The Big Botox day

My appointment with Dr Torgerson eventually arrived.  I was terrified.  I'm not usually a bad patient but this really did worry me.  I was volunteering for a medical procedure based purely on vanity.  No medical need whatsoever.  It wasn't going to make me healthier, just a bit less grumpy looking.  And for that I was risking a frozen face and droopy eyes.  Was I crazy?  What would my mother say if she knew?  And why was I spending so much on myself when I should be saving to go home and visit my family?!?

Despite the major butterflies (seriously-they were more like huge flapping bats) in my stomach, I arrived at Dr Torgerson's office.  My nerves pretty much vanished when I met his office staff-Helen and Breanne.   They are so nice and so warm.  It was impossible to stay worried!  Helen is also Irish which was a bonus.  I was given a lengthy medical questionnaire and a cup of coffee and settled down to my form filling.

Dr Torgerson was maybe half an hour late seeing me but the time passed quickly and he was obviously with someone else-not just messing around on Facebook or something!  Helen took my "before" headshots and I waited in a big dentist-like chair in the treatment room.

When Dr Torgerson came in, any lingering fears vanished.  He is immensely likeable and spent the first few minutes just chatting about my work, the move to Toronto and so on.  We then discussed the Botox and he commented that glabellar lines are perfect for it (I think they were the initial cosmetic indication too).  He explained the physiology of action, the duration, what I'd expect during and after the procedure and potential complications.   He likes to completely freeze the muscles involved in creating those lines (which he likes to call "concentration lines") unlike other parts of the face where he tries to retain more movement.  The usual dose he uses is 25 units.  He then said there was one more thing that I might benefit from at some point.  My heart sank.  I'd been dreading the critical eye of a plastic surgeon and the pronouncement that I needed a nose job, a jaw revision, new ears, Botox all over, new lips.  "In fact", I was sure he'd say, "we should just get a refund on this face and get you a new one altogether".  He didn't.  With apologies for being mean and picky, he said that I had "tear troughs"-a fold/hollow at the edge of the eye.  He reckoned it probably looked flatter and I looked more drawn when tired.  I had to agree.  He told me that filler (like Restylane) could be injected to plump it-giving a fresher appearance.  He by no means pushed the procedure-just said it was something to think about.  These photos made me think that he's probably right!  Still can't afford it though.

Anyway, I signed my consent form for the procedure and we got on with it.  His fancy chair can be tipped back and he told me that he uses a teeny tiny needle (32G!) for the injections.  I was given a squeezy Botox toy just in case.  The injections were really fine.  5 of them in total.  Some felt a bit funny-like a crunchy sensation by the inner brow-but perfectly tolerable.  It really is just a little pinch.  I held a little gauze to my head for a few minutes and then was ready to go.  He said it would take at least 3 days to show an effect and that top-ups were free if I didn't see enough of a change.   He also mentioned that they were getting Latisse the following week...which definitely sounded interesting too!

I chatted with Helen and headed out the door.

How did I feel?  Fine.  Can't say there was much of a sensation.  That part of my forehead felt a little fuller than usual and a bit heavy but didn't really bother me.  The tiny marks weren't even visible.  I went home, my Botox virginity lost forever...

Choosing someone to allow near me with a needle...

Having made the decision to go ahead with Botox, I was left with the task of choosing who and where!
The options in general seem to be:

• Doctor who specialises in cosmetic procedures: plastic surgeon/dermatologist/cosmetic doctor
• Doctor who did a course in Botox and does some injections to earn some extra cash (usually a GP)
• Nurse working for a doctor-variable degrees of supervision
• An aesthetician of some sort-spa or salon

I have nothing against nurses.  In fact, I think they're often better at procedures than doctors sometimes-they take more care.  However, when it comes to a neurotoxin being injected into my face, I basically want somebody with all the bells and whistles!

Botox is generally regarded to be safe but there are complications and risks with any medical procedure.  And it is just that.  A medical procedure.  Not a pedicure.

Risks include:

• Spreading to muscles not injected
• Eyelid or eyebrow ptosis (drooping)
• Facial asymmetry
• Difficulty breathing or swallowing
• Flu-like illness
• Local effects: bruising, pain
• Just getting the wrong effect!  Looking "frozen" or "done"

So who to go to?  I Googled around a bit and found it hard to decide.  Some providers charge per unit of Botox-from $10-$15/unit.   The amount they use in different areas varies though.  Allergan (who make Botox) suggest 20 units for glabellar lines but some will use 30 or 35.  And men need more.  Groupon or someone had a $99/20 units special from DLK dermatology on Avenue Road in Toronto but it was a nurse injection and they wouldn't even give information about what times they were available by email.  If you won't email me, I can't be bothered.

I decided to potter along to the National Women's Show in the Metro Convention Centre in Toronto the weekend before last.  Free samples were promised so I paid $14 to go (this grasp of economics may explain my financial issues).  There was a mix of stands-food, travel, beauty, massage...and some cosmetic surgery ones.  I spent a while watching Restylane injections which was interesting and then pottered around a bit more.  One laser centre stand had a hand-written sign offering Botox and saying it was $8/unit.  A woman in a white coat was manning it with a  baby in her arms.  She chatted to me while quieting the baby and then the doctor joined in.  Apparently it's $8/unit if the nurse does it and they were offering something like $10/unit for the show.  They were injecting patients perched on a bench in the middle of the hall.  He took out a crumpled diagram to show me that glabellar lines needed 30-40 units.  I decided to think about it.

They were announcing the end of the show when I passed another stand.  It was larger and looked professional with a surgical chair shielded by a screen.  The doctor could be seen around the side and he waved cheerily when he turned around and saw me watching.  He then went back to work on injecting though and seemed to concentrate completely on what he was doing.  He looked young and friendly so I picked up a brochure.  His name was Dr Cory Torgerson and he was a surgeon who initially trained in ENT surgery and then did further post graduate training in facial plastic surgery.  His practice was all facial cosmetic surgery-rhinoplasties, blepharoplasties, injectables etc etc and located in Yorkville, Toronto.  I browsed the website and liked what I saw.  I also had a look at http://www.ratemds.com/ and the ratings were mainly positive (some a bit tooooo positive, a couple unhappy; overall very good).

I decided to email the office and see what they said.  One of my first questions was "who does the injections?" and then if there were any openings on the Thursday and the cost.  The response from Breanne was rapid.  Dr Torgerson himself does all the injections.  She said I could pop in for a consultation that Thursday at 12.15pm.  Consultations are always free.  Their Botox is also per area-$300 each.

I liked the rapid reply, the friendly tone, the fact that he does all his own injections and the free consultation so I decided to go ahead.  Breanne even patiently dealt with me changing my mind about the time the next day when I asked for a later appointment instead.  Had completely forgotten a midday work meeting. 

I read Botox horror stories while waiting for the day to arrive and asked cosmetic doctor Twitter friends (@EternalYouth and @DrRaviJain) if I'd be frozen after it.  Eek!