Botox injections are the most popular cosmetic procedure performed worldwide.  Millions of patients are injected each year with the wrinkle fighting drug.  Its popularity is attributed to:

  • There is minimal downtime – 15 minutes of bumps from the injection
  • The procedure is highly effective in improving wrinkles
  • Discomfort is usually minimal
  • Side effects are few and rare
  • Cost is fairly reasonably, but depends on how many areas are done
  • The time it takes to get a treatment is less than 10 minutes

So why is the “Was it Worth It” review on Realself.com for Botox only 69%?  This can be attributed to multiple reasons, which be further elaborated upon in this blog.  (A large volume practice should have a satisfaction rate in the >95%.)

Although the Botox procedure looks very routine to the observer/client, don’t equate this to being a simple procedure that all injectors can master easily.

All patients will age differently, so what areas need treating for optimal cosmetic results needs to be tailored specifically to each patient.  A cookie cutter approach to every patient will not work.  There are several areas of the face which can be considered advanced:  lips, corners of mouth, neck, gummy smile, under eye, bunny lines, inner eyebrows which require a highly trained and experienced injector, or you will live with a disfiguring facial appearance for 3 months.

The trend is moving away from the frozen, no movement, very obviously treated face to a more natural appearance.  Rather than blasting and overwhelming the forehead with Botox, a technique using very small, precisionly placed aliquots that  allows for movement but with diminished wrinkles.  This is a more difficult technique to master.

Shortcuts are often routine in regards to Botox.  A majority of practices will draw up syringes of Botox in the morning, or the day before, by a nurse, medical assistant, or office staff.  That means the patient will need to get injected in multiples of what is contained in a syringe, leading to limited customization.  Also, errors in dilution and sterile technique are possible when filling the syringes is not done by the same person that is injecting the Botox.  (Botox comes in a powder form and needs to have saline added to reconstitute it to become an injectable solution.)  Dr. Weiner mixes all his Botox personally, and will draw up the appropriate amounts for each patient in the room, just prior to injection.

Discomfort related to the injection can be minimized using various techniques.  Using preserved saline has been shown to result in less pain than using regular saline.  Needle size, speed of injection, and using proper needle placement is also a key factor affecting comfort.  Dr. Weiner also uses several distraction techniques, capitalizing on the Gate Theory (the brain has difficulty processing more than one sensory input at the same time).

Varying the concentration of Botox is a technique Dr. Weiner has used for years.  Certain areas require different dilutions to lead to maximal cosmetic benefits.

Touch ups to correct minor imperfections require an advanced injectors experience.  They also need a responsive provider, easily available for a drop in or work in patient.

Getting injected by an unknown provider at someone’s Botox party, is never a good idea, and almost  always leads to problems that one has to live with for 3 months.  The “savings” never is worth it.

Although Botox is extremely popular, as the Realself.com stats show, there are many people that are not pleased with their experience.  This is not the norm for the high volume, experienced injector.  As explained above, there are many intricacies which can contribute to better results. Hopefully the public will understand that Botox should not be considered a routine cosmetic procedure, and they need to select their providers carefully.

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