Botox Ask the Experts


Ask the Experts

Dr. Toscano and Dr. Teleszky answer your questions about . . .


Q:        I think I’d like to try Botox but I’m afraid.  Is it safe?

A:        That’s a great question. You may have read a few years ago about four people in south Florida who suffered some severe complications after being injected with a research version of botulinum toxin. This was not Botox Cosmetic® by Allergan. Botox Cosmetic® is extremely safe and has been studied and used for cosmetic purposes for decades. There have been no reports of allergic reactions or serious complications from the cosmetic use of Botox.

Q:        Is it painful to get Botox injections?

A:        If properly done, Botox injections should not be painful.  The injection technique is very important. At REDBAMBOO Medi•Spa, we use a tiny syringe with a delicate 30 gauge needle which is nearly painless. Because the needle is so fine, it dulls quickly, so we use it to inject only a few sites before it is discarded. Also, we never insert the needle through a rubber stopper to draw up the Botox because that, too, dulls it immediately and dull needles are painful.

Even with these precautions, some people are more sensitive to pain than others and might find even a tiny needle uncomfortable. At REDBAMBOO Medi•Spa, our patients’ comfort is very important to us so we offer topical anesthetic and an ice pack to anyone concerned about discomfort.

Q:        What about bruising? I don’t want to be bruised up.

A:        Like pain, bruising is the result of poor injection technique. Some physicians push the needle through the muscle until it touches bone and then back off a little to inject. This is painful for the patient and almost guaranteed to cause bruising. When performed properly, the needle stays within the muscle, or even above the muscle just underneath the skin and bruising is extremely rare.

Patients who take blood thinners like Coumadin or Plavix are more likely to bruise in general and should not get Botox injections for cosmetic reasons. Also aspirin and anti-inflammatory medicines like Motrin or Advil increase the likelihood of bruising and should be avoided for ten days before receiving Botox injections.

Q:        How much does it cost?

A:        Botox should always be purchased by the unit. During a consultation, a physician experienced in the use of Botox can calculate exactly how many units you might need for a particular effect in a particular area. The number of units you need may vary significantly depending upon the size and strength of your facial muscles and the effect you want to create. This is why you should never purchase Botox “by the area.” If you purchase a treatment area like “frown lines” or “smile lines”, you have no way of knowing how many units you will actually get. Treating the frown lines between the eyebrows can take anywhere from 20 to 36 units depending upon the extent of the wrinkles, the size of the muscles and other nearby areas that may need to be treated as well.

Q:        Who should perform the injections?

A:        At REDBAMBOO Medi•Spa, we firmly believe that Botox injections should only be performed by Board Certified Physicians who have detailed knowledge of facial anatomy and specialized training in advanced Botox injection techniques. We do not believe that you should receive Botox from Nurse Practitioners, Physician Assistants or even Physicians who only perform the injections in their office on an occasional basis.

Q:        What can I expect afterward?

A:        You should plan to remain upright for about four hours after treatment and you should not rub or massage the areas injected. Other than that, you may apply make-up, return to work and carry on with your normal daily activities. You may start to see some effect within 4 to 5 days but it often takes up to two weeks to see the maximal effect. The effect lasts for about 3 months however, repeat treatments tend to last even longer.

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