Friday, May 27, 2022

Thinking About Botox? Here’s What You Should Know

Your Provider is Important

As with any medical treatment, it’s important to find a provider you trust. 

Donna Ennis, ARNP, is a double board-certified family nurse practitioner with over 25 years of clinical experience and is passionate about helping patients look and feel their best. 

At Ennis Plastic Surgery, Donna specializes in injectable treatments and is well known in Boca Raton as “the gentle injector” from her meticulous approach that gives her patients exact results without unnecessary discomfort. 

Donna Ennis ARNP is well versed in facial anatomy and has the advantage over many providers that don’t work directly with a plastic surgeon as she has worked with her husband, Dr. Scott Ennis, an internationally renowned plastic surgeon and assisted him in the operating room for many years. Through all of this experience, Donna can recognize an individual’s anatomy that might lead to this heavy brow, and will let you know if you are a good candidate for Botox or fillers or maybe it is time to consider something surgical. 

There will be a time in everyone’s journey in which the aging process can no longer be addressed by injectables alone, and patients need to transition more toward the surgical side of things. Donna and her husband Dr. Scott Ennis will guide you through this process to make sure the right tool is being used to specifically address your concerns. 

Watch Donna Ennis, ARNP Provide a Botox Treatment

An Injector Focused on the Subtle Techniques

When it comes to injectables, Donna is not only known to be incredibly gentle, she is also particularly dedicated to refining the subtle techniques needed to achieve natural-appearing facial rejuvenation without surgery, including treatments like Botox, Dysport and dermal fillers. She is part of a dedicated team that will work with you to exceed your expectations and give you the confidence boost you need to take on anything that comes your way!  More importantly, as part of the Ennis Plastic Surgery team, she will let you know when injectables might not be the best option for you, as there may be other tools that can offer better long term results. As we get older,  there will also be a time when injectables may no longer be our best choice and surgery becomes the better option for us. Donna will walk you through all of the subtleties both in the short and long term. 

Actual Patient Before & After Dermal Fillers

Botox FAQs (Frequently Asked Questions)

1. How do you know if Botox is right for you?

A common reason our patients consider botulinum toxin injections is to reduce the fine lines and wrinkles that develop over time from common facial expressions. Depending on your genetics and lifestyle, lines can appear as early as your twenties or as late as your forties. We treat every patient as a unique individual and provide treatment recommendations based on skin type, predisposition to wrinkles, lifestyle, and desired results. If you are in good health, have a positive outlook, and have realistic expectations, you are most likely a good candidate.

2. How should you prepare for your appointment?

Before your appointment, ask your injector about herbal supplements and medications. 

Some herbal supplements and medications might increase your risk of bleeding or bruising. Be sure to ask your injector which to avoid before your treatment and when you can safely take them again. You should also avoid aspirin, ibuprofen and naproxen for 1 week prior to minimize your risk of bruising. 

Don’t drink alcohol.

Alcohol increases the risk of bruising. We recommend that you avoid drinking for 24 hours before your appointment for optimal results.

3. Are there restrictions after your appointment?

Wait at least 24 hours after your injection before consuming alcohol.

Similarly to our recommendation to avoid alcohol before your appointment, we recommend for all of our patients avoid alcohol for at least 24 hours after their injection.

Wait 24 hours to exercise

If exercise is part of your daily routine, wait at least 24 hours to work out. Physical activity increases your blood flow and contracts your muscles, potentially spreading the toxin to unintended areas and reducing its effectiveness at the injection site. 

Go makeup-free

If you received a Botox injection in your face, take a break from makeup for 24 hours. Applying makeup will rub the skin, potentially dispersing the toxin. Injecting Botox or fillers through the makeup may cause the makeup to be pushed into the skin potentially causing granuloma formation, so it’s best to go with clean skin. 

Stay upright

Avoid bending, lying down, or sleeping for the first 4 hours after getting Botox injections. This will minimize the physical pressure and let the Botox settle into your muscles.

Avoid other skin treatments

Botox needs some time to settle into the muscle. For the first 24 hours, avoid getting these treatments as they may reduce the effectiveness of your injections:

  • Facials
  • Facial massages
  • Exfoliating scrubs
  • Dermal fillers

Stay out of the sun

Avoid sun exposure for at least 4 hours. The heat can promote flushing and increase your blood pressure, which may encourage bruising. To be extra safe, avoid the sun for 24 to 48 hours.

Common Provider Mistakes 

Frozen Face

Perhaps the most publicized Botox mistake is the “frozen face.” When inexperienced providers over-inject their patients, it can cause a frozen, robotic look. Our goal for our patients is to erase wrinkles and create a natural, well-rested look (even if you aren’t well-rested!). We believe that less is more; after all, you can always add more Botox, but you can’t take it away.

Heavy Forehead and Droopy Eyebrows

Because of the nature of Botox, injecting too much can cause muscles to over-relax and cause a negative alteration in appearance, especially when applied to the forehead. Over-injecting in the forehead can cause droopy eyebrows and excess eyelid skin. That’s the opposite of what we want! There’s no easy fix to this—the Botox just has to wear off. Because of this, choosing an experienced provider is especially important.

“Spock” Eyebrows

On the other side of our droopy eyebrow fears, we have the dreaded “Spock” eyebrows. When one or both eyebrows pull up too much, you can be stuck with a permanently surprised expression. This can also create wrinkles over your lateral brow. Contrary to the heavy forehead, this is an easy fix and can be corrected if it happens. However, with an experienced provider, you are much less likely to encounter this.


When Botox is applied to the eyelid muscles, it can cause the eyelid to droop. This makes it more difficult for you to open one eyelid as much as the other. This is much more likely to happen with providers who are not properly trained. Prescription eye drops can be a temporary fix, but you will ultimately have to wait until the Botox wears off.

Why Choose Donna Ennis, ARNP “The Gentle Injector”?


Although most Botox mistakes are temporary, and will wear off when the product wears off, 3 months is a long time to have to deal with poor results (especially for the face). 

We realize that our patients are putting trust in us to deliver the desired results, and we take this commitment seriously. Our board-certified practitioner will walk you through every step of the process and answer your questions clearly and knowledgeably. Donna will make sure you are pointed in the right direction and you are being treated with the right tool to address your concerns. This might be injectables or it may be surgical, but she has the advantage of working with her husband so that they can offer the best option for you. 

When done correctly, Botox can make a dramatic impact on your appearance and confidence. Our team is dedicated to working together to provide you with an exceptional experience and 100% satisfaction.

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This post is sponsored by Ennis Plastic Surgery.

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