When you are considering Botox® injections (facial expression weakening/paralysis), consider the following issues which should be part of every procedure consent for this cosmetic treatment. These include issues of Treatment Areas, Outcome of the procedure, Risk and Complications, and the all-important understanding of what the costs will be.
What specific areas are going to be treated? While the forehead and the area between the brows(glabella) are by far the most common, other areas could include the crow’s feet (side of the eye), upper and lower lips, corner of the mouth, and neck areas.
What type of results can I expect? Usually the benefits of the injections may take up to a full week to be seen. The results will not be immediate and the onset of the injections will start in a few days. Understand clearly that Botox® is not permanent and that the treatments will need to be repeated every 3 to 4 months for the results to be maintained. Also, there is some slight variability between patients in terms of how much the expression will be weakened and how much Botox®, in units, that it will take to achieve the best result. If you do not have enough expression weakening two weeks after the treatment, you may need more Botox® units.
Every cosmetic procedure has some risks and complications…Botox® is no different. Minor issues include the possibility of some mild injection site bruising and a headache (if done in the forehead) for a day or two. Every now and then I see a patient who does not get much muscle weakening from the treatment. This almost always is a reflection of the strength or age of the Botox and I, in my practice, repeat the injections for free. Usually, however, when a patient says they do not see a result….it turns out that they are not seeing as much result as they thought they would. Some patients expect total paralysis or freezing of the entire injection zone which may not be realistic given the number of units that were injected and for what they were willing to pay for the treatment. The most dreaded Botox® complication is that of drooping of the upper eyelid after treatment. This can occur if the injection were done too close to the eyebrow (where Botox® can drift down into the upper eyelid) or too much liquid volume was put close to the eyebrow area. This is a complication that I have never seen (nor do I want to!) as it will last for months until the effect wears off. The secret to avoiding it….don’t inject too close to the eyebrow!…stay high.
Lastly, know what you are going to pay in advance. There is no sense in ’sticker shock’ when you get to the front desk after your injection session. Experienced Botox® injectors know in advance how many units they are going to inject for each area. They should share that with you, and you should know to ask, before you get the treatment. Botox® is charged by the unit so the price is predictable in advance, plus or minus twenty or thirty dollars either way.