Category Archives: Belotero

Allergan considers a 3% increase in the price of Botox starting in 2015

Botox, Juvederm, Latisse to possibly get a 3% rise in cost for those Botox practices purchasing from Allergan USA

I don’t have this 100% verified.  But I heard a whisper about this as I am a regular Modesto purchaser of Botox, Juvederm, Voluma and Latisse.  I heard that across the board all these three products are going up in price in January except the 5 ML Latisse.  I do recall that last January, Botox had a sudden increase in price which wasn’t announced ahead of time.  I think Botox practices deserve to know ahead of time for planning purposes.

However Allergan is about to merge with Actavis, and many of these practices and policies of price increases are probably going to change

A history of price increases

I remember when we started purchasing Botox in 2006 that every year, the price would go up.  To our humble Modesto practice, it felt like a bit of a struggle to keep up.   When the recession became more of an accepted ambiance, Botox prices stayed the same for a few years.  But starting in 2014, the prices started increasing.  I had a strong feeling that many practices in Modesto, including ours had greater temptation to migrate over to Xeomin and Dysport from Botox.    However, I think as with inflation, there tends to be an increase in just about everything all the time.

How much would Botox Cost at our Modesto Practice?

I think we would consider following the trend of price increases.  If our Botox source goes up 3%, we would probably consider following.  However last year when Botox price increased for us, I elected not to increase our Botox price for patients, yet.  Please call our office for the latest information.  Our phone number is on our Modesto Website.

Such is life in Modesto and life in general

Hopefully Botox’s prices doesn’t skyrocket to the point where we have constantly diminishing returns.   Diminishing returns?  There is pressure, naturally, to lower the price of Botox for patients – there’s competition from other injectors, there’s fake Botox, there’s Botox from other countries, and their’s other products that do similar things to Botox such as Xeomin and Dypsort.

Enter Xeomin and Dysport into the Modesto market?  Belotero and Radiesse?

In general, it’s good to keep an open mind about the possibilities of other products that work in the same areas as Botox, namely, Xeomin and Dysport.  I already like a lot of Non-Allergan products – meaning non-Juvederm.  My personal exploration with these other products were brought about in the early 2014 price increase that was suddenly dropped on me in January 2014.  So good things come out of things that appear bad at first.  I think  I wouldn’t have been such a supporter of Belotero – Belotero Balance – if I didn’t have a kick from the sudden jolt that I received from Allergan in January 2014.

Getting Botox has never been a right, like free speech

Getting Botox injected into one’s glabellar complex or crows feet has always been a choice, not a right.  Thus we can simply choose to avoid this price increase by avoiding Botox altogether.  That could be a choice for the consumer, or it could be a choice for the Botox injector.  For a cosmetic surgeon, there’s a choice to focus more on surgeries.  We can’t complain, as a team, my wife and I have had the opportunity to do many cosmetic surgeries.  In fact in 2014, we were voted Best Cosmetic Surgeon in Stanislaus County (which includes Modesto) from Contentment Health Magazine.

But I’d like to think that I’m trying to keep the prices reasonable for our patients in Modesto, CA.

How many Botox Units for Crows Feet?

How many units of Botox are good for treating the crows feet around the eyes?

Quick answer?  8-12 units of Botox per side.  Because we usually want to treat both sides of the eyes, we would double that number and that would be 16-24 units.

8-12 units of Botox per side? (16-24 units of Botox)

Yes, about 8-12 units of Botox could be injected per crows feet (left or right).  However, everyone is different.  I have done more and I have done less.  This depends on Male vs Female, young vs old, and of course on personal preferences and experiences with Botox.

Another consideration is eyebrows.  Eyebrows can also be lifted with a certain style of crows feet injection, or even an extension of the crows feet injection.  Women and men have different eyebrows.  Women have more of an arch, which complements a certain style of crows feet Botox injections – these injections hug the eye a bit closer – especially toward the eyebrow region.

And yet another consideration is swelling under the eyes.  Sometimes too much injection in the crows feet can lead to temporary swelling under the eyes.  These are things to discuss with your personal Botox injector – preferably in person and at an appointment (face-to-face).

What to do for really deep Crows Feet lines?  Static lines.

Fillers may be an option.  I like to use Belotero as a filler for crows feet if needed.   Juvederm could also be used, but in my hands it tends to be a little bit bumpier.  But it is usually my preference to try Botox alone first.

That’s the beauty of Botox.  It is customizable.

Everyone will have different preferences and have a different response to Botox.  It becomes a science and art – this injection of Botox.

I hope I helped to answer the question of how many units of Botox are needed to help with crows feet around the sides of the eyes.


Let’s say we just wanted one number to be the answer.  Perhaps hang on to the number 20.  It’s a nice round number, and it’s between 16-24 units of Botox (for both sides).  I would say that 20 units of Botox is a nice treatment for many people’s crows feet!

Please feel free visit our Botox practice in Modesto.



Dexterity for Botox Injections – Chopin?

Dexterity for Surgery, Piano, and Botox Injections

Surgery depends a lot of dexterity.  So does playing the piano.  And so should Botox injections.


I have some unique ideas of developing and maintaining my Botox dexterity with Piano Practice.

  • As with piano playing, I like to keep my wrist supple and flexible when injecting Botox.
  • When injecting fillers, there are times where I have to do finger stretches to be able to maintain tension on the skin with my non-dominant hand, and then I also sometimes have to reach for the plunger which may be in slightly awkward positions for my dominant hand – it depends on the style of the plunger.  Radiesse Volume Advantage is one of the larger syringes due to it’s 1.5 cc volume which is more than some of the other syringes of dermal filler.
  • Timing is also key in Botox injections.  Timing is a big deal in music and performing piano.
  • Then there’s the grace in lifting off from the actual Botox injection.  It would be a shame to waste Botox with a heavy handed lift-off – in that case, the Botox isn’t injected into the muscle – it might even be injected into the air.  Thus a light lift-off is key.  It’s akin to musical phrasing with the tapering that occurs and the lifting off of each note too.

Chopin Etude Op. 25, No. 1 (Aeolian Harp) as Botox Dexterity Practice

Here’s a piano piece which is dedicated to finger dexterity building.  It is also one of the most beautiful melodies I have ever encountered in an finger dexterity etude.  This piece is also known as the Aeolian Harp Etude.

Yes, that’s me.  Recorded at my home in Modesto, California.  Yes, this is one of the great things you can do in Modesto – practice piano!  And record piano for YouTube!  And write this blog… ok, the list goes on and on regarding great things  in Modesto, CA.

Quoted from the wikipedia entry on this piece:

“Technically, the piece requires both dexterity and velocity, good balance and weighting of the arms coupled with flexible finger stretches”.

For me my dexterity and musical challenges are: evenness, flexibility in the wrist, and flexibility with finger stretches, light touch, and musical line phrasing. I hope to continue to work on this to make it even better.

Light touch?

And a light touch is very very important in lightening the sensation of any pain from Botox shots.

Consider getting Botox from us in Modesto, CA

Please visit my Modesto Botox injections home page.  We offer other Cosmetic procedures besides Botox.

Our other Procedures include:



Cosmetic Procedures Besides Botox

Minimally invasive cosmetic and acupuncture procedures I perform in addition to Botox

Some may call minimally invasive as “non-surgical.”  But to me these procedures are surgical.

  • Asclera vein injections – for those spider veins (especially on the legs).  Their slogan is “Enjoy the freedom to show your legs.”
  • Vein laser with the Dornier Diode Laser
  • Radiesse dermal filler injections
  • Juvederm VOLUMA dermal filler injections for cheeks.Voluma Apple
  • Belotero Balance dermal filler injectionsBelotero Box
  • Juvederm Ultra Plus XC, Juvederm Ultra XC, Juvederm Ultra plus (without XC), Juvederm Ultra (without XC).
  • Derma Pen – skin tightening procedure.  Also good for acne scars.
  • Blue Peel Radiance – Obagi product
  • Blue Peel – Obagi
  • Acupuncture for various conditions such as back pain, headaches, stress reduction, fertility, hormonal balance, allergies, etc.

My Surgical Assisting Consists of:

In addition to these procedures I also perform surgical assisting for plastic surgery, and for Spinal Cord Stimulator Implants and Morphine Pump implantations – both for chronic pain.

Spinal cord stimulator implant
Spinal Cord Stimulator Implant


Yes, this is a Botox Blog.  And Yes, this is connected to my Modesto Botox Home Page.   I just wanted to make a brief mention of the other cosmetic procedures I perform.  I recently (probably for frequently than I know) had a patient who didn’t know that I performed a particular procedure.  And it seemed like she would have liked to know that I was available for that procedure – which was Voluma Injections.  Yes, I do Voluma injections.

In the office, I mainly concentrate on procedures which are done with a needle.  One can call these minimally invasive cosmetic procedures.  And from time to time, I wander off to the operating room to perform, guess what?  Some surgeries!  But most of those surgeries are surgery assists.

Other than surgery, this is how I spend time in the office.  “Botox” here means Botox, and Dermal Fillers, and other minimally invasive Cosmetic Procedures:

Botox Pie Chart
2014 data for how my Veins, Acupuncture, and Botox division of office based procedures. Surgery isn’t included here since it isn’t done in the office. This chart is just the division of my patient load in the office.

Belotero Balance Injection Technique – a unique method

Belotero Serial Puncture or Serial Killer?

Belotero offers a dual cross-linking process of the hyaluronic acid which offers a natural-even integration into the dermis.

This Belotero page is for Botox/Belotero injectors.  And I’ve decided to call this Belotero injection method the “aerial dive bombing technique.”

I have my own version of this technique, but it’s more of a “submarine missile attack” (more on this someother day).  Actually I personally think that my idea is superior – well at least in my small hands.

Injection technique with BELOTERO BALANCE is simple and accurate

When injecting using the serial puncture technique, it is important to remember the following:

  • Penetrate the dermis just until the bevel of the needle is hidden.10
  • The needle’s bevel measures 0.75 mm in length.*
  • Typically, the dermis measures approximately 1.8 mm in depth.
  • Once the bevel is buried, filler can then be deposited accurately within the dermis.
  • Then repeat the process multiple times per wrinkle line.

*Bevel measurement based on the needle included with the BELOTERO BALANCE syringe kit.

Superficial injection of Belotero works!
Superficial injection of Belotero works!

For Killer results, consider the techniques above

and consider visiting us at our Modesto Surgical Artistry Botox Injection Center by Calvin Lee, MD

Lowest price Botox?

Lowest Botox Price matching?

We get this question from time to time regarding matching the lowest price of Botox or Juvederm.  It isn’t a common question, but it comes up perhaps once per month or so.  I figure it’s worth addressing.

This is not a blog about different Botox-like substances or Botox from other countries.  We receive our Botox directly from Allergan USA, that ensures that it is genuine.  So back to the topic of “Lowest Price for Botox?”

So, do we price match or compete on pricing?

The quick answer is “No.”

But we like to compete on “value”.  But in the end, we don’t see this as a competition.  We have a lot of respect for everyone.  We have set prices that make sense to us.

So the long answer is that we hope that we are considered the “best value.”  But all this depends on what patients value.  It might be different than what I might value.  So I can definitely understand different definitions of value when it comes to Botox injections.

Surgical Artistry doesn’t emphasize or compete with “cheapest” prices.

Our Botox Surgeons (mainly Calvin Lee, MD) value a high level of

  • results
  • safety
  • and comfort.

And the Office values a high level of

  • customer service
  • positive attitude
  • and communication

We hope to win with BEST VALUE.  I think we would lose the battle if we were going for price wars on Botox.

But hopefully we might win with best value – that’s our attempt.

Here’s a link to another topic of Botox Wars – The fight for Allergan Ownership.


Botox didn’t work for my “11s”

Botox didn’t work.  I still have those creases between the eyes!

I hear this problem from time to time.  Botox has a hard time with certain creases in the glabellar complex – and also in the crows feet.  Why?  because for me, it doesn’t seem to work very well on static lines.

Static lines vs. Dynamic lines:  this is the reason

Dynamic lines are wrinkles that are created with movement.  Static lines are wrinkles which are present even when the muscle is at rest – relaxed.  Botox main mechanism is to relax the muscle.  Although, I have seen Botox’s effect on possibly tightening skin – but that’s a different topic.

Botox works best on Dynamic lines

By relaxing the muscles, the dynamic lines diminish.  However, Botox has a harder time relaxing static lines.

Dynamic Lines eventually become Static Lines

It seems to me that most dynamic lines eventually becomes static lines.  Thus Botox works amazingly well in my opinion in preventing static lines.  This effect of Botox is one of it’s best uses.

So what can we do about these stubborn Static Lines?  More Botox?

I also believe that with some patience static lines can diminish over regular usage of Botox – perhaps after the 3rd or 4th time of getting Botox over 1 year.  I wouldn’t let too much time lapse between botox treatments.   I don’t think necessarily MORE botox per session is the answer – but perhaps more diligent usage of Botox – or perhaps a more “disciplined” approach to Botox scheduling.  Don’t forget to schedule your Botox Appointment with us in Modesto, CA.

Consider fillers or more time to help with these stubborn wrinkles.

So if time is on your side, and you can wait it out – consider waiting a bit to see if Botox will assist your body in repairing these deep static wrinkles.  However, if there’s a deadline (special event coming up), some of our patients would consider dermal fillers such as Belotero or Juvederm.  Much of this use would be considered off-Label-FDA usage.  Dermal fillers within the wrinkles will help smooth them out!

Disclaimer: please see your physician in person for personalized recommendations.  Above is just an academic discussion of wrinkles, Botox, and Fillers.  I have also encountered lines which just didn’t seem to be helped much with either Botox or Fillers – the human body is certainly very challenging, and keeps our jobs as Botox injectors very interesting.  Here’s a list of Modesto Botox Injectors – but of course, I hope you choose our practice (Surgical Artistry in Modesto).

Cosmetic Fillers compared in terms of thickness

Each cosmetic dermal filler is like a paint-brush

There are all these terms to describe the different properties of fillers including G prime, lift, thickness, hardness, and much more.

I have some thoughts about the projecting capabilities of the fillers and I feel that it is related simply to thickness.  These are my own thoughts about these cosmetic fillers.  I have been doing Botox and Fillers since 2006.  Please consider looking at other sources if you are seriously needing to compare thicknesses of these fillers.

The empty boxes of the dermal fillers used today
The empty boxes of the dermal fillers used in one day at my office in Modesto, CA.

From thinnest to thickest:  Comparing Dermal Fillers

  • Belotero Balance (Merz product) – thinnest
  • Juvederm Ultra XC
  • Juvederm Ultra Plus XC
  • Radiesse diluted with some added liquid lidocaine
  • Juvederm Voluma XC
  • Radiesse – straight out of the box. – thickest

I know integral lidocaine is currently being considered in Belotero Balance and Radiesse, but at the time of writing this blog – they have not been available.

Radiesse, Juvederm Ultra XC, and Belotero Balance cosmetic syringes - complement Botox injections very well
Radiesse, Juvederm Ultra XC, and Belotero Balance cosmetic syringes – complement Botox injections very well


I hope you can visit us at our office in Modesto for Botox and Dermal Filler Appointments.

Botox Related Products at Surgical Artistry

We carry products from Allergan (makers of Botox), Merz, Valeant, and others

We don’t have any contracts with any one company to be exclusive.  Botox belongs to the Allergan family of products: Latisse, Botox, and Juvederm.  These are the products we carry at Surgical Artistry.  We also carry aesthetic products from Merz, Mentor and Valeant.

These are the Botox related products we carry:

Not necessarily made by the Botox company, Allergan.

  • Asclera, injected for vein sclerotherapy.
  • Botox – Botox is supplied to us directly from Allergan USA in the form of 100U vials
  • Juvederm Ultra (without lidocaine)
  • Juvederm Ultra Plus (without lidocaine)
  • Juvederm Ultra XC
  • Juvederm Ultra Plus XC
  • Juvederm Voluma XC
  • Belotero Balance (Merz product)
  • Radiesse Volume Advantage (Merz product, this is 1.5 cc’s)

This list changes from time to time.  Feel free to call us.  Our contact info is at our Botox Home Page.

belotoro balance shelf

Above is a picture of our Belotero Balance Shelf


Radiesse, Juvederm Ultra XC, and Belotero Balance cosmetic syringes - complement Botox injections very well
Radiesse, Juvederm Ultra XC, and Belotero Balance cosmetic syringes – complement Botox injections very well

Above picture was taken on our conference table which has that rough texture on top.

We do not currently carry:

  • Xeomin
  • Dysport

Please take time and visit us on the web and in person.

Juvederm before and after picture for cheeks

Juvederm and Belotero Before and After
Juvederm ultra plus xc and Belotero injected via Cannula Technique by Dr. Calvin Lee

This is not done with Juvederm Voluma.  As of November 2013, I do not have experience with Juvederm Voluma.  Juvederm Voluma, however, is on it’s way to the office in Modesto, CA and I will soon have experience with this new dermal filler.  [update: I’ve used my first syringe of Juvederm Voluma on 12/24/13.  It was a very satisfying and positive experience.   I look forward to having even more experience with Juvederm Voluma.  I was able to use my 27g 1.5 inch cannula for Juvederm Voluma injections].

To improve my cosmetic dermal filler craft, I’m analyzing my past week. 95% of this result was performed with CANNULAS as an instrument of liquid implant delivery and a whole bunch of other secrets. There’s more that I would like to do with fillers for her, but my instructions were only to work on under eyes (tear troughs) and cheeks.

Background info:

Patient had lost a good deal of weight and it is showing in her face.  Options include face lift.  However, she chose to use Juvederm, Belotero, and Botox.  In the before picture she had Botox and Juvederm expertly done at another plastic surgery practice in our town of Modesto, CA.  I added upon that work to get the 13 day “after” picture using only Belotero and Juvederm.

Info about Brilliant Distinctions in our Modesto Cosmetic Injections practice.

Picture used with permission.  Thank you very much for letting me share this experience.  This is an off Label, FDA usage of Juvederm ultra plus XC for cheek fillers.