The Beauty of Botox
It's Makeover Monday!! So here it is...
You asked she answered! What you've all been waiting for, an exclusive interview with DFW's most sought after injector, my co-worker, and dear friend...
Sonya M. Ellis, RN, BSN, CANS, CPSN
1. Is Botox safe?
Botox cosmetic and other neurotoxins such as Dysport and Xeomin are the most popular cosmetic procedures in the world and are very safe in the hands of an experienced injector.
2. What should I look for in an injector?
Always make sure to check your technician’s credentials and make sure they or their Medical Director are a Board Certified Plastic Surgeon or Dermatologist. In my opinion, other fields should not be doing cosmetic Botox (i.e. your family dentist/OBGYN/or podiatrist). You can also look for specialization credentials such as mine. CANS means I’ve tested to be a Certified Aesthetic Nurse Specialist and CPSN means I’ve tested to be a Certified Plastic Surgery Nurse.
3. When should I begin Botox? What are the benefits of starting earlier as opposed to later in life?
It’s funny, I have completely changed my thought process on this over the past 5 years. I use to tell 20 year olds to “get off my table” that their wrinkles were not bad enough to warrant injections. Now all I can think is, why would we let the wrinkles get deep before we fix them? I can inject a 20 year old with a lot less Botox, get a fabulous result, and they just don’t get the chance to age as fast as my ladies I don’t see until 40. We do have to take a break during pregnancy and breast-feeding, but we always get them right back on track as soon as possible so we don’t lose much ground.
4. What if any are the side effects?
The most common side effects include swelling or bruising at the injection site, headache or flu-like symptoms. The medication may also spread too far and cause problems such as:
• Eyelid droop
• Cockeyed eyebrows
• Crooked smile
• Vision problems
5. How does Botox differ from Dysport and Xeomin? And what is the average cost of each?
A well-known company called Allergan distributes Botox, and the average cost is $12-15/unit in the DFW area, if you can get it cheaper than $10/unit, I would worry about that. Allergan is the #1 distributor of any neurotoxin, Botox has been around the longest and has the most proven track record, it works with my injection style and that is why I choose to use it.
Even though I’ve injected every type of neurotoxin, I don’t keep Dysport and Xeomin in my closet because I prefer to use one neurotoxin for all my clients. However, last I checked these were the average cost for the other neurotoxins on the market.
A company called Galderma distributes Dysport and it ranges around $4-6/unit (before you think you’ve found a deal, remember, it takes 3 units of Dyport to equal 1 unit of Botox (a 3/1 ratio), so they end up being about the same price). Since Dysport is more volume sometimes it’s a better neurotoxin for people with “thicker” muscle beds (think men), however, since there’s more volume, there’s also more chance for the neurotoxin to spread to areas it shouldn’t go and that can increase the chance of side effects too. It’s a great neurotoxin, but this is one of the reasons I choose not to use it. I feel I have more “control” over Botox so I enjoy using it more.
A company called Merz distributes Xeomin, it was the last neurotoxin to arrive at the party. Even though they have the least amount of market share, it’s still a good neurotoxin, but also not as good as Botox in my opinion. It is a 1/1 ratio with Botox, and is currently running around $9-11/unit.
So as you can see most neurotoxins are about the same price, but make sure there is not a max you have to buy or watch the centers that charge per area, I don’t think that structure is fair to everyone. You should pay for the units you use, no more, no less.
6. What is an average range of units?
Glabella (area between the eyes) Women12-30 units
Crows feet (around eyes) - 8-24 units
Horizontal forehead lines - 5-16 units
Bunny lines on the nose - 2-6 units
Upper vertical lip lines (smoker’s mouth) - 2-8 units
For a gummy smile - 2-4 units
Nefertiti Lift (picks up corners of the mouth) - 2-8 units
Mentalis (chin dimpling) - 4-8 units
Masseter (slim down thick lower cheeks) – 8-30 units
Platysmal Bands (bands that pop out down the neck) – 10-40 units
I know what you are saying, Sonya, these are big ranges? How do I know how much you are going to use on me………that’s just it, no technician can tell you that until they assess your face. We can give you these big ranges, but we need to customize a treatment plan that will suit your face and your face alone. Also men (or women with a thicker muscle bed) usually need more units for the treatment to be effective, so be prepared if that is you. I’m in this category as I use 62 units on my full face. However, most studies show that women are happiest when they use around 40 units for their full face.
7. When will I see my results? How long do they last? What is the maintenance?
This is where most technicians mess up on education. Results from your treatment will normally be seen in 3-7 days but can take up to 14 days for a final result. I believe in free touch ups, especially with the first treatment as the technician needs to “learn” what your face likes.
If you come in during your 20’s with small fine lines and wrinkles, it’s going to take less units to treat you, the treatment will last longer and you will respond quicker. However, if you wait to start Botox until the wrinkles are well established, I usually warn these clients that although they will see a marked improvement with each treatment, it won’t be until the 3rd or 4th treatment for a great result. “The wrinkle didn’t get there overnight – we aren’t going to get it out overnight.”
Most Botox treatments last around 3-4 months, if you are lucky up to 6 months. I prefer to use a lighter hand with my Botox injections and see the client more often for a “natural” look. More Botox is not always More Better.
8. What is the "Beauty of Botox" and why should I have this done?
I cannot think of one beauty treatment that works as well and as fast as Botox for wrinkle reduction even though some think the price is high. Studies show that women spend $2-4K a year on their face whether the treatments work or not, and I can almost give you a 100% guarantee that Botox works if enough is used, on an appropriate schedule and put in the right place by a good technician. Now this is not an announcement to stop all other beauty regimens and go blow your budget on Botox, we can’t fix everything with Botox and I like for you guys to save a little money for Retin A, Lasers/Chemical peels, Microneedling/Epidermal leveling, Fillers and Facials. I tell my girls all the time, you work on top of your skin, I’ll work down below your skin and we will meet in the middle faster.
9. What do you love most about your job?
I get to make a difference in my patient’s lives all day long. I know part of what I’m doing is purely for aesthetic purposes, however when someone feels better about themselves because they look better and you helped with that, there is something supremely satisfying to your day. I also like to have a relationship with my clients, still professional of course, but when you know someone really well, I feel like you are going to do better work for them, you know what they like, what they don’t like and they are happier with their results because of that partnership you have developed with them and their face.
Photos: courtesy of Allergan.
