Botox is the most requested minimally invasive cosmetic treatment in the country, and yet the experience can look completely different depending on who is holding the syringe. The product is the same. The skill, judgment, and honesty behind it are not.
So we did something simple. We sat down with the two Aesthetic Injection Specialists at our Woodbury med spa and asked them the questions patients bring up most, the ones you can’t really answer with a quick search. No scripts. No textbook talking points. Just two experienced injectors telling you how they truly think.
A quick word on who you’re hearing from. Nicole Putratz, RN, spent more than 20 years in healthcare across surgical, ICU, and medical-surgical nursing before moving into aesthetic medicine, and she is also a certified wellness coach and BioTE provider. Melinda Marston, APE, RN, has worked in aesthetics since 2014, holds an Advanced Practice Esthetics license, and earned her nursing degree in 2022. They practice as part of Skin Artisans, founded in 1991 by the board-certified plastic surgeons of Edina Plastic Surgery, ranked in the top 1% of Botox providers nationally and the number one provider in the region for Dysport, Restylane, and Sculptra. Some of the injectors here train other injectors. That’s the level of experience sitting across from you in the treatment chair.
Here’s what Nicole and Melinda had to say.
Will Botox® Make Me Look Frozen?
This is the fear almost everyone walks in with, and both injectors hear it constantly.
“The most common misconception is that it’s going to change the way they look,” Nicole says. “Most people are just scared because they don’t know what to expect, or they’ve seen bad results. I always ask what they’re scared of, so I can reassure them.” She points out something patients rarely realize: Botox is not permanent. If you decide you don’t love the result, it gradually wears off and you return to your baseline. Nothing is locked in.
Melinda takes it a step further by explaining the mechanics. “Patients worried about looking ‘cat-like’ are usually surprised to learn that neuromodulators don’t add volume or change the physical landscape of the face. They just relax muscles. We can use them strategically to make the face look more rested and youthful, but you won’t look unrecognizable.” Her go-to way of describing the goal? “It’s you on your best day, hydrated, with nine hours of sleep.”
If you want a fuller sense of how this neuromodulator works, we cover that on our Botox procedure page. But the short version from both injectors is the same: done well, Botox softens, but it doesn’t erase or change your natural features.
How Do You Decide How Many Units I Need?
There’s no universal number, and anyone who quotes you one before looking at your face is guessing.
Melinda starts from the clinical baseline and adjusts from there. “I begin with the FDA-recommended dosing schedule. The standard for the upper face is 64 units of Botox, and that’s been tested in thousands of clinical studies. That doesn’t mean I always dose 64 units.” From there, she factors in the patient’s goals, whether they want to keep some movement, the relative size and strength of their muscles, and any history that affects dosing, such as previous ptosis or a shorter-than-expected duration. She also stays honest about cost. “Aesthetic medicine is elective, and sometimes we have to be strategic to accommodate a budget. But I’m not willing to compromise safe, clinically appropriate dosing for the sake of one.”
Nicole’s process starts with an evaluation. “I watch them while they’re talking and animating. I have them frown, raise their eyebrows, and squint, and I listen to what results they’re hoping for.” She also assesses the skin directly, feeling for texture, tone, thickness, and elasticity. Her philosophy with new patients is to dose conservatively. “I dose lighter, because we can always add more at the two-week follow-up.” That follow-up is part of how we approach every new Botox patient. The thinking is simple: it’s easy to add a few more units if you want more movement relaxed, but you can’t take Botox back out once it’s in. Starting light and adjusting at two weeks keeps the result in your control and protects against the overdone look nobody wants.
Botox®, Dysport®, or Daxxify®: Does It Matter?
Skin Artisans carries all three, so we asked whether they ever steer a patient toward a different product than the one they came in asking for. This is where Nicole and Melinda see things a little differently, which is exactly why having more than one experienced injector matters.
Nicole likes to match the product to the person. “I always ask if they’ve tried other types. If they have and they prefer Botox, we continue on. But if someone doesn’t know the difference, I’ll walk them through the options.” A few of her real-world rules: patients with a cow’s milk allergy are not candidates for Dysport, so that’s an immediate conversation. Patients with an event this weekend may do better with Dysport or Daxxify, since results can appear faster. And for active, high-metabolism patients, she often suggests Dysport because it tends to last longer for them. She’s also candid about Daxxify. “People hear it can last up to six months and they want that, but there’s no way to know how long it will last for you until you’ve actually had it. Dose equals duration. Underdosing won’t get you the longevity you’re after.”
Melinda is more of an “if it isn’t broken, don’t fix it” injector. “I rarely suggest an alternative to someone specifically seeking Botox, unless they’re a returning patient who didn’t get the results they wanted after their first Botox treatment and follow-up. For most people, Botox is the best choice. It has the most clinical testing behind it and the best rewards program through Allē.” She’s quick to add that she’s a fan of all three. “I do love Daxxify and Dysport too. I’m not brand loyal to one product.”
If you want a full breakdown of how Botox, Dysport, and Daxxify compare to each other, we cover that in our “Wrinkle Relaxer Showdown” blog.
Worth knowing: Skin Artisans is a top 50 Dysport provider nationally and the number one provider in the region for Dysport, Restylane, and Sculptra, so when one of our injectors recommends a particular injectable, it comes from real experience across all of them, not a default. Each product also has its own loyalty perks, which you can explore on our rewards programs page.
What Surprises First-Time Botox® Patients the Most?
Melinda hears a good kind of surprise about the results her patient see. “First-time patients are often amazed at how quickly Botox corrects wrinkles they’ve lived with for years. After trying topical treatments and getting lackluster results, they can’t believe how effective it is after a single treatment. It delivers on its promise, and that’s becoming rare in the beauty industry.”
For Nicole, it’s how much the appointment is about education rather than the injections alone. “Patients tell me they feel truly listened to and understood, when at other places they didn’t feel taken care of. They’re also surprised the needle is so much smaller than they expected.” She remembers one patient who put off treatment for ages because she was so anxious about the pain. “Afterward, she was almost embarrassed about how worried she’d been, because it just wasn’t painful.” People are also surprised, she says, by how seamless and subtle the results are compared to the dramatic before-and-afters they see online, and by how many things Botox can address that they’d never heard of. Chin dimpling, underarm sweating, teeth grinding, jaw tension, and migraines all come up once patients sit down and start asking questions.
Preventative Botox®: Is It Worth Starting in My 20s?
Both injectors agree that “preventative Botox” is real, but it’s not for everyone, and a good injector will tell you when to wait.
“People who benefit early are the ones who have a lot of movement, or already have small lines starting to set in,” Nicole explains. “What I look for is lines when the face is at rest. If there are no resting lines but they deepen as someone talks and animates, I’d recommend starting small. If they’re not showing any deep signs yet, I think it’s okay to keep an eye on it and wait.” She notes that knowing your genetics can help you decide when the timing is right.
Melinda looks for the same patterns and adds an important caveat. “When I assess someone under 30, I’m looking for hyperexpressive movement, like frowning in concentration or raising the eyebrows excessively when they talk. Those are the muscle patterns that create static wrinkles over time. For those patients, smaller and less frequent doses can be beneficial.” But she doesn’t push injectables on young patients who don’t need them. “For most younger people, the diligent use of SPF and retinol to protect and repair the skin is a better place to start than injectables.” If you’re in that camp, our injectors and estheticians can help you build a skincare routine first.
What Should I Pair With Botox®?
Botox handles one specific job, so we asked what they reach for to round out a result.
Melinda’s answer is a clinic in itself. “I was an esthetician for 10 years before I became a nurse injector, so I’m always thinking about the layers of tissue in the face. Botox only works on the muscle, and that’s just one component.” She walks through the rest: the bony layer that loses structure with age, the deep and superficial fat pads that shift and atrophy, the muscle that creases the skin over time, and the skin itself, which shows dullness, laxity, and pigmentation. “Treating only one area is like doing glam makeup but then leaving your hair dirty and going out in your pajamas. It’s not wrong, but you won’t get the best effect.” Melinda’s balanced approach pairs dermal fillers and collagen-stimulating biostimulators like Sculptra for volume and structure, Botox for the muscle, and professional skin treatments for the surface.
Nicole brings an angle most med spas never touch: hormones. “If a patient comes in feeling tired, not sleeping well, and noticing wrinkles, I’ll ask about their hormones and talk about how hormonal treatments can play a role alongside Botox.” It’s not a tangent. “If a more mature patient has lost weight and wants a biostimulator instead of filler, we often need to optimize hormones to see proper results.” As a certified BioTE hormone optimization provider, Nicole can look at the whole picture rather than only the muscle she’s injecting.
What’s the Botox® Aftercare Tip I Won’t Find on Google?
We told them to skip the standard advice everyone already publishes. Both landed in the same place, and it’s not what most people expect.
Skincare. Specifically, medical-grade skincare. “If you use junky skincare, or none at all, your Botox results won’t be as optimized as they could be,” Nicole says. She also points to lifestyle and supplements, including vitamin C, zinc, and vitamin D, and the obvious culprits that work against your results, like sleeping in makeup, smoking, and heavy drinking.
Melinda explains why skincare matters so much at a structural level. “Botox relaxes the muscle and then allows the skin to heal and smooth on top of it. The best thing you can do is make sure your skincare routine is top notch.” Her ideal routine includes a cleanser suited to your skin type, an antioxidant serum to protect collagen, a moisturizer to keep skin plump and hydrated, a retinol or exfoliator to encourage healthy new skin, and a quality SPF to protect the investment. “Your results with a proper routine will be exponentially better than without one.”
If you want to go deeper, we’ve written more about getting the best results from Botox and making your results last longer.
What Does Going to a “Top 1% Botox Provider” Mean for Me as a Patient?
Accolades are nice on a website. We wanted to know what they mean for the person in the chair.
“It means we’re not guessing,” Melinda says. “Being a top provider means we’ve seen a lot of different faces and worked with a lot of different products. We have access to the best treatments and time-tested practice at creating reliable, safe, natural results. We can build a complete rejuvenation plan based specifically on a patient’s anatomy, with the clinical experience to effetively reach their goals.”
For Nicole, it comes back to the team. “We work together to give each patient precise, detail-oriented care, and we’re constantly learning from one another. When you have a group of experienced injectors comparing notes and staying current on techniques, the patient is the one who benefits.” That collaborative depth is part of what comes with a practice that’s the number one provider in the region for Dysport, Restylane, and Sculptra, a top 100 Sculptra provider nationally, and consecutively named Best Med Spa by Edina Magazine, all while operating under the medical direction of the board-certified plastic surgeons who founded it more than 30 years ago.
Ready to Meet the Woodbury Team?
If you’ve been curious about Botox or you’re just tired of guessing which provider to trust, book your appointment online at Skin Artisans Woodbury. Melinda and Nicole would love to meet you.
