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There are many news stories about people getting injured or bad outcomes at “Botox Bars” recently.  One must keep in mind that these injectables can be administered by physicians or nurses and that most of the time you are paying for the material being injected (which tends to be very expensive and the majority of the cost you pay), as well as the professional fee for the person doing the injection.  It makes sense, then, that the more experienced and trained physician charges more than a nurse injector.

What is a Botox Bar?

Botox Bars establishments provide injectables, notably Botox and its cousins (Dysport, Jeuveau, and Xeomin), as well as fillers such as Juvederm and Restylane products.  These non-surgical treatments are not administered by a physician, but rather a nurse, which lowers the cost of the treatment.  They are the go-to option for people that want to avoid a traditional doctor’s office or feel more comfortable getting treated in a more social, less “clinical”, atmosphere.

What Can Possibly Go Wrong?

All of the injectable neuromodulators are not “simple” to administer, as there is a lot of skill involved in picking the dosage as well as locations to inject to get the desired effect.  Too heavy of a treatment, and the brow can drop (thankfully, temporarily).  A few millimeters too low, and the eyelid can drop.  A few too high, and you don’t get the injection into the muscle that you were aiming for.
A common complaint that I see from people getting treated at Botox Bars is that they end up spending too much (getting over-treated), which is an error in judgment.  The dose is especially important because you are paying per unit injected, so the person injecting you is incentivized to inject as possible (to make the most profit).  A more skilled injector, or one that cares more for your long term result, will be more light-handed and count on you coming back months down the line.Though they lure you with a low price per unit, many people end up spending more Botox Bars because they get more units injected in total.
Another complaint is that there is a lot of turnover at these places, as they tend to get less experienced injectors, and often employ Groupon or other discounts, where people are lured in by low prices rather than good results.  They can get good results with one injector, but in 3 months once their treatment wears off, their injector has moved on and it’s another new injector in their place.  Not a problem unless you pre-paid for a package of several treatments (which is often a part of the “deal”),

What Are Fillers?

Fillers restore lost volume and are a great tool for facial rejuvenation.  They are administered by the syringe, which usually is 1cc of volume.  This is not a large volume, but placed strategically, that 1cc can go very far.

Risks of Getting Fillers at a Botox Bar

The prime risk of fillers comes from injecting the material into a blood vessel, which can kill the skin that is supplied by that blood vessel, or travel to another part of your head and neck and cause problems.  The scariest one here is blindness caused by injection into a facial vein.
Despite these risks, the treatments are considered safe and are quite popular.  If you suffer from one of these outcomes, however, you need immediate medical attention.  IMMEDIATE.  This is an inherent problem with getting treated at a Botox Bar, where a nurse injector is performing the treatment, and the doctor may not be on site.  See this news article (https://www.cbsnews.com/news/botox-injection-bars-raise-concern-among-medical-experts-i-think-im-turning-purple/) about how a patient had to wait for hours while the doctor came to administer the enzyme to dissolve the filler.
If you have one of these rare complications, you want the doctor there NOW.  The treatment is to dissolve the filler as soon as possible.  If “time is money”, then in this case, “time is face”, because if the facial tissues go for too long without blood, it dies.  The faster you restore blood flow, the less risk of tissue loss.  This is typically seconds or minutes, not “hours”.

Prime Risk of Botox Bars – Where is the Doctor?

Now the inherent risks of a Botox Bar become evident.  The Botox Bar has gotten serious medical treatments and brought the accessibility down at the cost of safety.  The doctor is farther, oftentimes out of sight and mind.  This makes the treatment less intimidating, but I don’t think it makes it safer.