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.
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?
Sources, related articles and resources
- RealSelf.com
- Skin Tour.com/Dr. Brandith Irwin
- Beauty Junkies: Getting Under the Skin of the Cosmetic Surgery Industry by Alex Kuczynzki
- BOTOX Cosmetic
- Woman Accused of Giving Botox Injections Without License (WPBF.com)
- Can Botox Make You Look Older? (bellasugar.com)
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.
Great build on interviewing your doctor. So many assume you’ll get injected right then and there. Thanks for taking a read!
Becca
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
I’m lucky to have an excellent doctor who is an expert at injections. I wish I had found him 10 years earlier!
It’s great to find a good doctor. I’ve found it’s a lot of trial and error!
Hi Debbie , is it possible for me to have your doctor’s details ?
Thanks
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.
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:)
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.”
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…
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
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.
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
Gigi, it’s a shame that some nurses are cheating patients out of the true Botox. TOO much saline and no results.
Are you in the New York area .. If so what’s your address …
Saleem, were you asking me or the prior commenter?
I have a physician assist do my injections and she does a fine job
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!
That’s true, it does. It also helps underarm sweating.
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
Ha ha “Ahnold”…thanks Clara.
Becca
Your honesty shall serve as a road map for others…
I hope so, its a more confusing path that it seems on the surface
Becca
Great info and great timing- I’m about to lose my Botox virginity very soon!!
Glad it helped! Let us know how it goes. Good luck (and it doesn’t hurt that much at all)
Becca
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!
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
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 …
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
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
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?
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?
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
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.
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
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
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
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.
it really doesn’t hurt at all and believe me I hate needles !
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.
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
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.
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
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.
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.
Thanks for your information. I am looking for a good doctor also. So can you tel me your doctor’s name in Manhattan. Thanks!
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.
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.
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.