The Truth About BOTOX® Cosmetic - Dr Speron Gets Interviewed:


    Q.  Why is BOTOX® Cosmetic so popular?

A.  For anyone who thinks frown lines, forehead creases or other facial expression lines are preventing them from looking as good as they feel, BOTOX® Cosmetic is a wonderful option. The results are pretty dramatic and there is no down-time.  Working people today definitely prefer the techniques with no down time so they do not have to sacrifice much time away from their busy schedules.  In 2004, there were 2,837,346 BOTOX® Cosmetic injections, up 25 percent from 2003.  With its recent FDA approval in 2001, BOTOX® Cosmetic has become even more popular because now people assume it’s safe. 


Q.  Is BOTOX® Cosmetic really safe?

A.  Definitely.  If performed by an adequately trained physician, the risk of complications is very low.  The FDA is responsible for ensuring the safety of anything it approves.  With its recent FDA approval, the public now knows about the extensive studies verifying its safety and efficacy.  It does makes a difference to some people who needed reassurance from the organization charged by the government to promote and protect public health.  However, it has been used since 1989 and its safety record has been excellent!


Q.  What are all the bad things that can happen?

     A.  Well, it is a shot so bruising and swelling are a possibility but usually very minimal.  Even though BOTOX® Cosmetic is now used to treat migraines, there is about a 10-13% chance of getting a temporary headache.  About 2-3% of patients get flu-like symptoms or nausea.  The one complication everyone worries about is getting a droopy eyelid.  The risk is quoted as between 1-3%.  If it does happen, usually there are some eye drops we can give you to help stimulate one of the other eyelid muscles to help out until the BOTOX® Cosmetic wears off.  Usually the drops are needed for only about 2-3 weeks. 


Q.  Does it hurt?

A.  Most people tolerate it well.  However, I always try to make things as painless as possible for my patients.  The first thing I do is give all of my patients a prescription for LMX, a topical numbing medicine.  Putting this on about 20 minutes before the injection helps eliminate the pain from the needle stick.  The second thing I do is mix the BOTOX® Cosmetic with salt water and a preservative, which takes the sting out from the actual injection.


Q.  How long does the procedure take?

     A.  It depends on the areas treated but usually 2-10 minutes.


Q.  When does it start working?

     A.  BOTOX® Cosmetic typically starts making a difference within a day or so.  By one month after the injection, the maximal benefit is usually present.


Q.  How long does it last?

     A.  For facial wrinkles, it lasts 3-6 months.  The first few doses need to be repeated at about 3 months.  With more injections, the muscle gets thinner so it typically spaces out the interval for injection to 6 months.


Q.  What areas can it be used on?

     A.  The best options include the forehead, frown lines, crows feet around your eyes, lip wrinkles, neck bands and also for excessive armpit sweating.


Q.  Does it really work on the armpits?

     A.  Some of my happiest patients have been the ones with excessive armpit sweating.  A BOTOX® Cosmetic session will typically reduce the sweating 60-90%!  And we’re talking about patients who have tried everything else including medical grade deodorants.  There really is no other option that comes close.


    Q.  How many people can you use one bottle of BOTOX® Cosmetic for?

    A.  For most sessions, one bottle lasts for 2 patients.  That is one of the inconveniences with BOTOX® Cosmetic.  Once you open it, you need to use it within 4 hours so scheduling can sometimes be difficult. 


    Q.  Do some offices use one bottle for more than 2 patients?

    A.  This is a frequent problem I have seen is some centers using one bottle for 4 or 8 patients.  They then come to my office complaining that it didn’t work that well or last that long.  For example, I have seen several patients who had a BOTOX® Cosmetic injection performed elsewhere that lasted a few weeks and was not that beneficial.  I offer to treat them at my office.  They are usually amazed to see it be very effective and last 3-6 months.  I can only assume that the problem was the BOTOX® Cosmetic was overdiluted.


Q.  Why would they do that?

     A.  The only reason I can think of is to make more of a profit.  I really can’t think of any other reason.


    Q.  Can only board certified plastic surgeons do BOTOX® Cosmetic injections?

    A.  Certainly not.  I think there are some very well trained eye doctors and dermatologists out there.  The one problem seen more frequently, unfortunately, is more and more doctors want to do the easy cosmetic stuff and make fast money without dealing with insurance companies.  I think patients need to be very careful!  Check the physician’s credentials. How many BOTOX® Cosmetic injections have they done?  One last thing to remember - To a plastic surgeon who performs forehead lifting and eyelid rejuvenation, an injection is easy, straightforward and the easiest case of the day.  I would also tell people to be cautious of getting BOTOX® Cosmetic at a salon or at a BOTOX® Cosmetic party.


    Q.  Why don’t you agree with BOTOX® Cosmetic parties?

    A.  I think the environment is not appropriate.  I do not think I could do a complete patient evaluation in this setting.  Usually people at these parties are drinking and the social atmosphere is very conducive to peer pressure.  In my opinion, the informed consent is not valid.  The last issue is OSHA safety and ensuring proper disposal of medical waste and needles.


Q.  Only doctors do BOTOX® Cosmetic injections, right?

     A.  I wish that were true.  Unfortunately, in today’s environment, practices only look at the bottom line.   Since there is not that much profit with BOTOX® Cosmetic, a doctor might not feel it’s worth his time to do the actual injection.  It is not uncommon to let someone else do this – whether it is a nurse or aesthetician.  In my practice, I probably do about 70% of the injections.


    Q.  What makes you think you are more qualified than a nurse or aesthetician to do BOTOX® Cosmetic?

    A.  When performing surgery, you know where all of the facial muscles are.  The injection is easy and pretty straightforward.  There are many years of training involved in becoming a plastic surgeon.  I work with nurses and aestheticians all the time.  Just as they are more qualified to talk to people about skin care products, I think I am more qualified to talk to people and evaluate them for BOTOX® Cosmetic as well as perform the actual injection.  I think patients need to start asking themselves – who is at the other end of that tiny needle coming at my face!  Most people have no idea.


    Q.  Do you personally perform all of the BOTOX® Cosmetic injections at your office?

    A.  No.  Injections are easy for me to do and do not take me very long.  The patient chooses, but the pricing varies depending on whether or not the injection is done by the nurse or the doctor.


Q.  How can I get more information on BOTOX® Cosmetic?

     A.  Feel free to call my office at 1-847-696-9900 and schedule a consultation with me - Dr. Speron.  I will go over your options with you after a comprehensive history and physical examination.  You can also email me through our web site at


*BOTOX® Cosmetic is a registered trademark of Allergan, Inc.

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