Botox for the face: what it can do, and what it can’t

The neuromodulator can soften lines that deepen when you move and give you a more rested look, for about 4 months. It doesn’t restore volume and doesn’t erase deep lines already etched in. When it comes to safety, the person injecting matters more than the product.

Hesitating because you’ve seen frozen faces, or because the word "toxin" scares you? We get it. We explain what the product can and can’t do, then how to choose the person who injects you.

Why lines bother us

Lines are a natural part of how a face changes, but their effect often goes beyond appearance. They can:

• give a constant impression of tiredness;
• project an image that doesn’t match your energy;
• affect your confidence, at work and in your personal life;
• create a gap between the age you feel and the one you look.

Before asking whether the product works, ask whether it answers what bothers you about your face.

What Botox can do for your face

On social media, you mostly see spectacular results. The neuromodulator has clear limits, though.

What it can do:

• Soften overly marked expressions
• Prevent new movement lines from setting in
• Give you a more rested look
• Last about 4 months

What it cannot do:

• Erase every line
• Replace a good skincare routine
• Correct deep lines already etched at rest
• Restore lost volume to your face, which is the work of fillers

Uses beyond aesthetics

Botox also has medical uses. Someone close to you who lives with chronic migraines may already be receiving it.

• Fewer headaches for some people. Chronic migraine is a Health Canada approved indication for Botox
• Reduced excessive underarm sweating, also approved
• Relaxing the masseter in people who clench at night. That is an off-label use in Canada, even though it is common in clinic
• A boost in confidence that often takes people by surprise

Is it safe?

"But it’s still a toxin, isn’t it?" It’s a fair question, and we hear it often. After millions of injections, the data are reassuring on several points.

What reassures:

• The product has been used medically for over 30 years.
• Thousands of physicians prescribe it every day.
• The effects are temporary and reversible.
• The doses used are tiny and tightly controlled.

The risks to know:

• Possible temporary bruising
• Mild tenderness for 24 to 48 hours
• A small risk of asymmetry, which gets corrected
• Passing headaches in some cases

Who injects you matters more than the product

Everything above assumes that the person injecting you is allowed to do it and knows what they’re doing.

In the United States. In 2024, American health authorities recorded 22 people hospitalized across 11 states after injections of counterfeit or mishandled botulinum toxin. Four needed a ventilator. The people affected reported blurred or double vision, difficulty swallowing, dry mouth, weakness and shortness of breath. These cases had one thing in common, the setting of the injections. They were given by unauthorized people, often somewhere other than a care facility, with products bought online.

In Quebec. In spring 2024, Quebec’s College of Physicians and its Order of Nurses made public the practices they were seeing in aesthetic medicine. They named:

• prescriptions signed by a physician who had never assessed the patient;
• injections into areas that are not recommended, such as the buttocks and breasts;
• no physician reachable within 15 minutes in case of a complication, when that is the requirement;
• premises that did not meet asepsis standards;
• products not approved in Canada.

In the wake of that, the College put an end to the collective prescriptions that allowed assembly-line injecting. These findings come from two professional orders, based on the complaints they receive.

Why the lowest price is rarely a bargain

The product has a floor cost for the clinic. It’s set by the manufacturer and it doesn’t move. When a posted price drops well below that cost, something else has been cut, most often one of these four things:

• the product, diluted more than intended or bought outside approved channels;
• the person, trained in a few days rather than over years;
• the medical framework, meaning the assessment before and someone reachable after;
• the setting, when the injection happens in a salon or someone’s home.

A drooping eyelid (ptosis), marked asymmetry or product diffusing where it shouldn’t have gone rarely gets fixed right away. You often have to wait for the effect to fade, three to four months, sometimes more, seeing a result in the mirror that you didn’t choose.

If this section worries you a little, that’s intended. We’re not trying to draw you to us. We want you to arrive with questions, here or anywhere else, and if a clinic won’t answer them, we’d advise you to go elsewhere.

• Who is going to inject me, and what is their professional title?
• Who assessed my face before signing the prescription, and did that person actually see me?
• Which product exactly, and is it approved by Health Canada?
• If something happens tonight, who do I call?

Here, it is nurses who inject, never an esthetician. You will know who you are seeing before you walk in.

When to avoid Botox

The product isn’t for everyone. Don’t go ahead if:

• you are pregnant or breastfeeding;
• what you want is lost volume restored;
• you have a particular muscular or neurological condition.

Not sure whether one of these applies to you? That’s what the assessment is for. It’s free, and it can conclude that this isn’t for you today.

How to keep a natural result

Don’t want to "look done"? We understand, and a few habits help a lot.

1. Start gently. Better to come back than to overdo it.
2. Space your sessions at least 4 to 6 months apart.
3. Choose a clinic where a nurse injects, and who understands the result you’re after.
4. Keep "before" photos to compare.

Is this the right time for you?

It’s probably a good time to start if:

• your lines are mostly visible when you move;
• your expectations are realistic;
• you’re ready to maintain the result;
• your budget allows regular sessions.

The neuromodulator doesn’t replace healthy habits or proper skincare. It adds to what you already do to take care of yourself.

Thinking about it? It all starts with an assessment, where we look at your face in movement before talking about units. See the full page on Botox and Dysport, or write to us from the contact page.

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Sources for the claims above

• Centers for Disease Control and Prevention (CDC), Harmful Reactions Linked to Counterfeit or Mishandled Botulinum Toxin Injections, alert still active.
• Food and Drug Administration (FDA), Counterfeit Version of Botox Found in Multiple States.
• Collège des médecins du Québec and Ordre des infirmières et infirmiers du Québec, Pour une protection du public accrue en matière de médecine esthétique, 2024.