Beyond the Injection: Behind the Scenes of a Botox Treatment

In this insightful episode of the “Anti-Aging Insights” podcast, Dr. Teri Fisher offers a detailed walkthrough of the entire Botox treatment process, demystifying what goes on behind the scenes at his Anti Aging Medical and Laser Clinic. Whether you’re a Botox newcomer or a seasoned client, Dr. Fisher provides clarity on how each procedure is tailored specifically to your aesthetic goals.

Dr. Fisher begins by explaining the vital preliminary steps that occur when you first arrive at the clinic, emphasizing a personalized approach from the initial consultation to understanding your motivations for treatment. This enables him and his team to customize the procedure to meet your unique needs, ensuring optimal outcomes.

The podcast covers essential pre-treatment procedures, including photographing various facial expressions to identify treatment areas, and assessing potential facial asymmetries. By utilizing a tailored approach, Dr. Fisher illustrates the importance of setting realistic expectations and clarifying that while perfect symmetry is challenging, Botox can significantly improve facial balance.

Dr. Fisher skillfully uses the analogy of a dimmer switch to help listeners understand the role of Botox. He discusses the importance of determining the right amount of neuromodulator units to achieve the desired reduction in muscle movement, whether aiming for a natural look or the fully ‘frozen’ effect.

The episode delves into the technicalities of the Botox injection process, including needle preparation, precise planning of injection sites, and strategies to minimize discomfort and bruising. Dr. Fisher also covers post-treatment expectations, including the usual mild side effects and the gradual onset of Botox’s effects.

Listeners are encouraged to reach out with questions or share their own experiences, while also staying connected via Dr. Fisher’s Instagram or YouTube channel for further insights into aesthetic medicine and related innovations.

Key Insights

• Dr. Teri Fisher provides insight into the complete process of a Botox treatment, from initial consultation to post-treatment follow-ups, emphasizing a personalized approach for each patient.
• During the consultation, photos are taken to assess facial expressions and potential asymmetry, allowing for precise tailoring of the Botox treatment to the patient’s needs and expectations.
• The treatment involves determining the appropriate number of Botox units based on desired muscle movement reduction, using an analogy of a dimmer switch to explain muscle relaxation.
• Preparation includes mapping injection sites with a makeup pencil, ensuring precise injections, and offering methods to minimize discomfort such as ice packs or stress balls.
• Post-injection, there might be mild soreness and redness, akin to a mosquito bite, with Botox effects beginning in three days and fully taking effect after ten days, with follow-ups encouraged for new patients.

Episode Transcript

Dr. Teri Fisher: Have you ever wondered what really happens behind the scenes when you go get a neuromodulator treatment such as Botox? Today, I am pulling back the curtains to show you the process that I go through behind the injection so that you know what I do to get you that flawless, wrinkle free look.

In this episode of Anti Aging Insights, we are diving into the world of Botox injections from the initial consultation to the actual treatment. I’m going to walk you through every step that I take and how we can work together to get you the best results that we possibly can.

So how does it start? Well, we’re going to go from you walking in the door right until you leave the door of Anti Aging Medical and Laser Clinic and I’ll tell you exactly what we do.

Well first of all, you are going to have some type of communication with our staff. Our staff are going to take some of your information down and assign the right amount of time in my day so that we can do the assessment and that we can do the treatment areas that you are requesting.

When you come in sometimes you will be greeted by a technician, one of my assistants. Sometimes it’ll be me that will take you into our exam room. And one of the first things that we’ll do, of course, is chat with you, get a sense of who you are, what you’re about, and ultimately how can we help you? We want to know a little bit of the why behind you doing this so that we can get you the best results. Why do you want to get this particular treatment? How would that change your life? We want to understand that so that we can really tailor things and make them as personal and as unique as we possibly can for you.

Once we have done that, we will then ask to take some photos of you. We want to get some photos that show the expressions that we are going to be treating with the Botox. Some of the common ones that we’ll ask you to do is to do a frown, where you bring your eyebrows together, we’ll ask you to lift your eyebrows up, we’re going to ask you to do a big smile, we may ask you to do a couple of other things depending on which areas of the face that you want to treat. We may ask you to scrunch up your nose like a bunny, we may ask you to pout, we may ask you to make a sad face, we may ask you to do a number of things, but they are all to test the muscles and assess the muscles that we are going to be treating.

We will take pictures of all of those areas so that we can document things and then we can look at those pictures with you and see which of these areas we want to treat. Sometimes we want to assess to see if there’s any asymmetry to begin with, because nobody is perfectly symmetrical. And sometimes there may be some asymmetry, for example, of an eyebrow. And by putting a little bit more neuromodulator in one side versus the other side, we may be able to balance out that asymmetry to a certain degree. We can never get things absolutely perfectly symmetrical and to do so I think, or to claim to do so would be a little bit I think disingenuine, because it’s really hard to do that and I think there has to be realistic expectations when we are doing these treatments.

I think it’s also really important then to understand for the patient what it is that we’re treating. When it comes to Botox, neuromodulator, we are treating dynamic wrinkles. Those are the wrinkles or the lines that you see when you move, when your muscles move. Botox is not the best at treating static lines, lines that are there even when your face is not moving. That usually requires some other type of treatment.

Now, having said all that, what we do next is we look at those pictures, we look at your live facial expressions, and then we determine how many units we need for your treatment. There’s a lot of variables that go into this. Most important one is what you want to do. If you think about your muscles in your face as a dimmer switch. I love this analogy. If we add just a little bit of the neuromodulator of the Botox, we’re lowering that dimmer switch a touch on the muscles, so the muscle just becomes a little bit weaker. That means that it still will be able to move, but it can’t move quite as strongly or quite as brightly as a light would if you had full maximum brightness turned on on that dimmer switch.

If you want to have less lines, less movement, then we add more units, and that’s like taking that dimmer switch down further and further and further. If we add enough units, then that dimmer switch is essentially down to the point where it is off, and we have turned off the muscle.

So, some people say, I want to be frozen. This is usually what they’re referring to. They’re referring to getting enough of the neuromodulator to the point that the muscle has been relaxed so much that it really isn’t moving for those three months that the BOTOX is working.

So again, part of that is that consultation, understanding how much movement you want. And then once we have determined that, then we can determine the number of BOTOX units that we need for each area of the face. Once we have determined that, we diagram that out. So it’s very clear to us what we’re doing and very clear to you, what you’re doing. If you have not already done, so we go through some of the consent process. We talk about some of the risks versus the benefits of the neuromodulator. And we do have you sign a consent form as well for that.

Then we go off and we let you sit and relax for a couple of minutes while we prepare the actual Botox injections. Depending on the brand, again, we have a number of different brands that we use. There’s Botox, Nuceiva, Dysport, Xeomin, and we then will discuss that with you. If you don’t have a preference, that’s fine. We will come up with a plan together, and then we go and we mix up the Neuromodulator. We are generally mixing it with bacteriostatic saline. So it’s saline with some chemicals in it that prevent any bacteria from growing in it.

We then draw it up into tiny little syringes. If you’ve not seen these syringes before, they are very, very small. They’re literally like a mosquito bite type size needle. And it’s often the needles that are used by diabetics when they’re giving themselves insulin. So we get that ready, we get that in a series of needles all set, and then we come back in the room to you.

We have a number of different things that we do at that point to prepare the skin. First of all we clean the skin very well in all the areas that we are going to be injecting. And then what we do is we take the time to mark out on the skin with a make up pencil where I’m going to be doing those injections.

So I take my time to plan it out, to map it out. The anatomy is extremely important and I like to do that so that I can be very clear on where these injections are going and so that they are as precise as I can possibly make them.

Once that is done, then depending on how you feel about this, there are a number of different ways that we can minimize any of the mild discomfort that is there with Botox injections. We can use a little ice pack just before each injection, to just numb the skin a little bit. We also can give you little squeezy stress balls to squeeze onto. There are a number of things that we can do. Some people say, I don’t want the ice. Some people say, I don’t want the squeezy balls. And some people say, give me both. And we, of course, work with you to figure out what will be the most comfortable for you. Regardless, as I mentioned, these are very tiny needles and the discomfort is pretty minimal.

So once we have determined what we’re going to do, we either use that ice pack, the squeezy ball. We freeze the area if that’s what we’re gonna do. And then we do the quick little injection. The injection just takes a second, and then we do that into each of the different spots where we are injecting.

One of the risks of this, of course, is that you can get some bruising, and that’s just simply by the nature of this treatment. When you inject a needle anywhere in the body for that matter, if you hit a tiny little blood vessel, a capillary, it can bleed a little bit and what happens is you get a little bit of bruising. So this is something that I always watch out for. The icing, by the way, does help with that because it helps to constrict blood vessels, makes them smaller. But nevertheless, if we do see any bleeding, then we immediately just put some pressure on that area and minimize any of the bruising as we possibly can. And then we go through and we do all of the injections. Nothing too spectacular about that. We work in a very systematic way. I tend to have a pattern of the way that I like to do my injections so that I keep track of everything. I generally start with the glabella, which is in the middle. Then I will move up to the forehead and then I’ll do the crow’s feet if we’re doing that, and then work my way down the face if we are doing some other injections further down.

And then immediately afterwards, yes, there may be a little bit of mild redness, may be a little bit of tiny soreness. Again, it kind of is like a mosquito bite. Right after you have a bite, it feels a little bit irritated, it might feel a little bit sore, it might be a little bit red. That’s basically what you can expect after this.

And then it does take about three days or so for the Botox to really start working. It takes about 10 days or so for the neuromodulator to really kick in, and then we’re always happy to have you come back and see us for a follow up if you happen to need any touchups. It’s really important for that, particularly if you are a brand new patient and we’re getting to know each other, and we’re getting to know your muscles and the way that your muscles respond.

And then you’re done. We see you out with a friendly smile, hopefully, and we get you back in about another three months time for your next treatment.

So that is a look at the behind the scenes of what I do to ensure that you get your best neuromodulator treatment. If you have any questions or you want to share your experiences, then feel free to, of course, get in touch with me or share them in the comments, wherever you are seeing this video or listening to this podcast, and I look forward to chatting with you again very soon.

In the meantime, feel free to follow me on Instagram at DrTeriFisher or check out my YouTube channel, which I’m doing a lot more videos these days on aesthetic medicine, as well as AI automations for an aesthetic medicine business.

Hope you’re doing well. Have a wonderful week. I’ll talk to you soon.