Treatment Provider

Scott J. Engel, MD, FACS
Board Certified Plastic Surgeon
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11 Week Turning Point

Just like clockwork, my Botox started to really wear off at the 11 week after point, exactly like last time. Therefore, it appears that Botox in my forehead works quite well for 11 weeks. Then I start to be able to raise my eyebrows a bit so that I have lines on the lower half of my forehead. It will probably gradually get worse and worse. I have another appointment in 4 weeks, and I figure the Botox will be gone by then.

I’m changing my rating to “worth it” for Botox on forehead because it really does eliminate lines for almost 3 months. I think it’s worth it to pay $250 every 3-4 months to get rid of my forehead wrinkles and also to be preventing those wrinkles from forming too deeply as I age. I like that Botox is mostly safe, preventative, and effective. It would be better if it were more affordable though! Fortunately, there are specials and Brilliant Distinctions coupons at times. I’m planning to fit forehead Botox in my budget on the regular. That is the only area that I feel I truly “need” right now. We’ll see when I think it’s worth it to expand to other areas.

Two Months After

Botox is still working in my forehead. I have noticed some muscle re-strengthening, but not enough to show significant wrinkling. However, the Botox for my crow’s feet never worked enough. Even after my touch-up, I could still move those muscles. They are weaker, but it’s still too easy to make crow’s feet wrinkles in my opinion. I was expecting a more frozen look and effect in my crow’s feet like I have experienced in my forehead. This treatment has shown that overall Botox is worth it for my forehead but not my crow’s feet.

I consulted Dr. Engel about my crow’s feet, and he said that he can’t completely paralyze that area but I could try more units next time. He said my crow’s feet should be softened by Botox. I don’t feel like the Botox has been worth it for crow’s feet. I will have to see how I feel once the Botox has worn off in that area to see if I miss it enough or not. I’m planning to maintain my forehead Botox on a regular basis but maybe not my crow’s feet.

I asked Dr. Engel about total units used in each area, and it was a bit confusing because he said it was 17.5 in my forehead when I thought he said 20 units on treatment day. He told me his dilution is .1cc = 2.5 units of Botox, which was different than what his nurse told me earlier that it equaled 5 units. So here’s an update on the totals: .1cc equals 2.5 units so .3cc at the touch-up was 7.5 additional units so more like 23.5 (or 21?) in forehead and 18 (or 21?) units in crow’s feet. So total may have been 41.5 for $475 so $11 per unit. But then again, I was given two different numbers, so I’m not pleased that I’m not able to be precise. I may ask my doctor again to go over these units. I really want to get it straight.

Touch-up Appointment

I had my touch-up appointment today, which was two weeks after my second treatment of Botox. Ever since three days after those injections, I could only raise my right eyebrow, so my eyebrows would look crooked when making expressions. Additionally, my crow’s feet were not completely gone, so I scheduled this touch-up appointment with Dr. Engel. I showed my doctor the areas of concern with a mirror, and he agreed to treat those areas with a little more Botox. Fortunately, there is no charge for necessary touch-ups.
I should have asked how many units were used today. Dr. Engel said .3 of Botox, which can mean different amounts of units depending how they dilute it. I read different doctors have different dilution preferences. It could be around 12-15 more units; I read that some do 5 units per .1cc. But it could be less; hopefully I’ll remember to ask next time. I was planning to keep track of the units.
Thus far, I’m feeling fine. The injection pricks (4 today) all seemed to bleed a little. They didn’t hurt much at all. The top of my forehead injection appeared to immediately cause a bruise, but then it went away after a few minutes of ice at the doctor’s office. No big deal, and hopefully it stays away. I’m not seeing any bruising now, at 7 hours later. Praying again for no side effects! And praying that all looks awesome in a few days, just in time for the party.

Provider Review

Board Certified Plastic Surgeon
2255 S Tamiami Trl., Sarasota, Florida
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Overall rating

I chose Dr. Engel for a previous procedure because he's an excellent board certified plastic surgeon, and I found he is also an experienced injector. I consulted Dr. Engel about my forehead wrinkles, and he agreed that Botox would be a good treatment. I asked him about anti-aging treatments for my whole face as well, and he didn't recommend anything else like fillers or lasers. He said I was still young and naturally beautiful, which was pleasing! He could have made lots more money off me, but instead Dr. Engel seems honest and honorable. I feel like I can trust him to put my interests first. I like that he is conservative with these treatments and that we have the same goal of a natural, beautiful result. Since I was a Botox virgin, Dr. Engel educated me about Botox and spent ample time answering my many questions. He calmed my nerves by being extra gentle and ensuring I was ready before each injection. Afterward, he gave me ice packs to reduce my pain and swelling. I was happy to have no bruising! A touch-up was required a week later, but fortunately I got in to see Dr. Engel right away. I was highly satisfied with my nice results as well as the compassionate care from my doctor. From my experience, Dr. Engel is exceptionally smart, patient, and caring.