One of the great fears of many new Botox® patients is that they will look unnatural. Or like someone they had seen on TV or in magazine who looked ‘frozen’ and artificial with their facial expressions. In reality, I have seen and treated only a handful of patients over the years who want no wrinkles at all and desire that ‘porcelain doll’ look. Almost every patient wants a natural look and certainly does not want everyone to know they have been ‘Botoxed’.
While creating an expressionless look is possible, there are some practical economic issues that makes that difficult to achieve even if that is what the patient wants. Since Botox® is priced per unit given, it takes a lot of Botox® to deanimate a whole forehead and around the eyes. That entire area may take up to 50 units or more, depending on how active and thick the muscles are, to completely paralyze. At an average cost of $12 – $14 per unit, you are talking in excess of $700 – $800 for a single treatment. For the average person, that is an expensive session that most people do not want to invest in two or three times a year. At the typical treatment cost of $300 – $400 per treatment session, which most patients are willing to pay, you can now see that a completely frozen look is not economically possible.
For the first time Botox® patient, I think about the MED or minimum effective dose. What is the least amount of Botox® we can use to create the desired effect. The MED is a concept that all drugs are based on, usually in an effort to prevent side effects or complications. With Botox® the MED approach is an economic one. Find out the least amount you have to pay to get a good result. That is why you start out with a low dose or number of units. Some practitioners may take the opposite approach of maximum or excess dosing for their economic benefit but, like all repeat business, people come back if they think they got a good honest value.
Dr. Barry Eppley
Indianapolis, Indiana