Botox Patient Information Guide:

What Every Patient Needs to Know:

Introduction to Botox Cosmetic

What causes a wrinkle?

This is a common question that many people ask.  I wish there were a simple answer, but this is actually a very difficult question. Wrinkles have many causes, but one of the primary causes is making the same expression thousands of times.  That means, the muscles of your face can cause your wrinkles.

These wrinkles are called “expression lines” but should more properly be termed “experience lines” or “maturing lines.”  Maybe even “wisdom lines.”

You probably have an idea where these occur on your face.  But here are some more examples:

  • Worry Lines Between the Eyebrows - these often make a person look angry or annoyed. 
  • Forehead Lines (often termed “thinking lines") – caused by a person raising their eyebrows too often. 
  • Crow’s Feet- (What an awful name!  I someverdana wonder how these names come about.)  A person who smiles frequently often has crow’s feet. 
  • Lipstick and Bleed Lines – which occur as a person ages, and which are certainly an unattractive cosmetic blemish on any person.
  • Drooping Mouth – a sad expression, due to hyperactive muscles that pulls the mouth corners down.  George “Dubya” Bush and Al Gore share this problem.
  • Bunny Lines – These lines are very common, and you have probably seen this on some people’s noses.  They can actually wrinkle up their nose. 
  • Neck Lines – many of these can be erased by Botox.

The presence of these wrinkles can add years to your appearance, often making you look angry, tired, or worried when you actually are not.  These lines occur in most sensitive people – people who are not really angry but just appear to be angry because their facial muscles of expression do take over. 

Here’s what some of my patients have told me about these lines:

“I am a business woman, and looking young is very important to me.  The other day a client came to me and asked if I was mad.  Well, to make a long story short, I wasn’t but I looked in the mirror and found that, indeed, I looked mad.  You see, I am an expression-able person.  When I talk and when I think, I contract my facial muscles.  Unfortunately, this has caused wrinkles in between my eyes and wrinkles on my forehead.  Fortunately, I sought out Dr. Dohner and now I no longer have this problem."

-Mary S (43), business executive

“I used to love the way I looked, but when I hit the big 30, things began to change – and not necessarily for the better!  My eyes really began to show ‘those changes’.  ‘Yucky crow’s feet’ began to show.  Well, I heard about Botox.  A friend went to Dr. Eric Dohner, and I thought I should.  Am I ever glad I did!  It has changed my life forever."

-Judy K (31), secretary

“I hate it when my lipstick bleeds into my upper lip.  I know they are caused by my smoking and years of sun exposure.  But do I need to live with them?  Not since I met Dr. Eric Dohner.  I attended one of his free information seminars, and then I went in for a consultation.  In two short treatments these lines were gone!  It’s been 6 months, and they are not back yet!“

-Mrs. Barb. C. (62), retired

Recently Botox has been used to help to control facial expressions, so that you don’t  look angry or worried when you really are not.  Botox treatments can help you show people how you really feel – by getting rid of your unwanted lines.  You don’t have to show any signs of negative, unwanted feelings.  Sure, you have earned those lines, but do you really want to show them?  If you don’t, Botox has been the answer for many people.  It can help you look rested, confident, and maintain the appearance you desire. 

What is Botox?

Botox is a highly purified, naturally occurring protein that precisely relaxes the muscles to which it is applied.  The relaxation lasts for a number of months, and the treated muscles gradually return to their original condition.  Botox does not affect the nerve response, for sensation, so there is no numbness or increased sensitivity in the treatment areas.  You can stop Botox treatment at any time if you do not like the results, and can be confident that you will gradually return to your pre-treatment appearance. 

How does Botox Work?

Although Botox is “magic” for many people, it is actually a highly purified, refined scientific treatment which has evolved through years of research.  The benefit of Botox comes from its ability to selectively and precisely relax the muscles by inhibiting the nerve signals that cause the muscles to contract, which cause wrinkles to occur.  The skin over the area of the treated muscle gradually becomes smooth with fewer wrinkles, as the muscles relax.  Of course, if the wrinkles are very deep, other treatments might have to be added. 

Botox treatment was actually invented by a Canadian dermatologist and his ophthalmologist wife, the Carruthers in Vancouver.

What are common uses for Botox?

A common use for Botox to reduce the deep furrows and lines that many people have between their eyebrows, thereby making you look less angry – other times, it can even make you look happy.  I have found that it is the gentlest, kindest people who have these lines. 

“Crow’s feet" around the eyes also add years to your appearance, giving the impression that you are squinting all the time.  Crow’s feet usually improve nicely when the muscles that cause the crow’s feet are treated with a bit of Botox. 

Unfortunately, the treatment doesn’t work visibly until a few days have passed, but most people have remarkable visible results within a few weeks.  Then the muscle power will gradually return, within three to four months, and the effects will begin to wear off.

That would be the ideal time to get re-treated.  Why?  Because is has been my experience, and the experience of many doctors, that if you are treated before the results completely wear off, the next treatment lasts a bit longer – maybe even an additional month longer.<

Likewise, if you have your third treatment before the second treatment wears off, it will last still longer.  However, if you wait until the results are completely worn off, you will be starting back at square one, right at the beginning again, and you will have to get treated all over again.  In fact, I have been treating some people since 2001, and they only require treatments at intervals of between four and 8 months!  Unfortunately, I cannot guarantee this will happen for everyone, but most people, including world authorities Nick Lowe of London and doctors Alastair and Jean Carruthers, have found this to occur. 

Now the amazing thing about Botox is that is works ONLY where we want it to!  Unaffected muscles continue to function normally, so that facial expression is unaffected.  Botox can also help to prevent lines from forming, so it can also prevent wrinkling. 



Does Botox Work for All Kinds of Wrinkles and Skin Folds?


Unfortunately, no.  The deep creases and skin folds (the ones that don’t go away when you are not moving your face) are very difficult to treat.  Botox probably won’t work for them, and we will need to use other treatments.  However, we have a lot of tricks in our saddlebag to try to make them disappear.


Many of these wrinkles are made worse by movement, so Botox might help improve them, but Botox alone cannot do it all.  Because these wrinkles are a combination of muscle activity and aging, other treatments are often necessary.  We can often fill in these valleys with filling substances such as Restylane, Juvederm, or collagen.  In other instances, we can use lasers to help achieve the desired effect.  For such cases, we use the non-ablative lasers – Aura, StarALux, and Thermage.  We also have the exciting new Levulan with Blu-U, to help in this treatment. 


So we are state-of-the-art, and we try to offer you the services you want and need.  We can help to lighten – brighten – tighten the skin.  To achieve this, we can also use chemical peels or the exciting new Aurora IPL/RF … but I digress. 


Another amazing thing we have noticed with Botox is it can help delay the development of new wrinkles and furrows, thereby reducing the long-term need for additional laser treatment or other treatments.  Botox can also help to delay or eliminate the need for the more dangerous and costly procedures, such as a face-lift, brow-lift, or neck-lift.


What is a Botox treatment like?


“Amazing” is how many of my patients describe them.  They are so gentle and quick that most people are surprised to find the treatment has been completed before they know it.  No sedation or local anesthesia is required, so you will be able to continue your usual activities immediately following the treatment.  You can certainly drive yourself home or back to the office.  Botox treatments take only a few minutes, and are performed in the clinic by Dr. Dohner. 


Who is Dr. Dohner?


Dr. Dohner is the area’s expert on cosmetic treatments. He has compiled many articles and speaks to many groups about cosmetic procedures. He established The Skin and Vein Center at Oneonta Laser Derm 7 years ago which has expanded to include a staff of 12 professionals to assist him and 4 of the most advanced cosmetic lasers.


If you would care to know more about Dr. Dohner, please phone our office at 421-2525 or visit our web site at

What is a Treatment Like?

Treatments are very easy.

First, before your treatment commences, photographs are taken.  You will also be asked to sign a Consent Form. 

You will then be asked to recline on an examination table, where you lean back and relax.  An ice cube will be put on the area to be treated.  A small amount of discomfort may be experienced when the needle is inserted into the muscle and a few drops of Botox are precisely injected into the muscles requiring relaxation.  The sensation lasts approximately 5 seconds. 

Many people report that they don’t even feel this discomfort.  However, for those with a low pain threshold, or for those who bruise easily, Dr. Dohner can take special precautions to ensure that your experience is as enjoyable as possible.

Are there special instructions to follow after Botox?


Yes.  It is as simple as 1-2-3!


  1. Exercise the treated muscles during the hours after your Botox treatment.  This will ensure the best possible uptake.  This is best done by practicing making faces in the mirror after the treatment, or just by using your normal muscles of expression. 
  2. Do not touch or rub the treated area for at least four hours following treatment. 
  3. Do not lie down for about four hours following treatment.  It used to be said that six hours were necessary, but new research seems to indicate that four hours is sufficient. 

How much do Botox treatments cost?


We aim to make Botox treatments available and affordable to you.  We charge a minimum rate per unit.  However, individuals using larger doses or having multiple areas done will get a significant discount. 


We may seem more expensive than injectors, but when you realize that quality is emphasized, making sure you get the right dosage for your problem, you will find that our prices are actually cheaper than low-priced competitors.  You see,  if you come back and haven’t achieved your desired result within a two-week period of time, we will treat you at no further cost.  And since the right dosage is used, treatments often last longer. 

How do we guarantee such excellent results?


•  Firstly, we use the proper dilution for your individual problem. 

•  Secondly, if the results are not optimal within two weeks, a touch-up is free.

•  Thirdly, for our regular customers, we have a special bonus: if you preschedule your next Botox treatment and keep the appointment, you get a 5% discount off any treatment you have that day.


If you desire even further cosmetic benefits, we would be happy to offer you a special discount.  We can pre-sell you 100 units of Botox at a discount over our regular prices. Or you can buy on the monthly deduction plan.  Give us the right to charge your credit card on the first day of every month, and we will gladly even out your purchases over a year.  Unfortunately, we can only give this to you if you receive three or four treatments a year.  Finally, if you send a friend to us for Botox, we will gladly issue you a certificate affording you $50.00 off the cost of our cosmetic procedures.

So we aim for a WIN-WIN situation for everyone.  We want you to be happy with your Botox and we want to provide to you the services and costs that you can afford.

Are You Afraid To Have Botox Done?

Many people who have had cosmetic treatments of any sort have had fears and doubts.  A common concern is that they will be thought of as being vain.  My experience has been that those who have a cosmetic treatment done are no more vain than anybody else.  What distinguishes these individuals is their intense desire to get the most out of life.  Having good looks, to them, is as important as how they feel.  Looking after your appearance is not about being vain; it is actually a normal human trait.  The history of the world tells us over and over:  I think you should feel proud of yourself for having the will and ability to change something you do not like.  The only time it is a mistake is if you do this for someone other than yourself – you need to do it FOR YOU!

What are the possible side effects?

As far as I know, there are no long-term side effects.  Some patients have been having Botox treatments for more than 10 years without problems.  The most common side effects are short lived – some swelling, discomfort, and bruising.  A small number of people have had drooping of the upper lid if the medication was improperly applied.

A few others have had headaches.

But the most serious problem that could occur is the material being inserted into a muscle where it shouldn’t, which might cause long-term drooping of that muscle and will take many months of recovery.

All of these are best prevented by having an experienced physician applying the medication. 

Are there reasons not to have Botox?

Yes.  Those who are pregnant, breast-feeding, or who have certain rare neurological disorders should not have Botox treatment done.  Also, if you have an allergy to albumin, you should not have it done.  If you are a Jehovah’s Witness, you may not wish to receive the injections, because it contains small traces of albumin, a blood product. 

Is Botox used for purposes other than treatment of wrinkles.

Yes. Many patients who have received Botox treatment for wrinkles have noticed a pleasant side effect: their headaches reduce or disappear! This is particularly useful if you can identify trigger-points, as putting Botox directly into these points frequently improves a person’s headaches.