What's more, the injections with a tiny needle are "pretty close to pain-free," says Los Angeles plastic surgeon Brian Kinney, M.D. Botox recipient Masica is even less equivocal: "There is no pain involved."
As a rule, Kinney doesn't numb his patients while he performs the several injections (three for your basic frown lines, for example). But patients who have a low threshold for pain may opt for a pre-injection numbing agent.
To minimize the chance of complications, patients are asked to do two things: use the facial muscles so the botox is attracted to the right areas — "just make funny faces for half an hour," clarifies Poitras — and avoid lying down for up to four hours.
Having followed these pointers, the improvements should show themselves within two to five days. There's no need to worry about being left expressionless, assures Kinney, while acknowledging that post-botox expressions may be less dramatic than before. The side effect might be perfectly acceptable for a poker player, but could be a liability for, say, a hardball negotiator whose ability to intimidate is a highly prized commodity.
The basic approach for injecting botox is "really straightforward" so risks are "minimal," according to Kinney, who has five years' experience offering the wrinkle-reducer. Doctors inject about 25 to 50 units of botox to smooth patients' skin, ten times fewer than the 3,500 units that could kill.
Still…paralyzing the facial muscles: The thought could unnerve the most enthusiastic youth-seeker. As a beauty school student, the botox basics were enough to scare Masica away for a time. "I knew it was botulism that paralyzed the muscles. That's a scary thought," she says. But with her job at a spa came a better understanding of botox and a confidence in the procedure's safety.
The risks, though rare, include bruising, numbness, swelling, muscle twitching, headache, droopy eyebrow and, most commonly, a droopy eyelid. Poitras explains, "Rarely, if the botox drifts too close to the eye muscles, a person can find it impossible to open their eyelid completely."