The Lowdown on Botox and Fillers

Pumped up about thoughts of a makeover this spring and considering cosmetic procedures? Here’s what you need to know before you get pricked and plumped

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Looking for a Lift? Here’s what you need to know about Botox and fillers


OnabotulinumtoxinA (a.k.a Botox) was first approved for cosmetic use in 2001. It has revolutionized cosmetic procedures and is the fastest-growing rejuvenation procedure in the world. In fact, according to 2011 stats from the International Society of Aesthetic Plastic Surgery, Botox ranks as the No. 1 non-surgical procedure worldwide.

The injection softens lines and furrowed brows by temporarily weakening the overworking muscles that cause creases and wrinkles in the skin. Results will gradually appear in three to 14 days and last an average of three to five months.

Side effects are commonly related to the injection site itself and can vary depending on the area being treated and your practitioner’s expertise. Reactions can include temporary bruising, and if Botox is done around the eyes, there can be drooping of the brows or eyelid. In cheeks, there may be facial droop.

As for the long-term safety of Botox, “It’s a very safe medication. It’s one of the most studied,” says Dr. William McGillivray, cosmetic physician and medical director at Project Skin MD in Vancouver. “It’s not processed by major organs like the liver or kidney. It’s broken down into [natural] amino acids and [has a] defined limited action over a number of months – an advantage for any drug.”

How much does Botox cost?

It can vary depending “on the area being treated and how strong the muscular contraction causing the wrinkling is. For men, the dosage can be higher than for women,” says Dr. McGillivray. An approximate cost for the glabellar (the area between the eyebrows above the nose) is $300 to $350; around the eyes is around $250 to $300; treating the marionette lines from the nose to mouth is approximately $120, but filler is also recommended for that area.

Dermal Fillers

The most common dermal fillers contain hyaluronic acid, which lifts areas that are hollowed out or grooved. The products, such as Restylane, Juvederm, Perlane and others, temporarily restore the skin’s natural hyaluron, a component that helps repair tissue. Results are instantaneous and can last from nine months up to a year.

Like Botox, side effects are related to the injection site itself and depend on the practitioner’s expertise. Reactions can include temporary swelling, redness or bruising, possible bumpiness at the injection site and in rare, extreme cases, tissue damage.

As for long-term safety, Dr. McGillivray notes these products have been in the market for 25 years. An added advantage is that you can reverse any unwanted side effects of fillers with an enzyme product called hyaluronidase.

How much do dermal fillers cost?

Like Botox, the cost of fillers varies depending on the type and amount used.

“A single syringe to address a very small amount of volume loss would start at $550 plus tax. Many patients need several syringes,” says Dr. McGillivray. 

Here are a few tips if you are considering injectable anti-aging treatments

1. Ask the practitioner about their training.

Are they licensed with any professional cosmetic or plastic surgical societies? When it comes to these medications, especially Botox, “This is a prescription drug and it should be used by qualified people,” says Dr. McGillivray.

2. Ask whether Botox or fillers (or both) are best for the results you’re seeking.

Because the facial musculature is complex and each person’s expressions and wrinkles are unique, it is important to get expert advice.

3. Make sure the practitioner uses sterile techniques and has supplies available to respond to potential emergencies.

4. Finally, it’s important to have realistic expectations.

“The goal is to help people look the best for their age, not change who they are,” says Dr. McGillivray.

Dr. Rhonda Low is a family physician and TV and radio health journalist in Vancouver. Keep up @doctorrhonda

Watch the video featuring Dr. Rhonda Low and Dr. McGillivray talking about Botox and fillers, and see the process of getting injected.