November 12, 2026 | Facial Procedures, Injectables
Next Wednesday, November 18, is BOTOX Cosmetic Day. From 12 pm Eastern, Allē members can buy a $50 BOTOX Cosmetic gift card online and get a second one free, one purchase per member, while supplies last. The cards do not expire and stack with Allē points. The full mechanics, and how the front desk at Southwest Plastic Surgery applies them, are in the practice’s post.
This is the surgeon’s version, and it is about the four things the deal does not touch.
The Dose
“Patients also need to understand that a lot of things matter in regard to how long the Botox treatment will last. Dose, dilution, injection placement, and product choice matter more than whether you are active or inactive. These are all customized depending on each patient’s consultation. For example, patients with very strong frontalis muscles, glabellar muscles, or masseters will require a higher dose than others.”
Two cards do not buy a number of units. The exam does. If a strong glabella needs more than the cards cover, it needs more.
The Product and the Hands
From the chain-of-custody answer I typed for the practice last month, which holds on a deal day like any other:
“We buy directly from the manufacturers, Galderma, Allergan, and Evolus. The toxin is shipped to us directly from them in temperature controlled containers. The vials are stored in a medical temperature controlled refrigerator that is monitored 24 hours a day for temperature variations.”
“We record the lot number and toxin information in every chart and encounter. Vials come sealed in a box with holograms. The lot number on the box matches the vial. All the toxins are reconstituted according to manufacturer FDA approved instruction. We do not use a middle man or discount pharmacy to order our toxins.”
“Botulinum toxin are reconstituted and administered by registered aesthetic nurses, nurse practitioners supervised by Dr. Agullo. Dr. Agullo also administers the treatments. Patients can see the vial at any time.”
The Aftercare
“I do ask patients not to exercise for twenty-four hours after a botulinum toxin injection, but this is not because it is going to wear off sooner. It is because I want the solution to stay exactly where I injected it, and strenuous exercise immediately after an injection could increase the risk of the product migrating, complications, and swelling.”
The Line Between Toxin and Surgery
This is the one a deal day blurs most. Toxin is a maintenance treatment, and I say that as a patient.
“It really is a maintenance therapy. I myself get botulinum toxin in the forehead, crow’s feet, and glabella lines every three to four months, just to maintain the wrinkle free appearance with a dose that still lets me express my face without looking abnormal.”
What it maintains is a muscle at rest. It does not lift a brow whose position has dropped with age, it does not remove upper eyelid skin that now rests on the lashes, and it does not tighten a neck. Patients who keep adding units to a heavy brow often get a heavier brow, because the frontalis was the muscle holding it up. When a patient tells me the toxin “stopped working” on the forehead, I lift the brow with one finger in the mirror. If the eyes open, the problem has moved from the injectable room to the operating room, and the honest answer is a brow lift or an upper blepharoplasty, with toxin kept for the lines afterward.
| Complaint | Toxin can | Toxin cannot |
|---|---|---|
| Frown lines, forehead lines, crow’s feet | Soften the lines, every three to four months | Replace lost volume |
| Heavy brow | Lift the tail of the brow a little, if the frontalis is spared | Reposition a brow that has descended |
| Hooded upper lids | Nothing useful; more forehead toxin makes it worse | Remove the skin; that is a blepharoplasty |
| Neck bands | Soften platysmal bands for a few months | Tighten loose neck skin; that is a neck lift |
Buy the cards on the 18th. Then let the exam, not the wallet, decide what they are spent on.
Why Choose Dr. Agullo
I am certified by the American Board of Plastic Surgery and the American Board of Surgery, completed my plastic surgery fellowship at the Mayo Clinic, and serve as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has listed me as a Top Doctor every year from 2014 through 2026. The toxin side of my practice runs through the med spa at Southwest Plastic Surgery, bought from the manufacturer and injected by nurses I supervise or by me; the surgical side, brow lifts and eyelid surgery, is mine. My commentary on what a deal day changes is on Dr. WorldWide, and the two-week toxin for nervous first-timers is in Boey.
Ready to Talk?
If your toxin has stopped doing what it used to, bring the question in before you spend the cards. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
