10 Botox® Techniques and Tips
As you know, with any new procedure, the more often you perform it the more comfortable you will become. This is why we recommend treating your friends and family before officially adding Botox® injections to your practice’s roster so that you can learn to see even the very subtle differences between your patients’ facial structures. Here are helpful Botox training techniques and tips to help you while you are gaining that experience.
1. Understand Facial Anatomy
It is vital, says the IAPAM, that before you treat your first patient you are absolutely sure that you understand facial anatomy. You need to make sure that you know, not just the proper names of each muscle, but it’s location and function. You also need to know where veins are placed. Some healthcare providers find it helpful to keep a facial injection chart on hand. In addition to making it easier to quickly review, they are helpful tools in explaining the details of a Botox® injection to your patients.
2. Remember Your Botox® Training
There is a reason “go back to the basics” is repeated so often: it works. If you start to feel overwhelmed treating patients, think back to the training you received. Mentally walk yourself through the different Botox® techniques you learned while you were getting your certification.
PRO TIP: Do this as part of the conversation you have with your patient about the procedure before you perform it. Talk them through every step of the process both before and as you are administering it. The repetition will be helpful and it will put your patients at ease.
3. Triple Check Your Botox Labels
Allergan is the only manufacturer that can make Botox®, but there are a few manufacturers of the botulinum toxin. Each manufacturer has minimum saline: botulism ratio that you will need to follow. The reason we bring up this seemingly common-sense tip is that it is entirely possible that your practice will include stock from multiple manufacturers. Always triple check which product you are using before you begin the prep process:
- Check during the drug’s preparation.
- Check when you remove it from storage.
- Check again just before administering the injections.
4. Mind Your Details
Double-check even tiny details. Here are a couple of tips from our Botox® Training program:
- Make sure the alcohol you used to sterilize the cap has completely evaporated before you begin preparing your Botox® injection serum. Otherwise, some of the alcohol may find its way into your vial.
- Have everything you need ready before the patient arrives, including needles, gauze, and a marking pen if you use one. Placing everything on a small dental tray is helpful.
- Always take photos! Patients often don’t pay attention to what they looked like before they came in and may have forgotten about that small depression they had since birth!
5. Botox® Needle Choice Is Important
The needle you choose for the procedure will play a large role in managing patient pain during a Botox® injection. The IAPAM recommends using a short, single-use needle, like an insulin needle that is 31, 32-gauge when you can. These are available through any medical supplier, like McKesson or a compounding pharmacy.
6. Dosage Matters
Botox® is not a “one size fits all” treatment. Every patient is different and it is important to measure the correct dose not just for the correct procedure but for the individual patient. In addition, gender makes a difference, males have larger muscles than females, thus require a higher dose. For example, for a cosmetic procedure like the treatment of Glabellar lines, you may administer anywhere between 10-40 total units,
7. Botox® Technique Tip: Watch the Eyes
When you are administering Botox® treatments for glabellar and canthal lines (two of the most popular procedures) you need to make sure that your bevel tip is pointed up and aimed away from your patient’s eye(s). With glabellar injections, make sure that your injections are all, at minimum, 1 cm above the orbital rim. Listen to a faculty member, Dr Wild discuss the landmarks to keep in mind when injecting a botulinum toxin, like Botox or Xeomin
8. Patients Only Remember the Pain
Injections are almost always going to be at least a tiny bit painful for your patients, even when you use small needles. To improve your patient’s comfort, The IAPAM blog recommends that you numb the injection areas before you administer the procedure. The simplest way to do this, according to the same post, and because the injections are shallow, is with ice. Numb the area a minute or so before administering the injection to ensure optimum patient comfort.
9. Only Hit Home Runs
Unfortunately, not everybody is a good candidate for Botox® treatments. Some people are more prone to serious side effects than others and for some, the treatment simply won’t be effective. Your patient’s history, current medical status, etc. are all important considerations you need to take into account before agreeing to treat a patient. Be thorough during your interviews and exams!
10. Project Positivity
Remember, while there are medical reasons to use Botox®, most of the patients who are interested in cosmetic injectables are insecure about some aspect of their appearance. It is important to be an empathetic listener and to pay very close attention to your patient’s emotional responses to your advice. If you are too “gung-ho,” your patient might worry that you agree with their insecurities. If you are too clinical, they are less likely to feel safe placing themselves in your hands.
You learned a lot about bedside manners when you were in medical school. Now is a good time to go back to step one and review what you’ve learned. This is what your patients will remember more than anything else. It is what they will communicate to people when they review your practice or decide to recommend you to their friends and family members.
Remember! It’s natural to feel a little bit out of your depth as you begin to administer these procedures to actual patients. Use these tips as a guide as you gain experience and grow your practice. Remember to advise your patients are aware of the pre-care and post-care instructions of Botox injections.
Botox® Pre-Care Instructions
When taking on a patient for treatment there are certain questions that need to be asked to avoid any unwanted complications or adverse reactions.
The medical administrator must ask the patient for their complete medical history to determine if Botox® is a suitable treatment for them. They must be aware of all medical illnesses, diseases and conditions and whether the person has undergone any surgeries or procedures in the past. It is also important to ascertain if the person is pregnant or nursing a child.
The Botox® administrator should inquire about medication, herbs, supplements, and other drugs the patient is taking and whether they have any allergies.
The patient receiving the Botox® injections must stop taking blood-thinning medication at least a week prior to Botox® injections. They need to avoid Aspirin, Advil, Excedrin, Vitamin E supplements and natural sources such as Fish oil, Ginseng and Gingko Bilbao. This will help prevent any bruising after the Botox® treatment. All pain medications are to be avoided except Tylenol.
Another important Botox® pre-care instruction is to cut down on alcohol in the days leading up to the Botox® procedure to prevent bruising.
The IAPAM recommends that with first-time Botox® users, a thorough examination of the patient’s face should be conducted with a comprehensive discussion regarding the patient’s expectations from the treatments. This can help decide whether Botox® would be the right course of action for them as Botox® can only target certain problem areas.
The patient should be briefed about the Botox® procedure and not form any unrealistic expectations regarding the results. They should be told about all the side-effects and success rate of the treatment to save them from any disappointments after the procedure.
Region to Treat
If it is decided that Botox® is the right solution for the patient’s problems then the next step is to decide which facial regions need to be treated. It is important to ask patients what their definition of an ideal result is – as sometimes the patient and medical professional might disagree on it. The targets of the Botox® administrator should align with the patients.
Botox® Aftercare Treatment
The IAPAM recommends after the Botox® injections, that a patient should take certain precautions and follow these after Botox® instructions to achieve the desired result and let their face heal quickly.
The patient should exercise the injected areas by trying out natural facial expressions for an hour after they are injected to help Botox® spread throughout the face.
Patients must avoid massaging the Botox® injected areas with their fingers for a few hours after the procedure, since the Botox® may spread to unwanted areas.
Painkillers should be used sparingly following the Botox® injection for headaches or facial pain. Strong painkillers such as Aspirin and ibuprofen should be avoided at all costs.
Ice and Ointment
Bruising may occur from Botox®, which may last a couple of days. It is important to let patients know that this is normal and can be managed by applying ice to the affected area. Some people can also be prescribed topical ointments to speed the healing.
Facial treatments such as chemical peels and microdermabrasion should be avoided for 24 hours after the Botox® is injected to prevent any reactions and complications.
Botox® patients must limit physical activity because if the Botox® spreads to unwanted areas it can cause breathing and swallowing problems. The patient must not lie down or bend for a couple of hours after they are injected.
Alcohol intake is to be restricted for those who have had Botox® treatments done. It will only slow down the healing process and worsen any complication or side-effect that might occur due to the Botox® injections.
If the patient experiences an extreme side-effect following the treatment they should immediately contact their healthcare professional for medical help. Medical administrators who advise their patients of these before and after Botox® measures will help them achieve a better Botox® experience and better Botox® results.
Botox is a trademark of Allergan Inc.; Dysport is a trademark of Galderma; Xeomin is a trademark of Merz Aesthetics