BOTOX
Complimentary Consultation

Botox is the cornerstone of most cosmetic practices. It is what many clients seek to provide a more relaxed and revitalized appearance. It provides quick, safe, and simple cosmetic enhancement without surgery. It really makes a wonderful difference but in such a way that other people often don't know that you had it done. Most commonly, others may comment that you look so relaxed and ask if you just came back from vacation. Or they may say that you look so well rested and bright or ask if you just had your hair done.  It looks very natural.

Clients are often not trying to look younger, they just want to look as good as they feel.   Some clients compare it to colouring their hair or buying a nice outfit, "it's about looking and feeling your best, it gives you confidence, it helps you to achieve".

Botox is often used for cosmetic enhancement and prevention of future cosmetic concerns. For example, brow lifts can enhance the eyes, treatment under the eyes can open up and brighten the eyes, the jaw line can be softened for a more feminine angle, the sad or down-turned smile can be uplifted, and lines on the neck can be diminished.  Prevention is also a priority for many people. Strong muscular contractions can permanently crease the skin over time so starting BOTOX® Cosmetic before this happens will "stop the clock" and prevent permanent wrinkles in certain areas. 

The most common areas to be treated are the frown lines between the eyes, and the crow's feet around the eyes. Other uses of Botox including the lower face and the neck can be safely and effectively done with highly trained professionals.  It is important to ask your clinician about their level of experience in all uses of Botox.  Consistent treatment by the same clinician and follow up appointments are also very important.  Dr. Wong performs all the injectable procedures herself at glow Medi Spa, including Botox treatments.  Photos are a crucial part of your treatment record and it also helps you to objectively assess the results too.

Most clients are nervous before they have their first treatment and that is normal.  After your consultation you should feel comfortable with your clinician and with your decision to have a treatment.  Being well informed, having your questions or concerns addressed, having minimal or no discomfort, and having excellent results with an experienced injector usually puts clients at ease.  Come in for a complimentary consultation and find out how Botox can make a positive difference for you.  Here are some questions that commonly arise.

COMMON QUESTIONS ABOUT BOTOX:

What is BOTOX® Cosmetic?
BOTOX® Cosmetic is a treatment for wrinkles caused by repeated movements.  It can also be used for cosmetic enhancement.  It is a purified protein from the clostridim botulinum bacterium that is manufactured in a lab.  It is very precisely dosed in very small amounts.  It is injected into the muscles with tiny needles.  It acts by blocking the nerve signal from the nerve to the muscle and relaxes that muscle.  Only the muscle that is being treated is affected.

Is it Safe? Is it toxic / a poison?
Botox is very safe and has been approved and proven safe for 20 years.  In fact, it is used in children as young as two years old to treat medical conditions such as tight muscles. The amount used for cosmetic treatments is much smaller than what is used to treat medical conditions. 

How much does it cost?
The cost can range depending on the area treated and the dose required. Typically it can range from $350 and up but in the consultation you will be informed of the exact price since it is customized for your needs.

How does it work?
Botox works by simply relaxing the muscles underneath the skin to create a smooth and refreshed appearance.

How long does the procedure take?
Our initial consultation usually takes about 30 minutes. The actual procedure takes approximately five minutes. It is very quick and simple.

How quickly does it work?
It can take up to two weeks for it to take full effect.

How is it done?
It is injected with a very tiny needle similar to the size of an acupuncture needle.  At glow Medi Spa, we use the smallest needles available (31G).  Each injection takes only a couple of seconds.

Does it hurt?
Most clients say it only feels like a little pinch or insect bite but everyone is different.  It is important to have a clinician that is extremely gentle and takes the time to make you comfortable.  As mentioned, we use the smallest needles possible so that it is not very uncomfortable. 

Are there any restrictions after the treatment?

For 4 hours after the treatment you should not rub at the treated area, do not lie down, and do not do any strenuous exercise.  This is to reduce the very small risk of ptosis (an eyelid droop) which is a rare possible side-effect when the frown/forehead area is being treated.

What are the potential side-effects?

As mentioned above, there is a very slight risk of ptosis (eyelid droop).  This is very rare (less than 1% when done by an experienced injector).  If this occurs, it is usually mild and lasts a short time (about two weeks).  There are prescription eye drops that can be used to open up the lids immediately and it is used three times a day for a few days until the problem resolves spontaneously.

There is a slight risk of bruising but with good technique and small needles, bruises are not common and usually very small if they occur.  There are tiny red spots that last a few minutes after the injections, but they may persist for a few days.  The spots are easily covered with make up.

Some people may develop a headache or pressure sensation after Botox injections but it is temporary and can be treated with regular tylenol or ibuprofen.  It may last a few days.  Botox is actually an excellent treatment for migraines and headaches.  The initial temporary headache seems to be due to the solution volume injected rather than to the Botox itself.

Another effect to watch out for is the "spock brow".  It is not a side-effect or complication of Botox, but rather a strong pull on the middle part of brows that can occur after having Botox in the frown / forehead area.  It is easily relaxed by an experienced injector with a small dose of Botox.  It is more of a cosmetic concern as it can create an unnatural appearance if not treated.  A follow-up appointment two weeks after your treatment is always recommended to check for these subtle effects and to make sure you are pleased with your results. 

Who cannot have Botox?

Patients that have rare neurological disorders (Guillan Barre or Myasthenia Gravis) are not appropriate candidates for Botox.  As well, pregnant women or women breastfeeding should not have Botox. 

How long do the effects of Botox last?

Botox typically lasts 3-4 months.  In the frown area, the longer Botox is done, eg. if more than a year, and if done consistently, it may start lasting longer.  For some clients, it may last six months or so.  In the frown area, the habit of the frown can be broken with Botox as it gives the muscle a holiday.  Clients often forget how to frown when they've had Botox regularly.

Will the wrinkles come back worse than when I started?
No -- If you decide not to continue your treatments, you will only return back to where it started. Botox simply "stops the clock" for a few months. It's like giving the muscle a holiday.

Will I look fake / frozen / unnatural?
No -- An experienced clinician such as Dr. Wong can achieve a very natural look.  You will simply look more fresh and relaxed.

Can you get hooked on Botox / is it addictive? No - although most people love the results so much they keep coming back for more treatments.  Clients typically complain of looking tired again when their Botox wears off and they miss the refreshed, relaxed appearance they have with Botox.
  
What is the difference between Botox and fillers? 

Botox is used in areas that improve with muscular relaxation.  For instance, in the frown area or crow's feet area, many of the lines/wrinkles are caused by the dynamic contraction of the muscle, so Botox can help to soften these lines by relaxing the muscle pull.

Dermal fillers are often gels that plump up the tissues and can reduce the appearance of lines/wrinkles/folds by fillng in the grooves.  Fillers do not affect the muscles.  Common areas for fillers are the deep lines from the corners of the nose to the corners of the mouth (the nasolabial folds), lips, and cheeks for increasing volume.

Botox and fillers are often used in combination.  For example, for lines around the mouth, Botox can relax the muscles to soften the lines and prevent the progression of the lines.  Fillers can plump up the existing grooves that are deeper and also by outlining the vermillion border around the lips, fine lines can be filled in effectively and naturally.

What areas can be treated with Botox?

There are many areas that can be treated with Botox in the upper and lower face and neck.  Advanced training and a high level of experience is required to effectively and safely treat all of the areas mentioned.  Dr. Wong has extensive experience in advanced Botox techniques.

 - frown lines (between the brows when you furrow your brows to look mad).  The frown is the most common area to be treated.   Most people do not like to be perceived as mad, stressed, or depressed even when they're not.   The frown lines always convey a negative emotion and so clients usually do not miss this expression and neither do others around them.  It does not make you look expressionless to not be able to frown.  The frown creases (#11 lines) are caused by several muscles that push the brows down and together, so relaxing the frown also gives a nice brow lift.  This is what can give you a more relaxed, refreshed appearance, like you were just on a holiday.

- crow's feet (laugh lines around they eyes).  We start calling them crow's feet instead of laugh lines when they start creasing the skin at rest, ie. when you are not smiling.  Some people do not mind these wrinkles as they say their crow's feet gives them character.  Relaxing them does not diminish the radiance of your smile, rather it reduces the lines and creases and refreshes the smile.  It looks very natural.

- forehead lines (horizontal lines across the forehead).  These lines are lines of expression, not necessarily lines of aging.  They start as young as in your teens.  The art of Botox comes into play when treating these lines.  If the forehead is "over-treated", the forehead will be extremely smooth but the brows may not easily go up/down to express elation/surprise.  This is when it may give that "fake" or "frozen" look that can scare away many potential Botox users.  A low dose is often effective to relax the lines but still allow expression so that a more natural look is achieved.

- brows.  Lifting the outer edge of the brows has a very uplifting effect.  Botox can lift the brows about 2mm which is enough to brighten the eyes, take some of the heaviness of an aging lid away, and open up the eyes.  It has a feminizing effect and works best when the frown is done at the same time.  It does not have to be like "Nicole Kidman" brows but a more natural overall lift to the brow is often appealing.

- under the eyes.  Opens up the eyes another 2mm or so by dropping the lower lid.  Brightens the look of the eyes and makes them shine.  It's not for everyone though.  A careful assessment is required as it has the potential to cause dryness of the eyes, typically in clients over 40 years old.  Great for Asian eyes and small eyes too.

- bunny lines (scrunching up your nose creates lines at the side of your nose).  This action is often habitual in some clients and although it may be perceived as "cute", when the creases start occuring at rest, it may bother some clients.  Also watch out for this if you have been using Botox for your frown area.  Some people try to frown still and end up recruiting these muscles instead, so it is referred to as the "Botox Sign".

- gummy smile (if you smile and too much gum shows above the upper teeth).  Botox can drop the upper lip slightly when smiling so that less gum shows.  It is very quick and effective.

- sad smile (a downturned smile).  The corners of the lips can be pulled down by two muscles that extend from the corner of the lip to the jawline.  Over time, this can create "marionette lines", but even when it is mild, it gives a sad appearance.  Botox relaxes these muscles and prevents further progression.  In some, it may create a more neutral or upturned position of the corners of the lips.

- lips (for lip lines or for enhancing the appearance of the lips).  Botox can soften lip lines by relaxing the pursing action of the lips.  It can also give a slight upturn to the lips which gives the impression of a slighter fuller lip (not fish-like lips) which many clients like.  It is not recommended for people that sing professionally, play a wind instrument, or like to whistle.

- chin (for apple dumpling chin which is puckering of the chin or for creasing of the chin).  Relaxes the chin so the crease relaxes and clients notice an improved angle to the chin and make up doesn't get stuck in the crease anymore.  What a relief.

- masseters (jaw muscles).  Botox can be used for sculpting the angle of the jaw.  A square shape to the jaw is often caused by enlargement of the masseter muscles, the ones you feel at the side of your face when you clamp down your back teeth.  The masseters can enlarge by grinding the teeth, frequent clenching with stress or by gum chewing.  Relaxing the muscle with Botox often gives quick relief to tension in the jaw and TMJ pain/pressure.  The cosmetic improvement is not seen for about 2 months after the injections when the muscle actually shrinks.  The jaw line then becomes more tapered, sculpting the jaw to the ideal appearance of an upside down triangle instead of a square.  It feminizes the jaw line.  Asians are typically characterized by a more square jaw line but it happens frequently in all ethnic groups.  Results are often long-lasting.

- neck bands (vertical muscles that pop out when you tighten your neck).  These platysmal bands can pull on the jowls and double chin and cause premature sagging in these areas.  Treating these bands is preventative but also it rejuvenates the overall appearance of the neck.

- horizontal neck lines (natural necklace lines).  These lines are often there since childhood but they can cause the neck to look more aged.  These lines can be reduced with a series of Botox treatments.

Come in for a personal consultation with Dr. Wong to find out how Botox can be tailored to address your anti-aging concerns, prevention, and cosmetic enhancement.  Call us at (416) 920-9998 for a complimentary consultation.