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Frequently Asked Questions

Select an injector who knows what he/she is doing - Good Botox depends on the skill and technique of the Botox injector.

Refrain from having Botox - if you suffer from any Neuromuscular conditions such as Myasthenia Gravis or Easton-Lambert syndrome; are pregnant or nursing.

Be aware - that some tenderness, bruising, temporary headaches can occur however typically resolve quickly.

Report any serious and or immediate allergic reactions - These reactions include itchy rash, swelling, and shortness of breath. Get medical help right away if you are wheezing or have asthma symptoms, or if you become dizzy or faint.

Be transparent with your injector - For your safety, tell your injector as much about your medical history and medications as possible so he/she can determine whether you are a good candidate to receive cosmetic Botox. Tell your injector: What medication, supplements, herbs, etc. you are taking What allergies you have If you have any medical conditions, illnesses, or diseases If you have or will have any medical procedures (i.e. recent Botox, surgery, other treatments, etc.) If you are pregnant, breast-feeding, or trying to conceive Anything else you can think of

Tell your injector if this is your first time getting Botox - Some injectors may be more conservative with first time Botox patients to gauge how the patient will react to the Botox and to give a better long-term result.

Make sure Botox is the right treatment for you - A reputable and experienced Botox injector will know what Botox can do for your skin and what it can't. For instance, you may be better off getting fillers instead of Botox for certain wrinkles on your face, so make sure you and your injector discuss the best therapy for your skin issues.

Ensure your injector understands your preferences - Make sure both you and your injector are clear about what facial areas you want to treat, how you ideally want them to be fixed, and what the ideal result may be. Different people have different aesthetic preferences. For instance, some people prefer little to no movement in the treated area, others prefer maintaining expression; both are fine –just be clear which you prefer!

Have realistic expectations about what Botox can do - Botox results can be drastically good, but your post-Botox results may not be as perfect as you expect them to be. Having realistic expectations about your results will save you from unnecessary disappointment.

Be aware – You may have small reddish bumps that can last a few minutes to an hour post injection.

Stop taking medication that can “thin” the blood (unless prescribed by a physician) - A week before you get Botox injections, avoid: Alcohol Aspirin or NSAIDS (Excedrin, Advil, Aleve or Motrin) St. John's Wart Vitamin E Fish oil or Omega-3s, Ginko Bilboa or Ginseng. This will minimize any potential post-Botox bruising. If you must take pain medication, Tylenol is okay.

Don’t stop taking any prescribed medication (even ones listed above). While your injector wants to avoid bruising you, it is better to have a few small bruises than interfere with your health.

Don't be afraid to ask questions. Make a list of questions you want to ask your injector and bring it with you to your Botox consultation. Ask how much the treatment will cost, how many units of Botox you will need. Ask about side effects, risks, and how you should take care of your skin after Botox and how often someone with your skin condition should get Botox.

At your appointment, bring your wrinkles; we will take care of the rest!

If you desire; just make sure no one is looking! A typical drive home in Houston traffic will cause plenty of facial expression. Some injectors believe BOTOX® may work faster with contraction of the targeted muscles, but it will work fine either way.

With BOTOX® you may return to normal activities right away since bruising and swelling is minimal and, although rare, typically would only last a couple of days. However, you should consider that it takes at least few days to see any improvement, and up to two weeks for the full effect. So schedule your appointment accordingly, 2-4 weeks in advance of your big event for best results!

Your result depends on the skill and knowledge of your injector. Feel free to ask any questions that you may have at your consult.  Some important factors to consider are:

  • Your injector’s medical expertise in facial anatomy. For instance, does your injector specialize in the field of aesthetic medicine or is your podiatrist doing BOTOX® on the side once or twice a month?
  • Do they only offer BOTOX® or do they also inject fillers? BOTOX® has limitations and is not a panacea for lost volume or deep static wrinkles.
  • How many years of experience do they have injecting BOTOX® and what percentage is dedicated to aesthetics?
  • Do they schedule a follow-up visit after treatment?
  • Do they charge for tweaking at the follow-up appointment after your initial injection?
  • Did they make you sign-up and pay in advance for multiple treatments or join a program with recurring monthly charge?

Be prepared to tell your specialist about any medical conditions, including any prescription medications, vitamins, or herbal supplements you are taking.

A "unit" is an arbitrary measurement of strength to calculate and record dosage, as determined by the manufacturer, Allergan. BOTOX® will be charged per unit as well.

It is important to note dosing units differ between other wrinkle relaxing (neurotoxin) products such as Dysport or Xeomin. Dysport typically will take 3x more units than BOTOX®, and therefore will always be advertised at a lower price per unit, which seems enticing, but since you will need 3x more, is typically about the same overall cost.

How many units will be required is dependent upon the strength and size of muscle being injected, how many areas you want treated as well as the degree of relaxation you prefer. Some patient's prefer a touch a of residual, natural motion, requiring less units, others demand absolutely no motion after treatment which will take many more units. 

Typical dosages by area for BOTOX® are:

  • Glabella (The "11's") 15-50 units
  • Forehead 10-25 units
  • Crow's Feet 7.5-25 units
  • Bunny Lines 5-20 units
  • Smokers Lines 5-10 units
  • Platysmal Bands (Neck) 10-50 units

BOTOX® is freeze dried and must be reconstituted with sodium chloride prior to injection to make it into a liquid. It can be diluted differently to vary it's effect and spread, so the injection volume may vary but the number of units would be the same, regardless of dilution.

BOTOX® Cosmetic should only be administered by an experienced doctor, cosmetic surgeon, or aesthetic nurse injector. Be cautious of aestheticians and medial assistants injecting as they may not appreciate the importance of muscle anatomy or sterile technique/contamination. New regulations in Texas require direct physician oversight of any non-physician injectors. A board certified plastic surgeon has the training and the experience to make sure that a BOTOX® injection is done correctly. As fully trained plastic surgeons, they have a far better understanding of facial anatomy and muscle function, and any injection staff at Bancroft Feldman Plastic Surgery has been personally trained by, and is held to, Drs. Bancroft's and Feldman's high standards.

BOTOX® works by inhibiting the nerve impulse at the targeted muscle, thereby relaxing it so that it is unable pull the overlying skin, thus reducing, or eliminating lines and wrinkles caused by muscle contraction.

You may resume normal activities immediately after your treatment with the following considerations in mind:

  • Avoid bending, lying down, straining or exercise for at least 4 hours after treatment
  • Do not massage the injection sites as this can cause the BOTOX® to spread beyond the intended target area and result in undesired effects such as drooping of the brow, eyelid, or mouth, etc.
  • Refrain from getting facials or massages for 24 hours after your treatment
  • Avoid wearing a cap or hat for 24 hours after treatment

Most rate it a 1-2 on the scale of 1-10. It is often described as a “mosquito bite” or "pinch". In comparison, it will be far more pleasant than a bikini wax, and you will LOVE the results.

BOTOX® has been used medically since the 1980’s and is approved for use in over 75 countries. It is an extremely safe treatment.  Most individuals tolerate it quite well. There is very little chance of allergic reaction, discomfort is minimal and occasionally pin point bruising is experienced from the procedure. Mild raised bumps are common immediately after your injection and resolve within few minutes after injection. It's important to note this is a highly purified toxin, in very controlled amounts being injected, not the actual botulism organism.

BOTOX® Cosmetic is an injection of purified botulinum toxin (onabotulinumtoxinA) that reduces wrinkles by relaxing muscle activity. Wrinkles only present during animation (muscle contraction) typically will be completely smooth. Those deeper wrinkles that are present at rest, may soften, but will remain after Botox. In that case addition of a filler may further reduce static wrinkle. Realistic expectations and the best product for your goals will be discussed during your consultation.

What to do BEFORE Botox

Select an injector who knows what he/she is doing. Good Botox depends on the skill and technique of the Botox injector.

Refrain from having Botox if you suffer from any Neuromuscular conditions such as Myasthenia Gravis or Easton-Lambert syndrome; are pregnant or nursing.

Be aware that some tenderness, bruising, temporary headaches can occur however typically resolve quickly.

Report any allergic reactions to your provider immediately. These reactions include itchy rash, swelling, or shortness of breath. Get medical help right away if you are wheezing, have asthma symptoms, dizziness or feel faint.

Be transparent with your injector. For your safety, tell your injector as much as possible about your medical history and medications so he/she can determine whether you are a good candidate to receive cosmetic Botox.

Tell your injector: What medication, supplements, herbs, etc. you are taking. What allergies you have. If you have any medical conditions, illnesses, or diseases. If you have or will have any medical procedures (i.e. recent Botox, surgery, other treatments, etc.) or if you are pregnant, breast-feeding, or trying to conceive.

Tell your injector if this is your first time getting Botox. Some injectors may be more conservative with first time Botox patients to gauge how the patient will react to the Botox and provide a better long-term result.

Make sure Botox is the right treatment for you. A reputable and experienced Botox injector will know what Botox can do for your skin and what it can't. For instance, you may be better off getting fillers instead of Botox for certain types of wrinkles on your face. Make sure you and your injector discuss the best therapy for your skin issues.

Ensure your injector understands your preferences. Make sure both you and your injector are clear about what facial areas you want to treat and what the ideal result may be. Different people have different aesthetic preferences. For instance, some people prefer absolutely no movement in the treated area and others prefer softening at rest, but maintaining the ability for dynamic muscle expression. Both preferences are perfectly fine - just be clear which you prefer!

Have realistic expectations about what Botox can and can’t do. Botox results can be amazing for the right indication, but Botox can't fix everything. Having realistic expectations about your results will save you from unnecessary disappointment. Be sure to discuss what this with your provider.

Be aware that you may have small reddish bumps at the injection site that can last a few minutes to an hour post injection.

Stop taking medication that can “thin” the blood (unless prescribed by a physician) two weeks before your Botox treatment to minimize any potential post-Botox bruising. If you must take pain medication, Tylenol is okay.

Avoid:

  • Alcohol
  • Aspirin
  • NSAIDS (Excedrin, Advil, Aleve or Motrin)
  • St. John's Wart
  • Vitamin E
  • Fish oil or Omega-3s
  • Ginko Bilboa
  • Ginseng. This will minimize any potential post-Botox bruising. If you must take pain medication, Tylenol is okay.

Don’t stop taking any prescribed medication (even ones listed above) unless your prescribing doctor has approved it. While your injector wants to avoid bruising you, it is better to have a few small bruises than interfere with your health.

Don't be afraid to ask questions. Make a list of questions you want to ask your injector and bring it with you to your Botox consultation. Ask how much the treatment will cost, how many units of Botox you will need. Ask about side effects, risks, and how you should take care of your skin after Botox and how often someone with your skin condition should get Botox.

What to do DURING Botox Appointment

What you do during Botox is not as important as what you do before and after Botox, but here are some things you should keep in mind for a good treatment session:

Go au naturel. Your skin will be cleansed with rubbing alcohol or an antiseptic before you get Botox, so feel free to show up to your appointment with nothing on your skin. If you wear makeup to your appointment, it will be removed at the treatment area.

Relax! The Botox treatment will be over before you know it. Stay still, don’t tense up, breath and just try and relax.

What to do AFTER Botox

What you do after Botox and how you take care of your skin is very important. Here are some things you should and shouldn't do after getting Botox injections:

Don’t rub or massage the treated area for 24 hours! Rubbing or massaging could cause the Botox spread to other unintended muscles.

Don’t exercise the same day after your treatment. It is best to avoid strenuous physical activity for 24 hours.

Avoid consuming alcohol for several days. Alcohol can increase your risk for bruising.

Don’t get facials, chemical peels, microdermabrasion, etc. for 24 hours. Lying on your face or muscle manipulation can cause the neurotoxin to spread to unintended muscles.

Don’t take the blood thinning medications, herbs or supplements mentioned above. It is best to avoid the for several days post treatment.

Don’t wear hats or headbands for at least 24 hours. The pressure/tension could cause migration of the neurotoxin

Avoid bending over or lying down for 4 hours after your treatment.

Apply a topical vitamin K and arnica ointment should you get a Botox bruise. Green or yellow concealers can also help cover up the bruises.

Go back for your two-week follow up appointment. At your follow up appointment, your injector may determine that a touch up is needed.

Do not hesitate to communicate to your injector if you are dissatisfied with your results. Your injector wants you results to be as amazing as you do and most often with a simple tweak can address any concerns.

Call your injector or seek medical attention if you experience any complications from the Botox treatment.

The effects of BOTOX® Cosmetic vary with each person but typically last 3-4 months. Factors that influence duration are:

  • Age
  • Lifestyle (alcohol intake, smoking, and exercise)
  • Skin condition and degree of sun damage
  • Severity of wrinkles
  • Strength of muscles injected
  • How many units were injected
  • Antibodies against Botox

We recommend you plan on coming for re-treatment every 3 months to maintain your most refreshed look and best result!

A few of the most common areas treated at Bancroft Feldman Plastic Surgery are: 

  • Forehead Lines
  • Glabellar Lines (the area between the brows commonly referred to as the 11’s)
  • Crow’s Feet (the area around the eyes)
  • Bunny Lines (wrinkles on nose)
  • Smoker’s Lines (wrinkles around the mouth/lips)
  • Frown Lines (down-turned corners of the lips causing a frown)
  • Platysmal Bands (the neck)
  • Under arms, palms of feet & hands (for the treatment of hyperhidrosis, or excessive sweating)

You can exercise 24 hours after receiving a BOTOX® Cosmetic treatment. While scientific data lacks sufficient studies to support this theory, it is believed exercise increases cardiac output and blood flow, the increased blood flow to the injection site may cause migration. This could potentially diminish the results of BOTOX® or even worse, it may travel to an unintended muscle and have undesirable results.

 

Mild redness and small raised bumps are expected immediately after a BOTOX® treatment. This will resolve in as little as a few minutes to an hour after injection. If you notice swelling that is significant or has increased after receiving your treatment, and leaving the office please contact our office at 281.313.0540.

BOTOX® Cosmetic is a treatment that treats wrinkles caused by animation (muscle contraction)

  • Smooth the wrinkles in your forehead or around the mouth
  • Erase the frown lines between your brows (often referred to as the 11’s)
  • Soften or erase crow’s feet (the wrinkles around your eyes)
  • Reduce the smile lines
  • Improve expression by correcting downward pulling of the corners of the mouth
  • Improve bunny lines (wrinkles at the bridge of your nose)
  • Treat hyperhidrosis (excessive perspiration in axilla area, palms of hands and feet)
  • Treat chronic migraines

Dermal fillers (e.g., Juvederm and Restylane) do not affect the muscle movement but replace volume loss or restore facial symmetry by expanding deflated tissue. They can also be used to treat deep wrinkles at rest that Botox can only soften. Fillers can:

  • Create sexy, full, plump lips
  • Enhance and fill out facial features (lips, cheeks, temples, chin, and other areas that lose volume as we age)
  • Reduce deepened or prominent nasolabial folds (the lines that develop from the sides of your nose to your mouth as we age or lose weight)
  • Smooth wrinkles that do not fully respond to BOTOX® treatment (such as deep 11’s or vertical smoker lines on lips)
  • Fill acne and chicken pox scars and smoker’s lines around the mouth 
  • Restore facial symmetry (e.g., straighten the appearance of a mildly asymmetrical nose or lip)
  • Improve the appearance of aging hands by restoring volume

Botox and fillers compliment each other and when administered together, amazing results can be achieved with minimal downtime. However, they do have limitations and cannot achieve surgical results. Therefore, having realistic expectations is paramount and will be discussed at your consultation. Keep in mind that while all aesthetic treatments can improve your look, it does not replace a proper skin care regiment. Your injector should discuss what products you are using at home on a daily basis and may make recommendations to achieve the best possible outcome.

Yes, you may safely touch the area after a BOTOX® treatment, apply makeup or wash your face however, it is important to refrain from rubbing or massaging the treated areas, as BOTOX® could migrate to an unintended area.

 

Safety is paramount at Bancroft Feldman Plastic Surgery and while we understand the desire to look and feel your best during and post pregnancy, we are unable to treat a pregnant or breastfeeding mothers as there have not been studies performed to support its safety. It's not worth the risk.