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Botox Treatment For Facial Wrinkles

BOTOX® Cosmetic is a simple, affordable non-surgical procedure that softens facial lines and wrinkles that develop over time, resulting in a much happier and more youthful YOU!

Our mission at Subtle Perfections Med Spa is to provide the Sarasota community with the best Botox injection results. We offer the highest quality medical aesthetic services to help you look your best in an honest, professional manner. We accomplish this by creating an individualized treatment plan and emphasizing a personal practitioner-patient relationship. We use the most advanced treatments and techniques to maximize results, and help you achieve your goals. Learn more about our outstanding team at Subtle Perfections.

Why Choose US for Botox?

Our injector is not just a medically trained Physician Assistant, she is also naturally artistic with a passion for sculpting and drawing.  Having an eye for facial symmetry along with an artistic touch means that the Botox she injects will be placed with the utmost care and expertise, maximizing your treatment.

At Subtle Perfections, we focus on YOU! We do not perform cookie cutter injections that you may find at some shopping malls. To us, it is an art and a passion. As with any medical or cosmetic procedure, it is important to choose an experienced provider. Botox and fillers are medical procedures, and they are more than just softening or filling in a wrinkle; it is all about facial contour and symmetry that will enhance your natural features.  Physician Assistant Nancy Callaham is known for delivering beautiful results with Botox and dermal fillers to many patients in Sarasota, Lakewood Ranch, Tampa and Venice. Make an appointment with Nancy to discuss an individualized treatment plan to enhance your natural beauty.


BOTOX® Cosmetic is a FDA approved prescription medicine that is injected into muscles to temporarily soften the facial wrinkles of both moderate to severe frown (eleven) lines between the eyebrows and crow’s feet lines around the outer area of the eyes.


BOTOX Cosmetic is a purified protein (Botulinum Toxin Type A) that is injected at very low doses to specific muscles of the face. While Botox is derived from botulinum, there are no live bacteria in the BOTOX® injection. It is actually the protein derivative that is used in manufacturing the cosmetic Botox. Patients can have confidence that Subtle Perfections Med Spa only uses actual Botox ™ direct from the U.S. manufacturer, and have no need to worry about the potential of botulism. This protein is safe and blocks the nerve impulses that control muscle movements, thereby restricting the ability to contract the facial muscles. BOTOX does not affect the nerves responsible for sensation, so there is no numbness in the treated areas.
The goal of Botox injections is to reduce the contractions of those muscles that cause the frown lines, forehead, crow’s feet, wrinkled chin. While the results are dramatic, it will not radically change your facial appearance. The muscles are simply relaxed, the wrinkles will be softened or non-visible at rest, so you can still express yourself by frowning, smiling, or looking surprised without the wrinkles and creases.


It is for women and men who are bothered by the signs of aging such as fine wrinkles, skin folds, furrows, post weight loss (hollow cheeks), lips, facial asymmetry due to disease or trauma. It is also for anyone who wants to look younger, but may not be willing or able to commit to plastic surgery.
Plastic surgery is often thought to be the blending of science and art. Treating facial wrinkles and contour is an example of this blending. It takes a very experienced eye and a steady hand to get the ideal outcome with Botox and injectable fillers. Nancy Callaham, MPAS, PA-C is a dedicated Physician Assistant trained in plastic surgery and non-surgical aesthetic services. Her approach to Botox injections and dermal fillers is designed to achieve balanced, natural-looking results.


BOTOX Cosmetic treatments can be performed in a number of locations, including between your brows (frown), eye area (crow’s feet), oral lines, and neck. Effects of BOTOX Cosmetic appear within a few days and generally last from 3 to 6 months. Botox can be used to elevate the corners of the mouth, eliminate smoker or vertical lines around the lips, reduce neck bands, wrinkly chin, gummy smile, wrinkly nose or bunny lines, and for severe underarm sweating.


There are many different factors that can determine how well a patient reacts to Botox.  Our provider will analyze your face to determine the amount of units needed to give you the best results.  Some of the most common factors in determining the most appropriate Botox doses include:

  • Facial muscle strength: typically developed through repetition of actions like frowning, smiling, squinting, or pursing the lips (drinking through a straw). Individuals who are more prone to these repetitions will require more Botox.
  • Genetics: family traits of strong facial muscles can be seen in the very young too.
  • Metabolism: Everyone has differing metabolism rates that will determine how long the effects of Botox will last. Botox typically lasts for 3-6 months. In athletes Botox seems to be metabolized faster and thus averaging 2-4 months, nevertheless we do not recommend injections sooner than 3 months.
  • Skin condition: those with severe sun damage skin will experience different results from people with little photo-aging and well-nourished skin.
  • Gender: Typically men have larger facial muscles compared to women and generally need more Botox.
  • Repeated Botox treatment: people who inject every 3-4 months will have better results than those who inject occasionally.


Generally accepted guidelines have been published, and most Botox providers use these guidelines as a starting point. At Subtle Perfections Med Spa, we team up with YOU to customize a treatment plan that is right for you (given your current skin-muscle condition and desired results):

  • Frown or Glabellar Lines: 15-30 Botox units
  • Crow’s Feet: 12-30 Botox units per side
  • Forehead lines: 8-18 Botox units
  • Eyebrows: 4-10 Botox units per side
  • Nasalis “Bunny” lines: 6-12 Botox units
  • Upper lip lines: 4-8 Botox units
  • Dimpled chin: 2-6 Botox units
  • Marionette lines: 6-10 Botox units
  • Gummy smile: 4-8 units
  • Platysma (neck bands): 10-20  units per band

*Note: The only treatments listed above that are FDA approved are for glabellar lines and crow’s feet. The other treatments are considered off-label uses.


At Subtle Perfections Med Spa, we make sure all of our Botox patients receive the proper amount of Botox as determined by our providers. Attempting to save money by purchasing only few units will result in “under-treatment”of  the area(s) which will not create a satisfying result and could end up costing more money. Our experienced and certified Botox injector will determine the right amount of Botox needed to deliver the results you deserve.


BOTOX Cosmetic procedures are non-invasive, and no anesthesia is required. Injections are administered with an insulin syringe with an ultra-fine needle directly into the muscles being treated. Discomfort, if any, is minimal, and brief and once complete there is no discomfort. Botox procedure takes about 15-30 minutes depending on how many areas are being treated. Most people return directly to work or normal activity following treatment.


First we listen to your concerns and determine what is bothering you the most, then we offer you a step-by-step plan to achieve your goals. A basic consent form is signed and confidential pictures are taken to establish your baseline.
The injection site(s) will be cleansed. Muscles will be marked and any anatomical variant will be discussed. Cold pack will be applied on the area (s) to prevent bruising.
No anesthesia is required. However, in some cases prior numbing with topical anesthetic might be used at the injector’s discretion.
The practitioner will administer the injections with a very fine and small needle. The area will be cleaned again and post care instructions will be explained in detail so you can maintain long lasting results.


You should expect to see the effects of the Botox injections within 4-6 days. However, because some muscle fibers may remain active for longer, it may take 7-14 days to reach full efficacy. Re-injection should be performed as the muscles regain activity, which is usually 3 months after injection.


Become a member of the Brilliant Distinction Program and receive special offers and exclusive invitations.  If you receive a treatment with us, with your permission we will sign you up for the Brilliant Distinctions Program where you can earn points on the Botox Cosmetic and Juvederm treatments at Subtle Perfections Med Spa.  For every Botox treatment you can receive 200-400 points which are equivalent to $20-$40 off on your next treatment. Learn more about Botox Cosmetic call us to schedule a complimentary consultation and start saving today!

Dermal Fillers

Learn about replacing lost volume, filling in wrinkle lines, or restoring youthful facial contours

Learn More


Learn about the benefits of injections to reduce or eliminate wrinkles.

Learn More

The Vampire Facial

Use your own blood platelets to enhance your skin’s rejuvenation.

Learn More

Our Values

Patient First

We begin by listening. Our goal is to meet or exceed your goals, so it is vital that we understand your desires so we can advise you on the most appropriate procedures to achieve the aesthetic and practical results you want. The safety, comfort and confidentiality of our patients are our top priorities.


We are in this together. During your private consultation we will address your needs and expectations to ensure the best possible results. We emphasize appropriate communication and education in order to maximize patient satisfaction.


We conduct ourselves in a professional manner and operate at the top/highest of our chosen profession. This includes continuing training and continuing medical education.


We treat our patients with honesty and respect. A consistent, conservative approach means we offer only what is necessary to enhance your natural beauty.

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Check out this 5 star Yelp review by W. Q.:
I wish I can give more stars
Talk about professionalzim, experience and magic hands
Went and get my lips done yesterday and they look...
See the review on Yelp by clicking the link below.
Check out this 5 star Yelp review by W. Q.:
I wish I can give more stars
Talk about professionalzim, experience and magic hands
Went and get my lips done yesterday and they look...
See the review on Yelp by clicking the link below.
Get your lips ready for Valentine's Day! Volbella is a FDA approved filler for lip and oral lines ONLY $400. Call or Text us today (941) 960-9489
Get your lips ready for Valentine's Day! Volbella is a FDA approved filler for lip and oral lines ONLY $400. Call or Text us today (941) 960-9489