Every year in Stanislaus County, we get a letter for online filing around February. This is due May 7th. One thing we learned is that Botox is considered property for a doctor and is thus subject to property tax. We file this ourselves online or sometimes we have our accountant who is in downtown Modesto, help us with the e-file. The Assessor’s office business division telephone number is 209-525-6461. This info should be helpful for other Botox Businesses in Modesto or perhaps other places as well.
Quick answer: For me it took me about 32 years of full time work to become a Surgeon / Acupuncturist / Cosmetic Physician.
I am a Board Certified General Surgeon with a past trauma career who assists in plastic surgeries and spinal cord stimulator / spinal pain pump surgeries. I am also an Acupuncturist who injects Botox as an extension of Acupuncture. Many of my Botox point selections are related Acupuncture points for migraine headaches and wrinkle prevention. 40% of my clinical time is spent at work is spent on Acupuncture, and 50% of my time is spent with cosmetic injections for Botox, Fillers, and Veins, and 10% of my time is spent assisting in surgeries. In a usual clinic day, It is common for me to use 250 units of Botox, 7 syringes of dermal fillers, and see about 6 acupuncture patients. Outside of my clinical time, I also spend a great deal of time as an administrator of Surgical Artistry – the combined medical office for myself and my wife, Dr. Tammy Wu, Board Certified Plastic Surgeon.
While discussing “life” with another surgeon friend. I sort of wondered why a chunk of my life seemed to be missing; I never caught on with today’s technology (I don’t have a TV or smart phone – yet as of 4/26/15). We calculated how many hours went into my training to become a surgeon/acupuncturist/Botox injector after high school. We came to the conclusion that for me it was roughly 58,000 hours! That’s more than 32 years at a full time job to do what I do as a surgeon/acupuncturist. Yikes – who does stuff like that?? (I guess I did).
I did not make this really nice graphic above.
I just found this online which shows that most doctors spend 20 years in full-time work hours to do what they do. I was coincidentally calculating how many hours of formal training it took me to become a Surgeon/Acupuncturist/Botox injector: My conclusion is 32 years at a full time job (58,000) hours. Here’s the website source of the graphic: http://www.bestmedicaldegrees.com/salary-of-doctors/ (warning – it might depress some doctors)
The data for the info seems to come from this webpage: https://benbrownmd.wordpress.com/
Just realized I might be unique. I have known that I might be one of the first board certified General Surgeons to become an acupuncturist in America. And I am probably one of the first acupuncturists to inject BOTOX regularly. And I am probably one of the first acupuncturists who assists in Tummy Tuck surgeries and Face Lifts. So it is possible that I am UNIQUE as a Board Certified General Surgeon who became an Acupuncturist who injects BOTOX regularly and assists in Plastic Surgery – and lives in Modesto, California!
Many of the injection sites for Botox are the same as Acupuncture points
I am starting to see BOTOX as an extension of Acupuncture – most of the injection sites for Botox are acupuncture points – especially points for relieving stagnant/congested feelings in the head which include headaches, depression, sinus issues, allergies, etc.
We are frequently asked at our Modesto Botox practice: “How much Botox do I need.” In fact, we get this question over the phone which makes it nearly impossible to answer. But one way I thought of to answer this would be to look back in our records and see what the last 40 patients (anonymously) used and perhaps an average number of Botox Units used in these 40 patients would help someone reach an answer to this question over the phone. The best way to get this answer is to schedule an appointment with me, the surgeon-Botox injector.
Special thanks to Jessica of the Surgical Artistry team who keeps track of this info. This is practically a chart review. This data shows a higher number than the last time we did this exercise back in 2012 where I came up with the answer that 29 units was the average number of Botox units a person used in my practice in 2012. Now it’s 36. Economy changes perhaps? I think my most commonly recommended Botox number of units is 40-50 units of Botox for cosmetic Botox.
The answer to the AVERAGE number of units used per patient 2015: 36 Units.
How is this info valuable?
Other Botox injectors can compare their data with ours.
Economists can try to use Botox to predict trends in the economy. Apparently plastic surgeons can predict the economy based on their patient load, etc.
And most importantly, patients can use this information to figure out what the average Botox cost might be. Just multiply 36 by the cost per unit. If it’s $12/unit then the cost of Botox for 36 units would be: $432.
Average cost of Botox would be $432 if the cost of Botox is $12/unit
But it’s good to keep in mind that many new patients consider 40-50 units very often.
Raw Botox Data
Here’s my most recent listing of Botox patients in Modesto. Most recent 40 Botox patients – going backwards in time from most recent to 40 patients ago.
Micro-cannulas are mini flexible versions of liposuction cannulas borrowed over from Plastic Surgery. This could be a long discussion but the brief version of my reason is for: Safety and Results
Safety from injuring nerves.
Safety from injuring blood vessels.
Safety from injuring glands and ducts.
Better Results: I can get a smoother and wider fanning result.
Better Results: I can usually have less bruising with my patients.
Better Pain management: Patients usually tell me that there is less pain with this technique.
Drawbacks to using blunt tipped micro-cannulas?
Sometimes it takes more time.
It is more costly for sure.
It is more complicated.
There is a definitely a technical learning curve. I can say that I am much more adept at this now than compared to two years ago.
What are the differences between brands of micro-cannulas?
Flexibility of the cannula
Location of the opening: some are closer to the tip and some are further back.
Packaging of introducer needles with the cannula – some come with the cannula, some come separately. (Like batteries sold separately).
The presence of markings on the hub of the microcannula “needle” which shows the directionality of the opening at the tip.
What I use for micro cannulas
I have been using micro cannulas to inject dermal fillers for several years. There are differences between the brands but I haven’t yet decided which ones I’d like the best. I’ve used Magic Needle and Dermasculpt associated with CosmoFrance. Right now I am mostly using Dermasculpt. I have the 25G – 2 inch microcannula which I buy several hundreds of these at a time. I’m starting to use this as my all purpose cannula for Cheeks, Tear Troughs, and Lips. I have somehow found that this cannula is more comfortable for the patient and the 2 inch reach is very nice to have. The other cannula I use from time to time is the 27G – 1.5 inch. This is my usual cannula for tear troughs and for shorter lips. But my thought process changes from time to time regarding which one I prefer. I like the stiffness of the 25 gauge microcannula. There are many options and I think one has to try several of these to see if they are worthwhile. One should check often with their price policies too, as I got caught once with a surprise in their pricing of microcannulas because I was using an older order form. I wasn’t too happy when I found out about the pricing / policy changes. At that point I needed to tell them about a bent 25 guage 2 inch microcannula which I received in the past. I have only received one bent (still in the package). If I have time, I’ll post the picture of the bent one. Regardless the cannulas are great, I don’t have a need for the directional marking of the side opening – that isn’t a feature that is currently useful for me.
I hope these ramblings about micro-cannulas for dermal fillers are helpful. For me they have been a great addition to what I do with Botox and Fillers. And I should add that I still inject directly with the sharp needles which are supplied in the dermal filler packaging.
Next, I probably need to probably write about a question a Botox trainee asked me recently: “Which do you inject first, Botox or Filler, if it’s going to overlap in location?” I have some thoughts on that. Till next time
I like to help other Botox injectors and I just got this question on my email today. I thought I’d share and hopefully help others
Question: How big of a fridge will I need for Botox? Which one do you recommend?
Answer that I emailed back:
Fridge Size: I use a dorm room sized fridge. It’s half height fridge which comes up to my waist. You don’t really need anything big at all for Botox. Small works just fine.
You could even get a square shaped mini fridge. But I don’t want to bend down all the way to the ground.
You don’t need a freezer for Botox. They make refrigerators without a freezer. This could potentially save electricity and some hassle of freezer issues. I think if I were to do it differently, I would get a refrigerator without a freezer. The ice in there messes up the temperature sometimes.
Regarding temperature regulation. I have two thermometers – one is digital (uses batteries) and broadcasts the temperature, and the other is just a plain analog thermometer (no batteries). It’s important to keep the temperature of the Botox within the guidelines suggested by the manufacturer. But sometimes, it’s nice to have a freezer section for the ice packs. These would be ice packs to hand out to patients for bruising.