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Home » Cosmetic Dermatology » BOTOX Injections by Dr. Hellman

Why should I see a cosmetic dermatologist for BOTOX® injections in NYC?

At Hellman Dermatology, we charge for BOTOX per area, and not by unit. Price includes all the BOTOX you need to look great, including free touch-ups if needed. Peace of mind for you and for us.

It is true that today, many non-dermatologists perform procedures out of their area of specialty, in order to bite off a chunk of the cosmetic pie. However, neither dentists nor gynecologists, family practitioners, ENT’s and other non-dermatologists have specialized training in the treatment of the skin and facial expressions. As a cosmetic dermatologist, I spend every day, the entire day treating patients’ skin, for both medical and cosmetic purposes. I pride myself not only on my background and training but my sense of aesthetics, which is rooted in my background in music and art.

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This helps me ensure that my patients walk out with a natural-looking, yet effective treatment. The best compliment is when they come back telling me how their friends comment on their youthful looks, without knowing that they came from a bottle. I also offer treatment by the area, not counting units. This lets me avoid over-treatment the first time, alleviates the patient’s worry about having to pay for a touch-up, and add more after a week at no charge if needed. This way, my treatment results are neither over, nor under treatment, yielding a natural, pleasing look. Charging by units or other ways often results in pressure on both the patient and doctor. In my practice, this is one less thing for you to worry about.

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I am worried about looking “frozen”

That is a good point. Too much of a good thing is… too much. I personally also prefer a relaxed rather than a frozen look. For this reason, especially when I treat someone the first time, but also each time thereafter, I always recommend a conservative start. After the BOTOX® takes effect, usually 5-7 days, I ask the patient to return for a touch-up. If there is any place that was under-treated, I inject more BOTOX®. NYC patients expect accurate and quick results. Touch-ups allow me to see how the patient responds to the initial treatment, and avoid that motionless, unnatural look.

Do I have to pay for the “touch-up” treatment?

No. Unlike in many other practices, there is a one-time charge per area only. Touch-up treatments are free of charge. This way, there is no pressure on me to inject too much initially, and there is no worry on the side of the patient that if they need more, it will cost them more. Over the years, this system has made me and my patients very comfortable.

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Before & After Photos

Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 1
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 1, photo 2
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 2
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 3
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 4
Botox® and Dysport® : Before And After Photos: Man - (frontal view)
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 5
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 6
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 7
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 8
Botox® and Dysport® : Before And After Photos: Female - (frontal view) patient 9

*Results may vary

What is BOTOX®?

A treatment I like to describe as “little pain but much gain,” BOTOX® is so widely popular, it is considered by some to be “the aspirin of the 2000’s”. In recent years, it has become the number one procedure of choice for facial rejuvenation.

BOTOX® is a substance made from Botulinum Toxin A and is injected in minute amounts into the skin to decrease the “angry look” that many people develop from years of frowning. Treatments are real crowd-pleasers since they can soften the unwanted, etched-in expression lines that result from the loss of the skin’s elasticity. The treatment is straightforward and takes only 10-15 minutes, but that little bit of material can make a huge visual impact on the appearance. In NYC, BOTOX® injections are one of the most common cosmetic treatments, and I admit that I use them myself. It’s also one of the easiest ways for someone to get their feet wet and experience the benefits of cosmetic treatments and minimally invasive facial rejuvenation.

How does BOTOX® work?

How does BOTOX work? BOTOX Injections by Dr. Hellman
This is a purified toxin that has a temporary effect on the muscles in the areas injected, stopping them from moving. In turn, this smooths out the wrinkling that results from the motion of those very muscles and restores the youthful look of the face. The onset of the effect takes about 5-7 days, and lasts between 3-5 months on average.

After being injected, patients often become accustomed to expressing themselves without constantly using and overusing certain facial muscles. Because of this “muscle retraining” effect, combined with a small degree of weakening in the muscles that typically occurs, the time needed between successive treatments often tends to get longer with a program of regular treatments. I have many patients who come every 6-8 months only.

Is BOTOX® dangerous?

It is generally considered a safe procedure with a low risk of serious complications when administered properly. It has been approved by the FDA for treatment of the frown lines between the eyebrows, but for many years before, injections were used for neurological disorders, eye problems, and treatment of migraine headaches. It is important, however, to have the injections by a trained MD who uses the product approved in a medical setting. Injection parties, treatments at malls and other forms of “casual” BOTOX® can cause unwanted complications.

But I heard that it is a toxin, isn’t that dangerous to inject?

No. The word toxin may sound scary, but the product is carefully designed to be safe when used as intended. It only takes a small amount to affect the small muscles that control facial movement. Additionally, it only works on those muscles around the injection site and is not capable of traveling long distances to impact other organs and systems in the body.

Who is a candidate?

If you have etched-in lines and creases associated with facial expressions may be a candidate. I treat not only women but also a lot of men. The typical ages range from early to mid 30s and into the 70’s and beyond. Occasionally people have hereditary wrinkles which develop very early on. I have treated such patients in their 20’s with premature signs of aging. The treatment is not suitable for those with severely lax skin and will not address the loss of volume or sagging.

Which wrinkles respond to it?

It is most commonly used to soften the frown lines (the so-called 11’s) between the eyebrows, eliminating the “angry” look. It can also be used for the horizontal lines of the forehead, the crow’s feet around the eyes, the “bands” on the neck, and can help turn up the corners of the mouth from their downward position as a result of aging. It also can help smooth vertical lines on the upper lips that are common in smokers and has even been used to lift the tip of the nose.

What about the nasolabial folds and other wrinkles?

The nasolabial folds and, in general, most of the lower face wrinkles are a result of gravity and loss of elasticity, not dynamic muscle movement. Therefore, they don’t respond to BOTOX®; rather, those can be treated by injecting fillers, such as Restylane, Perlane, Radiesse, or others. You can read about the different fillers in a separate section.

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Is the treatment painful?

I inject with a tiny, thin needle. Many of my patients have no trouble tolerating it without numbing. However, for the ones who hate the idea of pain, I offer topical numbing cream, which is applied right before the procedure and makes the treatment virtually unnoticeable.

How will I look after the treatment?

Right after the treatment, there is typically only a minor amount of redness and perhaps a tiny “bump” where the needle enters the skin. On very rare occasions, there can be a bit of bruising, which can be covered up by make-up, and resolves over a period of a week. It produces an immediately visible change. However, over the course of 5-7 days, the injection “kicks in”, and you will suddenly realize that the muscles injected are not moving very much.

This temporary paralysis in the muscles allows the facial lines to soften and gradually wears off after 3-5 months. Generally, I recommend for a treatment to be timed 2-3 weeks before a big event such as weddings, etc so that there is time for it to take hold and for any possible marks to be gone. This also leaves enough time for the touch-up treatment if needed.

Will I look worse if I don’t continue with NYC BOTOX® treatments?

No, in fact often the contrary is true. If you stop the treatments, the skin will simply return to the natural look you had prior to the treatments. Often, there is a natural improvement of the original wrinkles, due to decreased muscle use as long as the material “freezes” the muscles.

What is the cost of BOTOX® in NYC?

The material used is made by Allergan and is costly, and once a bottle is opened, it will have to be discarded if not used. The initial cost of the first area covers the cost of the material; additional areas carry a greatly reduced charge. Generally, my pricing is by area and is more advantageous for the patient, since pricing by unit, as practiced by many doctors, usually costs more per treatment.

What about the creams I see advertised that are supposed to be as good as injectables?

Unfortunately, false claims made often prompt people to purchase topical creams, which only result in disappointment. Don’t be naive or gullible – check out any claims made before you put your faith and money into a product. Think about the ads for pills that promise miracle weight loss of many pounds virtually overnight without exercise or dieting… would you believe in those products delivering what they promise?

Now, just apply the same thinking to “just like BOTOX®” topical products. In my opinion, you can put that money to better use by seeing a good movie, or saving it up for a genuine injectable treatment, which has been shown to be effective on most patients and may help you achieve the more youthful appearance you seek.

Written by Dr. Hellman on 2/5/2020

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Judith Hellman

About the Author

Dr. Judith Hellman is a board-certified dermatologist and an associate professor at Mt. Sinai Medical Center. Her passion for people shines through when consulting on a diverse range of medical skin conditions and how these may affect health, aesthetics, and self-esteem. Dr. Hellman has lectured globally and has authored many journal articles. Her fluency in English, Hungarian, and Hebrew helps enhance multilingual communication for many dermatology patients in NYC.

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