You finally did it–you booked your first botox treatment. And now you have a million questions. This one goes out to you. 

Hello and welcome! If you’re reading this you’ve most likely made the choice to finally try out cosmetic injections for the first time, and in the form of botox. 

I am so glad you have made this decision for yourself, but I want to absolutely stress: I don’t believe anyone needs botox. I think it is great that we have options and that botox treatments can help individuals regain their confidence, but the decision needs to be fully yours. 

If you are confident in your decision, let’s move on to the nitty gritty; the most asked questions about botox.

What is botox?

Often when you hear someone refer to botox they are referring to neuromodulators rather than the brand of neuromodulator, Botox Cosmetic®. This is the case for us throughout this entire blog. 

Neuromodulation is defined by the International Neuromodulation Society as, “The alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body.”

In layman terms, neuromodulators (Botox Cosmetic®, Dysport®, Xeomin® & Nuceiva™) are temporary wrinkle-relaxing injections of botulinum toxin that treat wrinkles, frown lines and crow’s feet.

How does botox work?

To understand how botox works, we first need to understand how wrinkles are formed. When the muscles in our face make expressions over and over again, wrinkles are formed where the creases of the skin naturally appear. Neuromodulators relax the muscles in our face by blocking nerve responses and therefore, potentially lessening the overall wrinkle outcome. Essentially, when the underlying muscle relaxes the overlying skin becomes smoother.

What is the best brand of neuromodulator

Of course there is a lot of debate around this topic and the answer changes depending on who you are talking to. There are four brands of neuromodulators on the market in Canada: Botox Cosmetic®, Dysport®, Xeomin® & Nuceiva. I personally prefer and offer my patients Dysport® and Nuceiva. For more information on exactly why I find more effective and natural results from these two brands, click here. ⠀⠀

Once I start botox, can I stop?

Absolutely! A common misconception circulating is that once you start botox you can’t stop–and if you do, your wrinkles will be worse than before. The truth is the exact opposite. As someone who has had to take breaks from botox as I was pregnant with my two boys, I can tell you that botox will not make your wrinkles worse and in fact, it prolongs the effects of aging. 

When your botox wears off after the three to four month effectiveness period, you may feel as though you look “worse than before” but that is truly only because you’ve become accustomed to the visibly smoother skin that is a result of botox. It is always your choice when to start botox, pause botox and start it again. If you have any questions on this, please do not hesitate to reach out to me directly at

How long does botox last?

Botox typically lasts between three and four months. However it has a different effect for everyone and some individuals report results lasting up to six months. 

Does botox hurt? 

Though there may be slight discomfort from the initial pinch, most of my patients would not say the treatment hurts. If you have a fear of needles, please let me know and we can discuss different strategies to make the procedure as comfortable as possible.  

Will I look “frozen” after botox?

My approach to all cosmetic injections, including botox, is natural and lifelong. I prefer for my own botox (and my patients) to always keep movement and expression of the face. Not all cosmetic injectors have the same approach–take the time to research reviews and ensure your cosmetic injector is properly certified.  For your guide for choosing the right cosmetic injector for you, click here. 

Are there any side effects?

This is a common concern for many trying botox for the first time and of course, no one wants to bruise. Luckily, it’s an extremely rare side effect. If bruising occurs, it can be covered with makeup or lipstick quite easily and will subside in a day or two.

What age should I start botox? 

This is another one of those questions that has a different answer depending on who you speak to. There really is no right answer, but my personal opinion is that you should not start treatment, even as a preventative measure, until you see static wrinkles. My approach to cosmetic injections is natural and a long-term plan. I personally didn’t start using botox until I was 30, and find this to be a common age. 

There is a caveat. If you start botox too young and do too much it can age you (your facial muscles can become stronger requiring higher units). Therefore, make sure you are seeing a trained doctor who will tailor your treatment to your needs and has your future in mind. ⠀

How long is a botox appointment?

As a general rule of thumb, botox appointments last 15 minutes. As you become more comfortable with the treatment and we begin to understand the number of units best for your facial structure and muscle strength, the treatment time could even decrease…unless we get chatting about life, which is quite typical for me. Most people are surprised with just how quick and simple botox procedures are. 

How many units of botox will I need?

This is extremely dependent on the individual’s concerns, facial anatomy, treatment area  and muscle strength. For your first treatment, I always tend to err on the side of less is more, as it is the best way to get an understanding of what works for you. Below are just approximate guidelines you can reference prior to your consultation: 

FROWNER: Approx. 20 units⠀⠀⠀⠀⠀⠀⠀⠀⠀

FOREHEAD LINES: Approx. 10 units⠀⠀⠀⠀⠀⠀⠀⠀⠀

SMILE LINES (EYES): Approx. 12-20 units 

How much does botox cost?

This will vary from injector to injector, but I charge $10/unit for Dysport® and Nuceiva for the first treatment and $9/unit for every subsequent treatment.

Is there anyone who shouldn’t get botox?

People who are pregnant, breastfeeding, or have a neurological disease shouldn’t use neuromodulators. When adding any new treatment into your routine, always consult with your family doctor before starting. 

What do I need to do before my botox treatment?

These recommendations are not absolute contraindications but recommended. You can still have the treatment if you have done any of the following but they are pointers to minimize unwanted side effects. 

Starting 72 hours before your botox procedure, you will want to avoid a few things. The first being Ibuprofen (or any other blood-thinning medications), which could increase bruising at the injection sites. Vitamin E and Omega 3 oils should also be avoided. It is also recommended to avoid alcohol and smoking 48 hours prior to your procedure. 

It’s best to have a cleansed face for your botox procedure, but not to worry if you’re in a rush from work, I have a cleansing toner and will clean the area for you. Remember to come to your appointment with realistic expectations. Botox is not an instant fix (though it’s close), and results will take up to 14 days to fully come into effect. 

What do I need to do after my botox treatment?

After your botox procedure, expect to be able to go back to your regular routine but with a few exceptions. For the first two hours post botox treatment, do your best to exercise the treated area to help “work” the botox formula into your muscles. For example, this could mean squinting and lifting your eyebrows if the forehead was treated. 

For the first six hours, it is important you do not lie down. This is the time when the botox is initially working and staying vertical and avoiding touching the treatment area is important (this means no facials or other similar facial treatments). It’s important you keep your head in an upright position, so avoid leaning over extensively (for example, texting with head down, gardening or doing the downward dog). 

For the first 12 hours, avoid applying any heavy makeup. For the first 24 hours post-treatment, you must avoid exercise, hot tubs, tanning beds and saunas. Exercise (and other warm activities) increases your heart rate which increases your blood flow. So in theory, exercise could cause the botox to diffuse away from the intended location. It is also important to avoid alcohol for the first 24 hours post-treatment as it may thin the blood and increase potential for unwanted diffusion as well as cause bruising. 

Finally, remember that it will take up to 14 days to see the full effects of your treatment, though many report visible results in the first 48 hours.

If you have any questions regarding your upcoming botox treatment with me, please do not hesitate to email at Remember, every treatment with me includes a complimentary consultation to review your concerns and outline your options. I will never start injecting until you are completely informed and comfortable with your treatment plan. To book at my Vancouver Island Locations in Parksville and Nanaimo, click here. You can also find my availability at my Langley and Chilliwack locations by clicking here.