Botox

About 3 to 4 months for frown lines, which is the duration stated on the FDA label. A 2023 meta-analysis of randomised trials found that treating glabella, crow's feet and forehead together at the full approved 64-unit cumulative dose extended median duration to about 182 days. Your own duration varies with dose, muscle bulk and metabolism.

Most people see the first softening between day 3 and day 7. Full effect is reached at about 10 to 14 days, which is why review and any top-up dosing are scheduled at 2 weeks rather than straight away.

Cosmetic doses are small next to the therapeutic doses used for conditions such as spasticity, and a meta-analysis of 7 placebo-controlled trials found no significant difference in adverse event frequency between botulinum toxin and placebo. All products carry a boxed warning about distant spread of toxin effect; the serious events behind it have been associated with much higher doses and with underlying medical conditions. The American Academy of Dermatology notes that no serious side effects such as breathing or swallowing problems have been reported when dermatologists use it for signs of ageing.

Not if the dose is matched to your muscle. The aim is less movement in the muscle that makes the crease, not a face that cannot move — you should still be able to look surprised, and annoyed. If you have had a result you disliked before, bring the brand and the unit count from that treatment; it is the single most useful thing you can tell us.

Effectively none. You can apply makeup as you leave the treatment room and go back to work the same day. The standing instructions are to stay upright for 3 to 4 hours, leave the treated area unrubbed and unpressed for about 12 hours, and skip strenuous exercise for 24 hours.

Muscle activity returns gradually and the treated lines come back to how they were before. Stopping does not leave the skin worse than baseline. Long-term repeated cosmetic use has not identified significant safety concerns.

All four are FDA-approved botulinum toxin type A products working by the same mechanism, differing in formulation, accessory protein content and unit potency. Units are not interchangeable between them, so a quote saying '30 units' without naming the product is not a price you can compare with anything. Which one is used is usually a matter of injector preference and how you have responded previously.

No. It treats dynamic lines produced by muscle contraction — frown lines, crow's feet, forehead lines and platysma bands are the four cosmetic indications on the US label. Static lines from sun damage, skin laxity or lost volume do not respond and are addressed with resurfacing, fillers or surgery instead.

Only a physician, in a Ministry-licensed health facility. A 2015 Ministry of Health circular sent to all 81 provinces stated explicitly that people outside the medical profession cannot perform these procedures on the basis of course certificates. A January 2025 amendment widened the eligible physicians beyond dermatologists, plastic surgeons and medical-aesthetics certificate holders to doctors working within the competence their training gives them — so asking specifically for a dermatologist or plastic surgeon is a question about training, not about legality. Beauty salons and non-physician injectors remain outside the law.

It tells you about the building, not the hand. For this procedure the variable that decides your result is the person injecting: reported eyelid ptosis after glabellar injection falls from a range of about 1 to 14% to under 1% in series from experienced injectors, and diplopia sits below 1% in experienced hands.

We do not inject during pregnancy or breastfeeding, in neuromuscular disorders such as myasthenia gravis, ALS or Lambert-Eaton syndrome, where there is infection at a planned injection site, or if you have reacted to any botulinum toxin product before. Medicines matter too: aminoglycoside antibiotics, muscle relaxants and anticholinergic drugs can potentiate the toxin, and a recent dose of any other botulinum product adds to your cumulative total — which is why the consultation starts with your full medication list and the date, brand and unit count of your last treatment. An eyelid that already droops or a brow that already sits low is not an automatic no, but it changes where the dose goes, and sometimes whether it goes in at all.

Trouble swallowing, speaking or breathing, new hoarseness, muscle weakness or drooping away from the treated area, blurred or double vision, or loss of bladder control. These are the signs of distant toxin spread named in the boxed warning, they can appear hours to weeks after injection, and they call for emergency care where you are — not a message to us first. They are very rare at cosmetic doses. Everything else — a bruise, a heavy brow, a lid sitting lower, asymmetry you notice in the mirror — is not an emergency: photograph it in good light and send it to us, because it decides what happens at the 2-week review and whether a correction dose is placed.

For almost everyone, no — repeated cosmetic treatment does not wear out the response. A small minority develop neutralising antibodies to the toxin and stop responding, and the risk of that rises with higher doses and shorter intervals, which is one reason the label sets a floor of 3 months between treatments and why chasing a fading result with an early top-up is a bad trade. What is far more common than true resistance is a session that used fewer units, a different product whose units are not equivalent, or injection points placed differently — which is why the brand and unit count from every treatment is worth keeping.