Ask a Dermatologist: Is Botox for Me?

By Kat Hirsch on November 23 2023

Botox is mostly known for reducing the appearance of wrinkles, frown and worry lines. But there’s so much more to these neuromodulators.

In this discussion with BC Living (BL), we looked at Botox and other neuromodulators with our very own Dr. Marcie Ulmer. We explored how to prepare and care for Botox, the potential side effects and the cost implications of Botox.

Let’s dive in.


So, what is Botox, and what are the benefits?

Dr. Ulmer: Botox is one of the brand names of available neuromodulators and is one of the most popular non-surgical aesthetic treatments performed worldwide. As the focus of numerous clinical trials and continuous research over the past two decades, Botox has established an excellent safety record, accompanied by a high degree of patient satisfaction.

Neuromodulators are injected into the facial muscles, just below the skin. Although Botox can be utilized for a variety of aesthetic purposes, it is most known for softening facial lines. By weakening signals sent from nerves to muscles, it reduces the strength of the muscle contraction, which, in turn, minimizes wrinkling of the overlying skin.

The other neuromodulators available in Canada are Dysport, Nuceiva and Xeomin. These products share similar active properties and have each proven to be safe and very effective. Typically, product selection will depend on patient and injector preference.


What specific areas can be treated with Botox to improve what? And where do you typically see the best results?

Dr. Ulmer: Botox is an ideal option for the reduction of frown lines on the forehead and between the eyebrows, resulting in a more relaxed and youthful appearance. Neuromodulators are also highly effective at minimizing crow’s feet around the eyes, smoothing a pebbly chin, relaxing bands in the neck and those “bunny lines” you see when you wrinkle your nose.

Besides smoothing wrinkles, Botox can also help lift the brow to open up the eye area and slightly lift the tip of the nose. Botox can minimize vertical wrinkles around the lips and the downward pull at the corners of the mouth, help reduce a gummy smile, and slim the appearance of the lower face.


before and after - botox crow's feet

Before vs. After: Botox in crow’s feet (eyes)


When will you see results from Botox, and how long do they last?

Dr. Ulmer: Patients will begin to notice improvements a few days after their treatment and will see full results at the two-week mark. The improvements come gradually with progressive rather than dramatic changes. Botox typically lasts from three to four months, but individual results may vary depending on dose and individual characteristics.

before and after - botox forehead

Before vs. After: Botox in the forehead


before and after - botox mouth

Before vs. After: Botox in the face


How should I prepare and care for Botox?

Dr. Ulmer: It’s best to arrive at your appointment without makeup on and to avoid alcohol and Ibuprofen a day or two before (and after) your treatment. This preparation will help reduce the small chance of bruising that could occur from the injections. For a few hours after the treatment, keep your head upright and avoid massaging the treatment area (in other words, this is not the best time to book a facial or face massage). For most people, it is right back to life as usual immediately after treatment.


Are there any risks or serious side effects of Botox you’ve seen in your patients?

Dr. Ulmer: Botox is a very safe procedure that has been used in millions of individuals over the past almost 20 years. Botox is a powerful molecule with a well-documented history of studied use across both cosmetic and medical applications.

Botox is not intended for use during pregnancy or in patients with certain neuromuscular disorders. The doses used for facial aesthetics are quite low in comparison to other applications. When precisely placed into the targeted facial muscles, side effects are exceedingly rare.


What is the cost (range) of Botox?

Dr. Ulmer: Some clinics charge a ‘by the unit’ (of neuromodulator) rate while others may present a determined cost based on the treatment area. Overall, cost will be influenced by how many areas of the face are being treated and will be guided by the strength of a patient’s facial muscles.


Read the full post on “Is Botox for Me?” from BC Living for more details on various individual responses to neuromodulators, how to ensure a natural look and other surprising medical concerns Botox can treat.