Karen Nichols, ARNP - Aging Gracefully & Living Happily
(located in the Avondale area of Everett, WA)

All About Botox® (But Were Afraid to Ask)
It's the most popular cosmetic treatment in the United States, but Botox continues to inspire fear and confusion in certain cautious corners.  Is it right for you? That depends on your taste, pocketbook, and tolerance for needles. 

Does BOTOX® prevent wrinkles?
Absolutely. Botox® (and competitors like Dysport® and Xeomin®) are highly purified toxins that can temporarily erase or reduce horizontal forehead lines, vertical frown lines, and crow's-feet. The injections slow muscles that contract hundreds of times a day, eventually etching lines in the skin. Botox® can also lift the corners of the mouth that sag with age, smooth out the "pin cushion" look in some chins, soften smoker's lines around the mouth, and soften vertical neck cords.

Will BOTOX® make me feel numb and look frozen?
It will not affect the nerves that cause sensation, or make you feel numb. When it is used correctly, it can lift the brow to give an appealing and sincere look. But if too much is injected in the danger zone, you can look Spocked, as in Spock from Star Trek. That's why it's important to be treated by an experienced practitioner who can judge the size of your muscles and how much Botox® you will need.

Does BOTOX® hurt?
Like most injections, Botox® can be slightly painful, especially between the eyebrows. Some practitioners offer topical anesthesia ten minutes before the procedure or ice the area to numb it.

Does BOTOX® have side effects?
Every drug has side effects, and Botox® is no exception. Luckily, they tend to be minor and short-live. In one to five percent of cases, there can be mild droopiness of the eyelid or eyebrow, which usually goes away within two weeks, and some patients experience slight bruising.

How much does BOTOX® cost?
Prices vary widely. In the Everett area, pricing is done by the unit.  You will see any where from $9/unit (think Groupon) to $15/unit.  The trick is how many units you need and how many areas you want treated.  If you want the frown between the eyes treated, and you are a woman, think at least 20 units.  If you are a man, think 30-40 units.  Really.  But it depends upon how deep the wrinkles already are, how old you are, how big the muscles.  Another area often treated is the forehead with those horizontal lines.  Then there is the crow's feet -- and sometimes the mini-brow lift is included in that area.  
The average is $400 per treatment, but experienced practitioners tend to charge more. The toxins come dehydrated and must be reconstituted, so some practitioners reportedly over-dilute, or simply don't use enough. The quality of the result always depends on who is on the other end of the needle.

Botox in bottle, dehydrated, for treating cosmetic wrinkles by Karen Nichols, ARNP, in Kirkland, WA What's the ideal age to start using BOTOX?
You don't need it before you have wrinkles to hide. Other than that, a patient can have Botox safely whenever they are bothered by their wrinkles. There is no issue with long term use: There are individuals who have used it repeatedly for over 20 years without bad effects.

How long does BOTOX last?
It varies from patient to patient, but good results usually last three and a half to four months.

Will my friends know I did BOTOX?
Yes and no. A good result will leave you looking fresher, more cheerful, and perhaps younger. Telltale signs of Botox that has been badly done are a smooth and shiny forehead, or a forehead and crow's-feet that don't move when you laugh or cry.

What can I expect the day after my BOTOX appointment?
Not much. Results begin to show in a couple of days and develop gradually over the course of two weeks.  If you are preparing for a big event, schedule your Botox two weeks ahead of time.  Patients taking medications that contain aspirin or NSAIDs can develop pinpoint blue bruising. Patients can wear makeup immediately but should avoid heavy workouts for 24 hours.  For the first 3 hours after injections, avoid head-down positions (yoga, massage, or a nap lying on one side).