The Truth About Botox

Botox Cosmetic is America’s number one non-invasive cosmetic treatment. It garners great reviews, great results, and affordable access. With its ever-increasing popularity, sometimes we forget a few truths about this mainstream treatment. 

Truth #1: A full treatment is 84 units

According to the studies submitted to the FDA by Allergan, the recommended full treatment is 84 units. 20 units will be used for the glabella (area between and slightly above the forehead) lines, 24 units will be used for crow’s feet and 40 units will be used for the forehead lines. 

FDA study here – link here  –

Truth #2: A full treatment is better than partial treatment.

Can you get fewer units? Yes, patients ultimately choose how much Botox they want. If you are on a budget, we recommend focussing your budget on getting a full treatment in your desired areas. For example, if you only want to spend on 40 units, then you can choose forehead lines OR crow’s feet and glabella. Do not try to spread the units to all areas or you will not get any results. 

Truth #3: 10-15% of patients will not see improvement in facial lines

Like with any medical treatment, results can vary based on biology and results are not always 100% predictable. The study linked above treated subjects with the full dose of Botox and assessors graded line improvement. What they observed was that 10 – 15% of subjects had no noticeable improvement. 

Truth #4: 57% of patients will be satisfied with their treatment

Even with optimal dosing, Botox Cosmetic will achieve desired outcomes 57% of the time. The study doesn’t go into why patients aren’t more satisfied with their treatments; However, our collective experience can perhaps shine some light. We recently spoke to a patient who was curious about Botox Cosmetic because she had a few lines on her forehead. Her question was “Will Botox Cosmetic help with this line?”. After asking her to do a few expressions we observed that her forehead lines were creased. This means that even without expression, the line is still visible. In this case, Botox Cosmetic will not help erase those lines. It will help prevent new lines from forming but creased lines will not see any improvement. We believe there is a disconnect in what and what cannot be accomplished with Botox Cosmetic.  

If I do have creased lines, what can I do about it? 

Improving your creased lines is accomplished using one principle: force your skin to produce more collagen to repair itself. Luckily, there are various ways to stimulate collagen production:

  • Topical Retinoids or Niacinamide. These topical products work by speeding up the cell turnover process from the bottom up. After several months of usage, the result is new skin on the topmost layer of your skin.
  • Laser Resurfacing. Laser resurfacing works by buffing away the creased lines using an intense laser. Keep in mind that this is a very intense treatment where great care must be taken in the healing process.
  • Exfoliation. Similar to the laser option above but much more mild and uses a mechanical device versus a laser. A common treatment is microdermabrasion. Although effective over the long run, it will take a year’s worth of consistent microdermabrasion treatments to achieve the same results as the laser option listed in point two. 

The last piece of advice for patients looking to improve creased lines is the following: 

Combination treatments work best!

The best results and the most satisfied patients approach creased lines with a combination of topical products, laser resurfacing, and exfoliation treatments. Improving creased lines takes commitment, consistency, and science. 

If you have any questions, please contact us.