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hosted by: Dr. Teri Fisher
Episode 7: Your Beginner’s Guide to Neuromodulators

Episode 7:  Botox 101: Your Beginner’s Guide to Neuromodulators

Botox, Dysport, Xeomin and more

In this episode, Dr. Teri Fisher talks about neuromodulators, commonly known as Botox, in this episode of anti-aging insights. He explains that Botox is one brand of neuromodulators, which are used to interrupt the message from the brain to the muscles to contract, resulting in relaxed muscles, reduced wrinkles, and a more youthful appearance. Dr. Fisher clarifies that Botox is a neurotoxin that comes from the bacteria, clostridium botulinum, and is used for both cosmetic and therapeutic purposes. He also mentions the most common areas of the face where Botox is used, such as the frown lines, forehead lines, and crow’s feet.

For more information or to book an appointment with Dr. Fisher, feel free to book your consultation online or phone 604-261-9121.

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Today’s Guest

Dr. Teri Fisher

Dr. Teri Fisher is a physician who combines his meticulous and scientific approach with his artistic eye and skilled dexterity to provide outstanding results for his patients. He is known for connecting with his patients to understand their needs and leaving them feeling healthy, confident, and empowered with improved “Health Esteem.” Dr. Fisher has BSc, BEd, MSc, MD, CCFP (SEM) degrees and is a specialist in Aesthetic Medicine, Sport & Exercise Medicine. He is also a clinical assistant professor at the University of British Columbia and host of the “Anti-Aging Insights Podcast”. He is also a member of the Canadian Association of Sports & Exercise Medicine, Canadian College of Family Physicians, and Canadian Medical Association.

Key take aways

  • Neuromodulators, or Botox, interrupt the message that the brain sends to muscles to contract, resulting in relaxation of the muscles and prevention of wrinkles and fine lines.

  • Botox is a brand name of the neuromodulator botulinum toxin, but other brands such as Dysport and Xeomin also exist.

  • Botox is harvested from the bacteria clostridium botulinum and purified before being packaged with different proteins, depending on the brand.

  • Botox is used for both cosmetic and therapeutic treatments. Cosmetic treatments typically involve injecting Botox into muscles to diminish wrinkles and fine lines, while therapeutic treatments may include treating conditions such as migraines or excessive sweating.

  • The most common areas for Botox injections are the frown lines or 11s between the eyebrows, the forehead lines, and the crow’s feet around the eyes.

  • The Botox procedure involves injecting small amounts of the neuromodulator into specific muscles with a fine needle.

  • Some common myths and misconceptions about Botox include that it will freeze your face or make you look fake, that it is only for older people, and that it is a permanent solution.

  • Botox typically lasts for 3-4 months before the effects wear off and the procedure needs to be repeated.

  • Botox should only be administered by a licensed medical professional with experience in the procedure.

  • If you are considering Botox, it is important to do your research and consult with a qualified provider to determine if it is right for you.


Episode Transcript


Dr. Teri Fisher: Hello and welcome to this week’s episode of anti-aging insights. It’s great to have you along. And this is another one of those solo shows where we have the opportunity to chat about a particular topic and learn a little bit more about it. Today’s topic is neuromodulators or often known as Botox 101. So this is your beginner’s guide to Botox. 

If you have ever considered getting Botox, if you have had Botox, or you know somebody who has had Botox or is considering getting Botox, and you just want to know a little bit more about what it is, how it works, how the process goes, then this particular episode is for you. 

So let’s get right into it today. Today I want to cover a little bit of an introduction to these neuromodulators. I want to cover a little bit about what they are and how they work. We will talk a little bit about the uses of these neuromodulators or Botox. We’ll talk about the procedure itself. What happens during a Botox treatment? I have a few myths and misconceptions that we can speak about as well. And then we’ll wrap it up with some final thoughts and some direction for you, if you want to learn a little bit more about Botox. 

So let’s get right into it. The first thing I want to mention is I want to clarify some of the terminology. I’ve already used a couple of different terms interchangeably here, as you may have noticed: neuromodulator and Botox. Botox is one brand, of the neuromodulator botulinum toxin. There are other brands on the market as well. Some of them are Dysport, xeomin. These are probably the most common ones after Botox itself. But oftentimes a neuromodulator treatment is simply referred to as a Botox treatment because so many people are familiar with that term. It’s kind of like generic tissues or the term Kleenex. People use Kleenex all the time, even though that is a brand name. It’s just the same with Botox and neuromodulators. So in this podcast, you will hear me referring to neuromodulators as Botox and sometimes as neuromodulators. I’ll be using those terms interchangeably, just like how most people use them. 

Where does Botox come from? Botox is actually a, neuromodulator, a neurotoxin that comes from the bacteria, clostridium botulinum. It is harvested essentially from this bacteria, purified, and then depending on the brand name, it is packaged with different types of proteins. But ultimately this product, this neuromodulator, is then used to treat a number of different conditions and for a number of different aesthetic treatments. 

How does it work? This neuromodulator works by interrupting the message that your brain sends to your muscles to ask them to contract. So in a little bit more detail, when you are getting your muscles to contract, let’s say that you are frowning and you want to frown, your brain is telling your frown muscles to frown. That signal is coming from your brain through the nerves, to the muscles in your face. And then those muscles get that message from the nerves, telling them to contract and then they go ahead and do that. Now when you have a neuromodulator, such as Botox, injected into those specific muscles, the frown muscles, it interrupts that message. Meaning, the nerve, which typically puts out a chemical, acetylcholine, to tell the muscles to contract, that chemical gets blocked. That message no longer gets to the muscles, telling them to contract. And what happens? The muscles don’t contract. They relax. And over time when those muscles are not contracting, you no longer get the movement over those muscles, which would typically cause wrinkles and fine lines. And when you don’t get the contractions, you don’t get the wrinkles and the fine lines. Your skin appears more smooth. It appears more youthful and that is really how neuromodulators such as Botox work. 

So again, it interrupts the message from the nerve to the muscle. And in turn the muscle relax. You don’t get the contractions. And as a result, you don’t get the wrinkles in the skin overlying those muscles. It’s a pretty elegant system. And of course this has been taken advantage of for many different medical treatments and for the aesthetic purpose as well. 

So let’s get into this. Let’s talk a little bit about some of the uses of Botox or neuromodulators. There are both cosmetic or aesthetic treatments. And there are therapeutic treatments.

Let’s cover the aesthetic treatments first. The most typical treatments for Botox include the treatment of wrinkles and fine lines. Meaning, when we inject the Botox into a particular muscle in the face, it causes the muscle to relax. And then you have a diminished result of the appearance of those fine lines and wrinkles. This can be done in many different areas of the face. The most common ones are the frown lines or the 11s, right between the eyebrows. The forehead lines, the horizontal lines across the top of your forehead. The crow’s feet, or the wrinkles along the outer edges of your eyes. Those are also very common areas to be treated with Botox. But there are so many more. There are lines along the sides of your nose, sometimes known as bunny lines. You can use the Botox for lines in the upper lip, and this can smooth out these lines and they can also be used to get a result called a lip flip. So when we inject the Botox into the upper lip, it relaxes the muscle and that actually allows the lip to just slightly elevate and it creates the appearance of a fuller lip known as a lip flip. You can also use Botox in the chin and reduce some of the dimpling of the muscle directly in the middle of your chin. You can also use Botox along the neck and for platysmal bands. Sometimes you can see strong bands that are running down the neck and Botox can help to relax those as well. There are a number of other uses from an aesthetic purpose as well. For Botox things like an eyebrow lift, you get an eyebrow lift. And you can even treat some nasal labial folds and do things with the smile. If you have an asymmetric smile, sometimes you can fix that with Botox as well. 

From the therapeutic side of Botox, there are a number of uses as well. One of these is for migraines. Migraines can be worsened by contracting muscles around the scalp and creating tension in the head. By injecting Botox into those muscles, you can relax them and that can help with migraines. You can also do a similar treatment for temporomandibular joint pain, jaw pain by injecting and muscles into the masseter muscle and helping that to relax. You can also use Botox for hyperhidrosis or excessive sweating. So you can inject that into the armpit or the axilla, or you can even inject it into the palm of the hand, where there are common places to have excessive sweating. 

There are a number of other uses for Botox as well. You can actually use it to cause some facial slimming by atrophying or making some of the muscles in the face a little bit slimmer. This can also be done in other areas of the body where, depending on the culture, some areas prefer to be slim and you can use Botox to do that. One example is the calves. As you can see, there are lots of different uses for neuromodulators and there are others as well, but I haven’t mentioned in this podcast episode. 

Now, let’s say that you do want to go ahead with a Botox treatment. What is involved? Let’s talk a little bit about that. When you decide to get a Botox treatment, one of the first things that we ask in our clinic is why? What do you want to achieve with your Botox treatment? And this really starts the consultation process. We want to know, what is it that we can help you with and is Botox the appropriate way to do that? 

So, a very typical scenario for a Botox treatment is having a person come in who says, I just don’t like my frown lines. I don’t like the wrinkles on my face. I want to treat those. I want to look younger. I want to look more restful. I don’t want to look as angry. I want to look more energetic. And that typically is a great, great scenario for Botox injections. 

So once we go through a little bit of the consultation process and understand why you want to do it, then we get into the design of the treatment. We take some photos of you. And then we look at where we’re going to place the Botox. We determine the appropriate dosing of the Botox. And then the actual injection itself is extremely quick. It’s just takes a few minutes, if that. And literally what we do is we get some ice packs. We help to numb the area. We clean the area with some disinfectant and we simply inject the Botox into the area. The needles that are used are extremely small. In fact, are the same type of needle that people diabetes use to inject insulin on their own. They are essentially insulin diabetic needles that we use for the Botox. They’re tiny. They’re 30 gauge needles for those of you that are interested in the specific size. And they are administered very, very quickly. 

What happens after that? Well, some of the side effects that we always tell all of our patients about is that when you have injection as with any injection, you are injecting something into the body and you can get a little bit of redness in the area. This typically goes away extremely quickly. One of the other things that can happen with any injection is if you inject it into an area and there’s a tiny little blood vessel there, you may have a little bit of bruising just from a tiny bit of bleeding in that area. That’s something that can happen with Botox. We try to minimize that as much as possible, but it is something that you should be aware of. 

And something that is extremely rare, but also something that you should be aware of is that if the dosing is not done correctly, or if it’s not done in the correct location, you can sometimes get an eye brow droop, or an eyelid droop. This is very uncommon. And this is actually one of the reasons why it is highly recommended that you have your Botox treatment done by somebody that is experienced in this, simply because they have the knowledge and the practice of knowing how much and where to place the Botox injection. The good news in this sense is if this were a complication that were to happen to you, botox is completely temporary. It’s completely reversible, meaning after three months it wears off, the effects wear off and your muscles go back to the way they were before you had the Botox injection. 

Now, depending on your perspective, that may be a downside because for those that really enjoy getting Botox injections, I can imagine that they would rather have the Botox last much longer, but the reality of it is that Botox lasts about three months. So if you do enjoy the effects of Botox, then repeat treatment every three months is what is recommended to really see the effects and the effects can be cumulative, meaning the more you do it, the muscles become more and more relaxed over time. Less and less wrinkles over time as well. For those of you that are new to Botox, the temporary effect of the Botox may be something that is quite appealing to you because you can try it out. And then you know that three months from now, you can then choose to just be done with it and never do it again, or you can say, you know what? I really liked the effects of it, and I want to go on, I want to have my second treatment. So Botox is a temporary treatment. And depending on your perspective, you may or may not like that idea, but that’s the reality of the situation. 

A couple of other things that I want to tell you about Botox. You may have heard the term baby Botox. What is baby Botox? It simply is a fun term for small doses of Botox. Particularly for people that are trying it for the first time, that want to try just a little dose, everything that I mentioned in this podcast episode already applies to baby Botox treatments. The only difference is that it’s a smaller dose. So the effects are not going to be as obvious. And it’s a way that people can feel a little bit more comfortable about trying the treatment, particularly for the first time. 

Now, one of the misconceptions or myths about Botox is that it is for women only, and this is totally false. In fact, more and more men are having Botox treatments because they are noticing that with these treatments, they do look more refreshed. They look more youthful. They don’t look as tired. They don’t look as angry. And for that reason, we are seeing more and more men as patients as well, when it comes to neuromodulator treatments. 

So finally to wrap things up. I hope that you have seen that Botox is a very elegant, very unique type of treatment and very effective type of treatment for aesthetic results as well as some therapeutic results. Botox has actually been used for these reasons now for well over 20 years. It is extremely well-established and it is an incredibly safe procedure, and very, very effective for those that want to look, as I’ve mentioned, youthful, rested, and less angry, just more friendly. It is a wonderful treatment for that. The final thing I’ll mention is if you do want to look into Botox, I encourage you to do your research. Find a provider that is well experienced, has had a lot of practice, and is knowledgeable in facial anatomy and is an expert really on administering the Botox. For the reasons that I mentioned already, it’s critical to find somebody that you trust and that you believe will provide excellent service to you. 

With that being said, of course I would be only too delighted to be able to help you out with your Botox treatments. We have a number of other injectors at our clinic at Anti-Aging Medical and Laser Clinic, and they too are fantastic and I am sure that they would be only too delighted to help you out as well. So if you’re interested in checking that out and checking out our services, feel free to check out our website at or if you’d like you’re welcome to check out my personal website at, D R T E R I F I S H E As well, if you have any other questions about Botox that I did not answer in this episode, feel free to reach out to me as well. Probably my most convenient way to respond to you is through Instagram. My handle is Dr. Teri Fisher as well, D R T E R I F I S H E R. And I’d be happy to chat with you there. 

Thank you once again for tuning into the podcast this week, I hope you learned a lot about Botox and neuromodulators this week. And I look forward to chatting with you again very soon. As always, if you enjoyed the content, a review on your favorite podcast player would be much appreciated, as would sharing out this content to others that you think would benefit from the messages here in the Anti-Aging Insights podcast. 

Thanks so much. And I look forward to speaking with you again next week. Until then take care be well, and I’ll talk to you soon. 

Next Episode
Episode 8: Revolutionary Hair Restoration

About the Show

Anti-Aging Insights Podcast

Join renowned Anti-Aging, Aesthetic, and Sport & Exercise physician, Dr. Teri Fisher, as he explores the latest news, treatments, technologies, research and developments in non-surgical cosmetic and anti-aging medicine. Throughout each episode, Dr. Fisher is your guide to help you understand what you can do to look and feel amazing, and to improve the quality of your life today and tomorrow. He breaks down the medical evidence to determine what works (and what doesn’t) to help you better understand the world of aesthetic medicine. Dr. Fisher interviews experts and leading practitioners in the field to discuss the latest strategies and techniques for maintaining health and wellness as we age. Whether you’re looking to improve your physical appearance or overall well-being, this podcast has something for anyone who is interested in maintaining their health, youth, and vitality as they get older.

Please note: This podcast is for informational purposes only and is not intended to be a substitute for professional medical advice. Always seek the advice of your qualified healthcare provider before starting any treatment.

Visit Dr. Teri Fisher’s website here.

Dr. Teri Fisher

Dr. Teri Fisher is an Aesthetic and Sport Medicine Physician, and a Clinical Assistant Professor at the University of British Columbia. He has been a podcast host for over 10 years and is particularly known for his approachable, thoughtful, and friendly manner. It is through his aesthetic medicine practise that Dr. Fisher combines his passions for art, science, and technology. For more information about Dr Fisher, please click here.

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