A Dr. discusses “Botched Botox” disasters on the internet

There are many examples of bad outcomes from cosmetic procedures on the internet, just Google it. Some of these sites seem to have fake photos – pictures that have been “photoshopped” to make them look worse, many are not examples of bad Botox, but bad everything – filler, surgery and Botox.

Photo from news.com.au

Frozen Face?

Why am I writing about this? Questions about “Frozen Face” or “unnatural look” are very common with first time Botox clients. At Mountain Radiance Medical Spa, I specialize in natural look with a significant eye toward the concept that “less is more”. The most common error of injecting Botox is the use of too much of it. The second most common error is injecting in the wrong place – mistake of “newbie” injectors or those who don’t do it very often. I am frequently asked if plastic surgeons aren’t the best people to inject Botox, they are after all, surgeons. Well actually surgeons are usually doing surgery and don’t actually inject much themselves. Frequently, at a plastic surgery office the RN will be “in charge” of doing injections.

What is the right amount of Botox?

People also ask frequently, “How much is the right amount?” I like to tell them it is hugely variable from patient to patient. The only area that is relatively constant is the forehead which normally takes about 10 units of Botox spread between 5 tiny injection sites. Even this can vary with the range generally being from a low of 6 to a high of 14 or even 16 units.

When you move to the area between the eyebrows, the “angry lines” or “elevens” this really is hugely variable with new customers needing between 15 to 30 units (delivered in 3, 4 or 5 tiny injection sites).

What is the range of Botox for the “total face”? Again, this varies tremendously from client to client. About 25% of our clients at Mountain Radiance in Asheville, NC are under the age of 30, and they generally need much less treatment than older clients. Of course, many of our clients are over 50. Sometimes a client who has never had Botox around the age of 50 or 60 who has a lot of sun damage or who has the bad luck to have genetically strong wrinkle muscles may need as much as 70 units if we are treating forehead, angry lines, crows feet, and raise the eyebrows. I know this seems like a lot, but it is the correct amount for some clients who have neglected their skin! Having said that, the average client presenting for just forehead and “angry lines” is 35 units.

Some practices charge fixed price to treat certain areas such as $xx to treat the forehead and $xx to treat the angry lines. Again, I feel it is more appropriate to charge for the amount of Botox each individual person may need because some need less and some need more, so customization for the individual is obviously the best way to go.

This question – how much Botox is the right amount is kind of like asking “how long is a piece of string?”. Every situation is different and the best answer to that is to see your experienced provider and have them make recommendations.

Please contact my office if you’re interested in learning more about Botox in Asheville, we’d love to schedule your complimentary consultation.

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