact and there are hundreds of published papers that discuss this. The toxin damages the functioning of neurotransmitters that can affect almost every organ in your body…including your brain. The anxiety and panic that can be created from this drug affecting neurotransmitters in the brain are side effects that I do not wish on my worst enemy. I have experienced first hand the reason why there is such concern should this toxin ever be used as a chemical weapon. The anxiety and akathesia created from this toxin is like having a severe panic attack ALL of the time……24 hours/day. The pressure against your body is unrelenting…the feelings of not being able to breathe are horrific….the electrical shocks running through your nervous system are excruciating…..the burning sensation feels like acid has been poured into your bloodstream….you are living in a state of absolute terror constantly…..the terror is in your skin, your brain, your bones…is permeates your entire being. For HOURS on end. There are times that you truly would rather be dead as opposed to living in the nightmare that you are caught in. This is a common thought those of us who have experienced this.

    There are HUNDREDS of people that I have personally “chatted” who are suffering these debilitating effects. None of us have any agenda other than to educate ourselves and others on what really CAN happen with this toxin. There are lots of horror stories on this site….and tens of thousands of reports submitted to the FDA.

    Read the black box warning on the drug. It is there for a reason…..although it took a consumer advocacy group to petition the FDA to demand it. And…the side effects do NOT just happen in cases at higher doses or only with people with previous neurological conditions. Find the scientific studies done in the lab that indicate that once injected….the toxin can move from nerve axon to nerve axon…and into the central nervous system including the brain. Learn how the toxin affects nerves beyond the neuromuscular junction…with effects lasting for years. Find the numerous studies that conclude that not enough is known about how this toxin is actually metabolized in the body or how (or if?) it leaves the body. All of this information is out there. Believe it…and believe me.

    I still cannot drive….I still cannot live alone….I still need help with normal tasks….and I still struggle on a daily basis…5 years later. I made the biggest mistake of my life when I decided to have toxin injections. Sometimes the only thing that gives me strength is when I can help to educate others to the real danger of this drug. DO THE RESEARCH. I didn’t…until it was too late for me…and admittedly….I did not make an informed, educated decision. You now can. Hopefully it is not too late for you.

  • Reply
    Misty Cole
    May 24, 2015 at 3:14 AM

    I need a good, conversative and responsible priced dr in Midwest City or OKC

    • Reply
      Deborah Bright
      May 4, 2016 at 4:05 PM

      Hi Misty, don’t know anyone in OKC but have a GREAT ref for Tulsa.

  • Reply
    SLW
    June 10, 2015 at 1:37 AM

    I live in Manhattan and am looking for a good doctor to go to – any that you can share?

  • Reply
    ANNETTE Blancaneaux
    June 13, 2015 at 10:52 AM

    Thank you the for a very honest and candid blog on your personal Botox experience.
    I enjoyed your humor.

  • Reply
    Callie Marie
    June 15, 2015 at 4:01 PM

    I have been thinking about recently getting a Botox around my eyes. This article addresses a few the concerns I had. In particular, knowing that the effects will fade after a few months makes me feel better about going through with the procedure. Thanks for the advice about what to do before and after Botox.

  • Reply
    NP
    June 16, 2015 at 3:43 PM

    YOU ARE IGNORANT! you need to educate yourself! Pissing off Nurse Practioners is not the way to go here. Learn the facts, lady. You are so dumb, but yet we know that by what you did to yourself. DUMBASS.

  • Reply
    Georgie
    August 2, 2015 at 11:11 AM

    Hi

    I’m a bit late to this conversation but I just wanted to share very briefly how I was poisoned by Botox (dysport).
    I’ve had it 3 times…first time, fine. Second time, initially seemed fine then months later I developed extreme nerve pain through my body. Didn’t connect to Botox so had a third go…biggest mistake of my life. My left eye shortly after developed pain/strain, then blurriness and 5 months on, I have double vision. I still have nerve pain and now I have issues with my internal organs. I’ve had all the tests, been to neurologists etc. The only help on info I found was a wonderful site botoxsupportcommunity.com. I now understand that I was ignorant to think it wears off and stays local (because doctors, the media and everyone says that’s the case). IT SPREADS THROUGHTOUT YOUR BODY!!!!! AND ITS THE MOST DANGEROUS NEUROTOXIN KNOWN.

    • Reply
      Georgie
      August 2, 2015 at 11:18 AM

      If people need evidence that it goes into your central nervous system, check this university findings out;
      https://www.uq.edu.au/news/article/2015/04/botox-makes-unnerving-journey-our-nervous-system

      I implore anybody to visit the botoxsupportcommunity.com website before injecting….everyone on the site WOULD DO ANYTHING TO GO BACK & NEVER HAVE BOTOX

      IT DESTROYS LIVES …I’ve spent over $5000 already on medical bills in 6 months.

      ITS LIKE PLAYING RUSSIAN ROULLETTE…you never know which injection will do the damage…it can be the first or the twentieth…but once it affects u, it’s all over. It’s an absolute nightmare

      • Reply
        Betty
        August 5, 2015 at 10:18 PM

        I had 3 injections of dysport on my 11s then 2 days later came down with the most debilitating headache I have ever known that lasted 3 days, then came down with my first ever head to toe case of hives, then lost about 25 percent of my hair over next 6 months. At 36, pretty injection, i weighed 120 lbs, ran marathons, never missed a day of work, never had asuffered a migraine, nor a case of hives. My year after dysport was from hell. My muscles ached from the inside and doctors treated me like a paranoid schizophrenic even though i had never seeked medical care for anything in my life other than one broken leg in college. The nurse that injected me said “it must have been something you ate.” Perhaps it only affects a small percentage of us, but unfortunately you don’t know that until you almost die.

  • Reply
    Susan Miller
    September 25, 2015 at 5:10 PM

    It is such a shame so many ignorant people resort to botox. Do any of you exercise and if so why would you stop at your neck. Does anyone think anymore? Botox is injected into muscles, duh! Do you know what this means? Duh, you have muscles in your face that ypu can exercise and look young naturally. People who do botox cant truly see how ridiculous they look. Yes it looks like a horror show on the streets when I see a botox face. I am 46 years old and have been exercising my face since I was 33 and I still get asked for I.D. And get second looks when people realize my age. Never have I been asked if I get botox because my face looks natural.

    • Reply
      Rylee
      October 10, 2015 at 1:44 PM

      Susan, can I private email you regarding your face exercises?

  • Reply
    Silverchica
    October 8, 2015 at 5:05 PM

    Old post, new comment. I have a different perspective, as an MD with an art hobby. I work in a non-derm, non-plastics medical field with other MD’s, NP’s and PA’s all who are incredibly skilled at handling a needle with precise injections.

    Although I find the post informative, I respectfully disagree with a number of the comments.

    I wanted Botox and didn’t want to pay stupid prices for it, so went to a class, taught myself, and taught my closest medical friends how to inject. To be fair, they ultimately also went to a class to tweak out nuances. It is really not rocket science. One does not need to be a Cosmetics specialist or Plastics person to inject with fabulous aesthetic outcome. One does not need to be an MD. One must, however, have experience with injections, anatomy, clean technique, and understanding of adverse effects.

    I do this as a hobby for the past 5 years, mainly because I can save $1000’s for myself and friends. Allergan charges $5.50 a unit. A markup to $10+ more is absolute greed. Market, market….

    We as a group have dozens of people asking us to inject them, mainly because we do things safely, artistically, and logically. Anyone who injects Botox (all legally, of course) with those ideas in mind will do a good job. Patients vary with muscle strength, pre-existing lid droops, facial assymetry, and ultimate goals. An injector who uses a one dose fits all women or men approach will fail at their goal. As an example, I have 2 friends who have the same forehead goals (lateral eyelid lift and removal of dynamic forehead lines). One needs 1/5 the botox that her friend needs for the same result. It is obvious in a 10 minute evaluation. The injector should be touching your face, feeling out your muscle strength and discussing your previous treatments.

    One does not need to be a Plastics practitioner to have all the necessary skills to do art with a needle. As some of the previous commenters have mentioned, they have had varied results from people who should have been the best by pedigree, but fall short of the mark because they didn’t follow the basics. A great artist does not need a degree from an art institute. Of course, your injector should be a licensed person functioning legally.

    I have a few peripheral friends who have asked me to inject because I did a better job than their 3 previous prominent board certified dermatologist injectors.

    I haven’t hung up a shingle because doing this every day would be, well, boring. Money maker? Sure. However, I prefer to spend more of my time practicing medicine and doing the art of botox injection as a hobby. My cost for an upper face (~50 units)is just under $300. I have my PA friend whom I taught to inject the product administer injections on me, and she does a fabulous job. Balanced, not frozen, lifted in the right spots.

    PS, Allergan does not offer Botox in a 200 unit bottle. Regarding ‘irreversible damage by illegal injectors’…(7/2012 comment) not sure how that happens. Are you referring to people going to a ‘Botox party’ and getting something other than Botox injected in them by an unlicensed cosmetician? Botox can conceivably spead to distal sites via arterial injection, highly unlikely on the superficial face, and can cause temporary (months) ptosis even in the hands of the most experienced injectors. Hopefully no one here would be accepting an injection of an unknown product in their face from an unlicensed practioner. (Yes, I know that happens amongst the desperate, but it is extremely rare, and I refer back to initial comment that the ‘pedigree’ on the wall does not guarantee results.) I am board certified in my medical specialty as well. Just not a Plastics person. Those who wish to pay double or triple, go for it. It’s not a guarantee of anything, and I have zero doubt that any of those MD’s will have you sign paperwork that states that exact fact.

    • Reply
      Featherduster
      November 4, 2015 at 8:31 AM

      Thank you for your insight Silverchica. Are you in the Midwest by any chance? I’ve been getting over 30 units on my 11’s which is really a deep “1” with no results. I’ve been going every 3-6 months since 2012. So frustrating. Any insight? I go to an RN who is at a plastic surgeons office.

    • Reply
      anne
      December 28, 2015 at 10:15 PM

      hey silverchica, ‘irreversible damage’ happens firstly when someone uses bad placement technique and disrupts the natural balance of the muscles, if this happens enough it does not ever go back to normal and as i said before – this was done to me by a past pres of the AAPS.. and someone who is currently chairman of the Board for Injectables Safety… its been 4 years and my face is still damaged. as well as my health. becuase he used bad placement and also gave me wayyy wayyy too much, and did not take into account the natural assymetry of my face. pedigree and education certainly are no protection here.

      the other way irreversible damage happens is becuase this is an incredibly potent neurotoxin, which does not actually ever stay in the local area in which it is injected. most people have sub clinical damage, and so they either dont notice it, or dont connect it with their injections, which isnt helped by the fact that most drs they see will not hesitate to tell them that botox ‘couldnt possibly’ cause this kind of damage. that is not what is written in the black box warning or the current safety information though. im sure you noticed how many people on this thread mentioned losing a lot of hair, terrible headaches, ongoing neurological or autoimmune problems, etc. this is a reaction to being poisoned. even though many have not connected it with thier injections. it is actually extremely common with those who have been poisoned. it is very good if you are doing this artfully and cautiously.. that is the way it should be done. but even so, the next step is for all injectors to have proper respect for the incredibly high toxicity of this substance. it definitely can poison people, and it definitely can spread easily away from the injection site, for many reasons and with little advance warning, causing systemic health issues that can continue for years or longer and for which there is no cure. it really is russian roulette as to when this next injection will be the one that puts you on the floor.. and once you are there, it really is a living hell. very few injectors treat this substance with the respect and caution it deserves, and this is the main problem.

      in allergan’s own internal studies on toxicity, when they injected primates with botulinum and waited for them to die, they then autopsied all at the end of the experiement. -all- animals regardless of dose had significant internal and sub clinical damage to their internal organs, muscles, nerves and brain. even those who externally, appeared to be unaffected. you realize this means that just becuase you arent noticing the damage being done to you, that damage is still occurring internally. many people eventually cannot take the overload and this is when their symptoms become visible. just becuase someone is not having adverse symptoms, does not mean they are not being damaged internally. many people notice symptoms, but ignore or dismiss them as something else. the possibility of severe and long term damage is extremely real and it has been shown by allergan’s own internal studies, which they then paid plenty of money to make sure never saw the light of day. good luck to you and please continue to treat this incredibly toxic substance with the respect it deserves.

      anyone reading this considering getting this treatment, please be aware the risk of permanant damage or problems both to your health and face are very real, even if you are seeing ‘the best’.

  • Reply
    Rita
    October 12, 2015 at 12:15 AM

    Excellent information and we’ll written. Thank you so much.

  • Reply
    Neel
    October 15, 2015 at 6:35 PM

    My plastic surgeon never told me to sit up straight after a Botox treatment or never to do strenuous exercise for 24 hrs from last few years I was not satisfied with the result but she said that bec I have been doing it for several years maybe it is not working for me I believed her but recently I hv got it done by a nurse practitioner she told me not to sleep for 4 hrs no exercise for a day hope it works for me u r right just bec it is a plastic surgeon doesn’t mean she knows about Botox wish I had changed earlier wasted lot of money and time

  • Reply
    Anonymous
    October 26, 2015 at 5:52 PM

    Excellent summary on things to think about. You are right, this is definitely an area that you get what you pay for. There is a lot of training and experience that goes into being a good injector.

    Regarding recovery, have you every heard about OcuMend? It is mainly for dermal fillers, but works equally well for people who bruise with botox.

    http://www.cearna.com

  • Reply
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  • Reply
    Mary Fowler
    November 19, 2015 at 11:12 PM

    I have read so much all over the Internet and learned so little. You have given me more info here and helped me understand better than all I have read. Thank you for sharing.

  • Reply
    Want2bwell
    December 24, 2015 at 2:23 AM

    Like a few others who have commented, Botox has ruined my life. I have had health issue after health issue…thousands of dollars of medical bills…and no doctor that believes it’s from Botox. However, after talking with others in similar situations, I know in my heart that this is the cause. I had 4 injections, all from reputable physicians. I wish I could go back in time. I am a professional and was completely healthy pre-injection (no hospital stays except child birth) and even taught fitness classes for 20+ years until I could no longer do so…Botox has damaged my nervous system. I won’t go into my extensive medical history nor resulting pain, but know that there are risks and each injection is playing Russian Roulette.

  • Reply
    Georgie
    January 1, 2016 at 7:38 AM

    I think consumers need a thorough investigation done into the long term effects of Botox on health before any of us just pop into a doctor or clinic for injections. There’s so much we do not know.

  • Reply
    heather
    January 11, 2016 at 10:28 AM

    lololol…….so many people think they know so much, know so little…..didn’t read but a few comments, but just throwing this one out there…..who would you have start an IV? a doctor or a nurse?….same concept, its not the degree but the knowledge and experience of the “person” performing! all are licensed to perform!

    • Reply
      Becca
      January 12, 2016 at 11:19 AM

      That is untrue about everyone being licensed, it varies by state in the US. This matters because it impacts who can officially trained. That said, not everyone has the talent and eye to be a great injector even if they’re a terrific surgeon or Derm. Regardless, not sure I would the person running my IV to do my facial injections. Good luck with that.

  • Reply
    Jess
    January 19, 2016 at 11:11 PM

    Hi Becca. I moved to NYC from the South a few years ago and despite extensively researching all of the doctors I’ve switched to NYC, they’ve been awful. Could you share the names of the derms that you’re happy with? I’m looking for a derm for the cosmetic and also one to meet annually for skin cancer screening. I’ve been searching and searching but I haven’t found anyone I feel good about. I’ve been putting off going to the derm for years because I’m afraid of wasting my time and $$ with the wrong doctor. NYC is too expensive to throw it away on bad doctors!

    • Reply
      Becca
      January 23, 2016 at 9:55 AM

      Hi Jess – drop me an email and I’ll send you a few names.

  • Reply
    Newbie
    February 8, 2016 at 12:03 PM

    Hi Becca

    I just received my first Botox injection 6 days ago. I went to a MediSpa and was injected by a Registered Nurse (Burlington, Ontario).
    First, I want to mention that my experience was quite painfull!
    I was expecting bug sting sentations but it was much more intense than that…I have a high tolerance for pain and never thought that it would hurt me this much.
    Once finished, I had to hold a few tissues to some of the bleeding injection sites on my forhead for a while and paid then left the clinic still holding them on my forhead.
    The pain in the area (the 11’s) lasted for 4 days, it was so painful in fact that I couldn’t touch that area of my face.

    Now, on another note…..
    I am 43 ( Female) and she said that I have a mild case of the 11’s, nothing serious. I, just wanted them gone!
    So she said I would need between 35 – 40 units. Being new at this , I said Ok, After I came home and did some research, I realized that this is wayyyy more than the usual doze for a mild case of 11’s!
    Their botox was on sale for an excellent price, but I think I was either over charged or the botox was diluted…..I was charged for 40 units for the 11’s!

    HOW DO I KNOW HOW MUCH BOTOX (UNITS) WAS ACTUALLY USED ON ME? (there were about 10 injection sites)

  • Reply
    Dean chaudhry
    February 9, 2016 at 2:23 PM

    I had Botox done for the first time 4 months ago for my 11’s. I saw little difference if any. The doctor/injector said over time, the results improve. He did seem very knowledgeable. As it was my first time, should I expect to wait another say 4-6 months (and a couple more sessions) before there’s any difference?

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    Combat
    February 19, 2016 at 8:54 AM

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    Keep up the superb works guys I’ve incorporated you guys to blogroll.

  • Reply
    Leslie
    March 2, 2016 at 2:11 PM

    I was looking into getting botox at the greenwich medical spa in Greenwich, CT…..It looks as if a nurse practitioner (APRN) does the injections…….I am only 37 but have bad forehead lines due to years of prescription meds which caused dehydration….I figured it must be the scripts because I have two older sisters and they don’t have forehead wrinkles, one is 39 and the other 41……..The wrinkles are really effecting my confidence, but I am very nervous because botox is a toxin, and the thought of injecting a toxin three times a year from 37 onward is a scary prospect……..the medical spa has very good reviews online, do you think it is safe? and there is even a video on youtube of her doing the injections if you search greenwich medical spa on youtube……

    • Reply
      Becca
      March 4, 2016 at 6:19 AM

      I avoid med spas like the plague. Some are ok but they often don’t have an MD on the premises. Nurse practitioners can be good but check to make sure they are licensed to inject in your state (it varies state by state). This is important because it impacts who can be properly trained. If this is your very first time, I would see a licensed cosmetic dermatologist for a consult. Botox isn’t the only way to treat a wrinkle and often they’ll take a more holistic, healthy approach. Good luck!

  • Reply
    NEWBIE
    March 9, 2016 at 9:33 AM

    Becca
    Any comment on my above comment please!!!
    is 40 units normal ???

    • Reply
      Becca
      March 9, 2016 at 9:41 AM

      Newbie I would avoid the med spa and see a cosmetic derm for an evaluation. I know that’s not the answer you want to hear, but I am not a doctor do don’t know what is right for your case. 40 units is a little high but not unheard of. That said, I’ve heard stories about diluted Botox, even so who knows what the methods of the Med Spa were. For your first time, it’s critical to get a broader evaluation from a reputable, licensed cosmetic dermatologist.

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    DebatingFREEBotox
    March 14, 2016 at 12:52 PM

    Hi! Glad I found this page! I am 37 and have been contemplating Botox for the past few years since having several children seemed to have wiped out a lot of elasticity from my face. I’ve interviewed 2 different dermatologists and asked about getting it in my crows feet, forehead, and 11’s. One told me that they wouldn’t do all 3 areas at once because I would end up with a “frozen” look. Fast forward to derm interview #3, a very reputable doc who has the most successful practice in our state for regular dermatology (not limited to costmetic) — think waiting room and office walls lined floor to ceiling with framed awards. Anyway – the appointment went terribly well, as they had me scheduled for a “regular” derm appt and not a cosmetic. After waiting 1 1/2 hours, they “squeezed me in” and I met with the doc for a rushed 5 minutes. Of course, I was very upset and told them that I didn’t think I could trust a practice like this that is so disorganized and rude. Well, they offered me the “unique opportunity” to have $1500 worth of services (botox in crows feet, forehead, 11’s and small filler in 11s) for FREE… only catch is that I would have to come back in 6 weeks after hours for their dermatology resident training program. i.e. – med students would be doing the injecting under the supervision of the doc. Well, the doc has over 20 years of experience with Botox, and I was assured he would be “right there” while the residents are performing the injections. … The lady who signed me up for the appointment said that she, herself, has done this free program several times and it is great. She said, “the worst that can happen is a droopy eyelid, and you just come back and the doc will fix it for you…”. At first I was excited to be getting all of these services for “free”, but now, after reading some of the comments on this thread, I am having extreme second thoughts… The night is scheduled in two days — any advice?? Thanks!

  • Reply
    Patricia
    April 6, 2016 at 12:17 PM

    Hi Becca.
    I live in NYC and despite extensively researching doctors I’ve not come up with anyone to go to. Could you share the names of a few doctors you would recommend for a first time bother. Really want to try a little botox but afraid ill end up at the wrong place.
    Thanks you for writing this article.

    • Reply
      Patricia
      April 6, 2016 at 12:18 PM

      *spell check changed Botoxer to bother….

    • Reply
      Sheagl
      April 11, 2016 at 12:50 PM

      Run

    • Reply
      Becca
      April 20, 2016 at 6:58 AM

      Right now I’m using Dr. Ellen Gendler. She’s very conservative which I like. She’s no BS either and won’t sell you stuff you don’t need

  • Reply
    Mary
    April 21, 2016 at 5:27 AM

    I’m 55 yrs old, mother of two great children, live in chaotic London. My face looked so old and tired. I have already undergone several face treatment but the best one was facelift done at forme clinic, prague. I have done facelift and necklift and I’m very satisfied with the results. It gave me more than 5 yrs of my age back.

  • Reply
    Pickingmyfaceup
    April 21, 2016 at 6:28 PM

    Thank you for creating this forum for people to talk about the good, the bad and the ugly involved in keeping our face in place with fillers. I’m a woman of color over 55 and working in a high profile stressful outside medical sales job in the Midwest. I need to keep it together. I had some experience with Juvederm in the nasal labial area when it was first introduced. My skin is sagging and because I had high cheek bones I have lost considerable volume. I went to a plastic surgeon with a good yelp reviews allowed this person to inject Radiesse & Juvederm, and in my cheeks and some on the nasal labial area. This practice has a reputation of being conservative with the product. Although I feel like it was better their prices are outrageous and I clearly needed more. So I decided to go back about three months ago because I have not found anyone that I trust ( I know enough about the business to be skeptical) I am also turned off by someone attempting to up sell me. I had more injections in my cheeks, under my eyes and the corners of my chin. The chin area was the worse. I left with a lump from the inside of my mouth on my chin area because I’m sure the surgeon caused a bit of trauma. I couldn’t tell if the lump would show on the outside of my skin until after a week. I tend to swell. I definitely had a lump and I made a decision to not go back. This team of surgeons (there are two of them) have good reviews. I really believe that they spend a lot of time with their patients to make up for the lack of honed skills. It’s just my intuition. Their office is in a very expensive area or Chicago. I would like to find someone in the Chicago area who has a busy practice that includes Injectables and not charging the highest rates in the country. I would probably be okay paying the rates in I knew the skills were there. I know that some injections can be done in a way to minimize swelling. Even access the area inside the mouth. I would appreciate a recommendation in the Metro Chicago area.

  • Reply
    Mark Hamilton
    May 3, 2016 at 12:00 PM

    Becca,

    Thank you for a great site and good information.
    Many excellent comments here.

    I do want to let you know you left out two very experienced groups of surgeons who do injections regularly. They are facial plastic surgeons and oculoplastic surgeons. They are one of the 4 main “core specialties” for cosmetic surgery and I doubt there is anyone in organized medicine who would question their credentials for injecting and cosmetic surgery in their respective ares of expertise.
    As specialist of the eyes and face, they are if anything probably more qualified than less focused specialist.

    Thank you,

    Dr. Mark Hamilton

  • Reply
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