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The 5 Most Common Botox® Misconceptions

Gemma Montgomery Skin Care Specialist

1. I’ve had Botox ® but you can still see a line.

Gemma’s explanation : 

Botox® injections will only work on wrinkles in motion. In other words, lines that appear when you frown, smile, or raise your eyebrows. If you look in the mirror and can see visible lines when your face is rested and not expressing, then you have static lines.  Botox® will not get rid of these type of lines, only at best soften.

Gemma’s solution :

I’m clear about setting expectations with clients during consultation. This means highlighting static lines, poor skin quality and Botox® limitations. Also the fact that the client may still be able to see the lines after treatment. The key is complete honesty forming a relationship with clients going forward. This means working out a clear treatment strategy going forward. For instance, I may be able to treat these stubborn lines of concern with additional or combinations of other treatments along with medical skincare regimes. Sometimes after having Botox ® treatments over several sessions, static lines soften fantastically.

This is where the term ‘I’m having treatment for prevention’ came from. Whilst I don’t advocate treatment at a very young age, treating with lower doses and sensible time frames between each treatment, is an option for those starting in their 30’s.

2. I want to get rid of my lines but don’t want to be frozen.

Gemma’s explanation :

To soften or erase lines with Botox ®, there has to be some restriction in movement, that’s simply how Botox® works. Although it must be said that Botox® doesn’t actually freeze the muscle. It cleverly works by temporarily blocking the chemical acetycholine that tells our muscles to contract. This effect is temporary and the receptors grow back after several months, with full movement returned.

The less restriction in movement there is, the more natural the result will be, the trade off for this will be that there may still be lines visible.

Gemma’s solution :

My ethos is about looking good for your age, natural and fresh. I pride myself in being able to administer Botox® where my client is happy with the degree of line softening, but still maintains a very natural soft look. I do this by this by adapting the injection points and amount injected per point.

Of course some patients do still prefer minimal movement and the less a line visible the better and I have to go with their desires. I’ve gladly mastered the art of this look too, but without making someone look overdone.

The key is respecting individual needs and making an accurate assessment of what doses their muscles can tolerate.

3. I want to get rid of the lines that run across my forehead and would like my eye brows raising up at the same time.

Gemma’s explanation :

This is a very common question and for a client to understand the answer properly, they must understand how each muscle functions.

The forehead muscle – The one we use when we raise our eyebrows that creates those horizontal forehead lines. This muscle helps to keep everything upright, Such as our eyebrows and upper eye skin. We often use this muscle daily, but unaware as we age, as it’s often for the purpose of lifting the upper eye skin from our vision. This is due to the eye skin becoming more hooded with age.

Likewise the muscles we use when we frown, the ones that create those lines between our eyebrows that resemble a number 1 or 11 act in a way to pull everything down. As you age you may notice the skin hooding over the eyes more when you make the frown expression.

Therefore when we inject the forehead muscle to soften horizontal forehead lines, it ultimately becomes more relaxed losing some of it’s ability to keep everything upright. This is great for softening the forehead lines, but any injection into this muscle has the potential to lower the brow, making any hooded eye skin more visible.

Likewise when you inject the frown muscle to get rid of the lines between the eyebrows, it has the opposite effect. When you can no longer pull those muscles down, they relax and lift the eyebrow slightly.

Therefore it’s very tricky to create a lift and treat horizontal forehead lines simultaneously.  Sometimes a client who on examination may not be able to tolerate moderate to standard doses, may have to choose whether they prefer a lift and some forehead wrinkles or treating the horizontal forehead lines and in turn loose some of the lift.

Gemma’s solution :

The trick here is in the patient assessment. When a client attends, I’m looking for any factors present that may worsen were I to inject. The forehead muscle (the one we use when we raise our brows) is very temperamental and it’s strength differs in everyone. In terms of Botox®, this means that some can tolerate more dose than others.

During consultation I can identify if a client isn’t a suitable candidate for injections in the forehead or in certain circumstances I start with minimal dosing and progress up with treatment over time.

4 I don’t want to look overdone!

Gemma’s explanation :

Overdone really doesn’t have to be the case. If your practitioner has done an in-depth assessment of your face and observed for how Botox® will affect any preexisting issues it can be dosed to look very natural. The classic overdone look is down to how the product is placed, along with dosage.

Gemma’s solution :

Less is more. You can create a lovely finished look, without going too high on dosing. At the end of the day clients want to look like themselves, with just better looking skin, so they look less tired, more fresh and polished. I like to try to create a result where people tell my clients that they’re looking really well but can’t put their finger on it as to why.

When someone appears very strange or overdone, there are several factors at play.

Many of the so called bad, overdone examples we see in the media under the term pillow face or cat like appearance are the result of too much of everything! Including full-blown surgery.

5 Mr Blogs down the road charges £99 for his Botox ® injections, I might go there

Gemma’s explanation :

Please remember, there’s so many factors involved in the administration of Botox ® . It’s simply not a one size fits all! Here’s a quick overview.

1. Botox ® is a brand of Botulinum toxin A. Just like a black handbag, you can buy Prada, Marks and Spencer or Primark versions. Essentially they’re all black handbags and they all do the same thing, the same way there are various Botulinum Toxin A brands all with varying pricing. As a practitioner, I personally choose Botox ® , but that’s only my choice. My reasons are, It’s the most studied in terms of safety as it’s been on the market the longest, several decades in fact. I like working with it, it’s durability, quality and I like the final look it achieves.  That’s not to say that there’s anything wrong with other forms of Botulinum toxin A.

2. Dilution.  Each vial of Botox ® or most other Botulinum Toxin of choice is diluted with saline to reconstitute it into an injectable form. The dilution strength is advised from the manufacturer and  should ensure you get maximum benefit in terms of concentration, hence results from your treatment, whilst ensuring safety.

3. Number of units administered.
A safe practitioner will assess your units based on your physical examination, and your desired end result. This will all impact on where the injections are placed.

Gemma’s view : 

It’s simply not a one size fits all. Every treatment is bespoke to each particular client. I explain that the treatment takes 2, sometimes 3 weeks in total when including final tweaks to be made.  Every client comes back for review and amendments where needed.

My price is based on very standard amounts. Should a client require less or able to tolerate less, then the price is altered accordingly.

Also remember you are paying a skilled practitioner for their knowledge and training that they invest in keeping their skills up to date, to give you a safe and effective treatment.
A big factor is being able to deal with complications, should something go wrong. I take pride in the fact that I worked hard investing in studying and achieving my prescribing certification, which means I am able to prescribe medicine within my specialism, the same way a doctor can and treat complications.

So there you have it! Botox ® does indeed have its limitations, but in the right expert hands can be performed to ensure, lovely natural subtle results. It most definitely isn’t a one size fits all procedure and should never be used as a substitute to good nutrition, healthy lifestyle and good skincare. Only as an add on to enhance these factors, should someone wish.