When patients come to my office for a Botox consultation, one of the most common questions that I am asked is, “Well doc, where do you think I need Botox?” My policy is to always have the patient first tell me what area of their appearance is bothering them most. What I see when I look at a patient can be completely different from what the patient sees when they look at themselves in the mirror. Once I know what is bothering the patient, I can recommend the best treatment regimen for what is concerning to them as well as point out other areas that may benefit from attention as well. Sometimes the best regimen is a single mode treatment, but more often it is some combination of treatments that includes other injectables, skin rejuvenation treatment, at home skin care and sometimes even surgical procedures.
There are two types of facial wrinkles – dynamic and static. Dynamic wrinkles are those lines that appear on the face when the facial muscles create various expressions. Static wrinkles are the lines that are apparent on the face at all times. Over time dynamic wrinkles become static wrinkles. Horizontal lines on the forehead are from raising the eyebrows, vertical lines between the eyebrows are from frowning and crow’s-feet are from squinting and smiling. By paralyzing the muscles that cause these facial expressions, it is possible to diminish or eliminate (depending on the patient’s request) dynamic wrinkles which will lead to an improvement in the appearance of static wrinkles.
Patients with mild to moderate wrinkles are best treated with Botox. Deep inset wrinkles will likely only have minimal improvement with Botox, but they may be improved with dermal filler injections. Since Botox helps prevent dynamic wrinkles from becoming static wrinkles it can also be thought of as a “preventative medicine”. Treating an area when only fine wrinkles (or even no wrinkles at all) are present is perfectly acceptable. Regular treatments with Botox, along with a good skin care regimen, beginning in your 30s will lead to fewer wrinkles in your 40s and 50s.
A final question that is always asked is, “How much do treatments with Botox cost?” There are two common methods of charging for Botox treatments – price per area treated and price per unit injected. I personally charge per unit injected. I think that this is the fairest method since different patients require different amounts of Botox to get the same result. The price per unit will vary across the United States and from office to office in the same area, but the average cost is approximately $12-15 per unit. Again, remember that the number of units injected varies depending on the needs of the individual patient. In consulting with your doctor, he or she should be able to tell you how many units that they will use and what the per unit and total cost will be for your treatment.
In addition, the national average Botox patient receives 37 units of Botox, this area is Glabella and forehead, not including eyes. The crow’s feet are generally around 24 units.
Thank you Dr. Lesnik !