After nearly a decade as both a cosmetic injector and patient, Dr. Heather Iverson, ND shares how her perspective on cosmetic injections has changed—and what she wishes she had known when she started.
The first time I had botox and lip filler, I was 29. I knew exactly what was being injected, where it was being placed and what the potential side effects were. I had the medical training. I understood the anatomy. And still I had nerves arriving for my treatment and checked my reflection in the rearview mirror for most of the drive home.
The treatment was extremely conservative, maybe 30 units and a quarter of a syringe for my lips ( Jesse didn’t even notice). But I noticed everything: the swelling, the sensation, the subtle changes in my smile and the quiet boost of confidence I felt.
That experience taught me something my training as a provider could not. My patients do not experience cosmetic injections as anatomy diagrams, clinical explanations, carefully mapped injection points or formula breakdowns. Even with all the information at my fingertips, I found myself feeling nervous before the treatment, asking silly questions even though I knew the answers, obsessively examining the swelling from every angle and nearly texting my injector several times while waiting for my results to settle.
My First Injections
I began offering cosmetic injections in the spring of 2017, but I hadn’t personally tried them. I could overexplain the risks that the complex network of blood vessels surrounding the eyes presents during a tear-trough treatment, or how a botox brow lift depends on selectively relaxing the corrugator supercilii, procerus and lateral orbicularis oculi while preserving the lifting action of the frontalis, but I had never been the person sitting in the chair wondering how much it would hurt, what I would look like the next day or whether anyone would notice.
Becoming a patient and the feelings I had during my first injections (botox and lip filler), altered how I showed up for my own patients. Since, I have committed to putting myself in my patients shoes to understand and anticipate what they may be feeling, what information they may need to hear reiterated. So, when it is appropriate, I like to experience treatments and products myself so I can provide both perspectives: one as a cosmetic injector and one as a patient myself. If you’ve been following me on social media for a while, you’ll already know this about me. At one point, I even treated each side of my face with a different neuromodulator so I could give a first-hand, honest answer on which I thought is better: Botox Cosmetic® or Dysport®.
Of course, this does not mean my experience will predict every patient’s result. Every face and goal is different. Clinical training and evidence remain the foundation of every recommendation I make. But being a patient gives me another kind of knowledge: what the treatment feels like, which parts of recovery may create anxiety, what questions tend to come up at home and what I would genuinely choose again for myself.
When I recommend a treatment, explain that a result takes time or reassure someone that the awkward swelling stage will pass, I am not speaking only as the person holding the syringe. In many cases, I have been where they are. I have gone home swollen, waited for neuromodulators to loosen after getting too many units, made the decision to dissolve my filler and start fresh.
My hope is that our shared experience changes how my patients feel when they choose to work with me as their provider. It helps me give practical, honest advice without minimizing the vulnerability involved in trusting someone with your face.
Everything I’ve Done to My Face
Cosmetic injections are personal. Some patients prefer to keep their treatments private, while others are comfortable sharing. I respect both choices, and patient confidentiality is always honoured. I choose to share my own treatments because openness can soften the stigma around cosmetic injections and create space for honest questions.
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This is one of the first personal transformations I shared publicly. The “before” photo was taken in 2014, before I had tried any cosmetic treatments, and the second was taken in 2021. In the earlier photo, you can see my naturally gummy smile and forehead wrinkles. In the later photo, my lips and cheeks look subtly fuller, while my forehead and crow’s feet appear smoother. I still look like myself, perhaps just a little more confident. None of these changes happened all at once. They reflect years of thoughtful, conservative treatments.
Over the last 10 years, my treatments have fallen into three broad categories:
Neuromodulators. I have treated my frown lines, forehead, crow’s feet, platysma bands, lower face frown lines (DAOs), jawline, chin, gummy smile, and I have tried a lip flip a few times and the nefrititi neck lift. I have also tested different brands—including treating each side of my face with a different neuromodulator—so I could understand how the products differed beyond their clinical descriptions.
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Dermal filler. I have used filler in my lips, middle and lateral cheeks, chin and shadow, jawline and nasolabial folds. I have also used Redensity® II for the shadowing caused by vertical lines above my upper lip. These areas were not all treated at once or maintained continuously; my choices have changed with my face and priorities.
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Skin and regenerative treatments. I have tried mesotherapy with hyaluronic acid, Sylfirm X, microneedling with VAMP/PRP, HydraFacial and JetPeel treatments. These experiences reinforced that filler is only one part of supporting healthy-looking skin.
For me, one of the most impactful changes was treating my gummy smile. It was never something that needed to be “fixed,” but it was an insecurity that regularly affected my confidence. A combination of subtle lip filler and a lip flip made a meaningful difference for me.
Trying the lip flip myself also taught me how different it feels from filler, right down to temporarily finding out just how difficult it was to use a straw. That firsthand experience helps me give patients more practical advice about what to expect. I truly have a love-hate relationship with lip flips ha!
Being open also means sharing what I have chosen to undo. When some of my lip filler migrated beyond my vermilion border, I had it dissolved with hyaluronidase rather than continuing to add more. I documented the swelling, bruising and the stage when my lips felt a little like a shrivelled-up raisin. Although I understood what was happening clinically, experiencing it as a patient still felt vulnerable.
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When I later treated my face, I addressed what it needed at that time rather than automatically repeating everything I had done before. That treatment included 0.9 mL of Revanesse® Kiss in my lips, 1.2 mL of Revanesse® Ultra+ in my nasolabial folds and 0.4 mL of Redensity® II above my upper lip. I did not add more cheek filler.
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Today, my approach is focused more on maintenance than constant change. My annual routine generally includes Dysport® every three to four months, an annual lip refresh, minimal dermal filler approximately every two years and regenerative skin treatments spaced throughout the year.
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That is what works for me right now, but it is not a universal formula that should be copied and pasted into your life exactly.. My routine will continue to change as I age, new evidence becomes available and my priorities evolve. And of course, I’ll be sharing it all every step of the way.
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Becoming Confident in My Choices
When I first began offering (and getting) cosmetic injections, I was fairly quiet about it. I worried about what other Naturopathic Doctors might think and whether people would see cosmetic treatments as incompatible with natural medicine. A decade ago, the conversation was much more black and white. You either wanted to age “naturally,” or you chose cosmetic treatments. There seemed to be very little room between those two identities.
I’ve written before about why I’m comfortable offering botox and filler as a Naturopathic Doctor, but it took time for me to feel that open. Over the years, patients began having more honest conversations about their treatments, and more of my ND peers started incorporating cosmetic injections into their own practices. The stigma hasn’t disappeared completely, but it has changed significantly.
Cosmetic injections becoming more accepted does not mean they are insignificant or appropriate for everyone. These are still medical treatments with risks, limitations and responsibilities. Normalizing informed choice should never mean minimizing the importance of training, anatomy, realistic expectations or proper patient selection. It has simply created more space for choice.
What I Wish I Had Known
If I could speak to the version of myself checking her lips in the mirror after her first treatment, I would tell her that she didn’t need to feel embarrassed, that the swell would go down and the peer judging you for “getting your lips done” would get lip filler too soon.
Caring about natural health and choosing cosmetic treatments are not mutually exclusive. I can prioritize nutrition, hormones, sleep, movement, skin health and prevention while still choosing to get a little Dysport® and filler. I can offer cosmetic injections and still tell a patient that they do not need treatment—or that the treatment they want is not in their best interest.
Everything is grey. You can love your natural features and still choose to get subtle amounts of filler. You can enjoy a treatment and later decide it no longer belongs in your routine. You can dissolve filler, change products, do less or stop entirely.
Almost 10 years later, the most valuable advice I can offer is not about a specific product or treatment. It is permission to make your own informed choices without shame. My role is not to convince you to convince you to get cosmetic injections. It is to help you understand your options, including when the best option may be doing nothing at all.
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