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Expert Advice For Injecting Botox

Botulinum toxin is widely recognised as being one of the cornerstone treatments in aesthetic medicine, so it’s something new injectors are keen to learn. To help you fine-tune your technique, we rounded up a selection of our established aesthetics experts’ best advice for injecting botox.

Here’s what members of the Harley Academy faculty feel you need to know to provide safe and effective toxin treatments. Read on for their top tips…

Learn to understand the dose effect of injecting botox


Dr Tristan Mehta, founder and executive chairman of Harley Academy, co-founder and aesthetics specialist at STORY Marylebone.

Start by using 2 units in the forehead, in the frontalis muscle, because then you can start to understand the dose effect of those 2 units at the two week follow-up. This also reduces your risk of having a brow ptosis, which is basically inevitable as you start to learn how botox works.

Remember to allow for toxin product diffusion


Dr Kalpna Pindolia, director of education and aesthetics specialist at STORY Marylebone:

Check for frontalis hyperactivity – this is a key factor for reducing the risk of brow ptosis.

Keep in mind the 1-1.5 cm diffusion of toxin product when planning treatment and injecting botox.

Keep realistic expectations in mind – frozen is impossible for the entire treatment duration and deep static lines are unlikely to respond dramatically well to treatment. It is generally a good rule of thumb to under-promise and over-deliver on treatment results. However, your patient should be made fully aware of what the likely outcome could be and what it cannot be.

Understand the principles of why you inject in certain patterns


Dr Joanna Hackney, senior clinical trainer and aesthetics specialist at The Academy Clinic.

Learn your anatomy, for example muscle origin and insertions, innervation, depth and location.

Develop your understanding of the principles of why you are injecting in the pattern that you are learning. If you grasp the fundamentals, you will be able to adapt your practice according to the individual patient’s requirements and, as well as achieving better aesthetic results, you are less likely to run into complications.

In addition, specifically, do not learn the depth of your injections according to the “amount of needle inserted”. This is a poor indicator of ‘depth’ as there are other contributing factors, namely the angle of insertion. Also, this method is heavily reliant on using the same needle length for all treatments! I frequently see students getting caught out by this in mentoring if we change the needle type or length used for the treatment.

Consider how muscles work together for predictable results


Dr Mariam Michail, clinical trainer and aesthetics specialist.

Don’t think about muscles in isolation but consider how muscles work together. This will give the most predictable results.

Understand risk factors for brow ptosis and when to avoid frontalis treatment!

Students working towards their Level 7 Diploma in Botox and Dermal Fillers receive comprehensive training in botulinum toxin, both in theory and during practical sessions. 

This industry-leading Master’s-level aesthetic medicine training course provides the anatomical, technical injecting and product knowledge required to build a successful career as an injector. Furthermore, it also prepares you to minimise treatment risks, manage any potential complications and identify when patients are not suitable for treatment – a frequently overlooked skill!

We hope you find these expert tips on injecting botox helpful. Do let us know if you try any of them out in practice, or if you have any advice of your own that you’d like to share! You can do so on the private Harley Academy Comma if you are a student, otherwise do leave us your feedback via our Instagram account.