Markham, Ontario · Physician-performed

Botox in Markham

Botox® is a purified neuromodulator that temporarily relaxes the facial muscles responsible for dynamic wrinkles, softening frown lines, forehead lines, and crow's feet. Treatment is quick, requires no downtime, and delivers natural-looking, refreshed results while helping to prevent the formation of deeper lines over time.

Price

$10 per unit

Appointment

30 minutes

Performed by

Dr. Mazzuca, MD

Location

Markham, ON

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Quick answer

Botox in Markham at Dr. Monique Mazzuca Aesthetics costs $10 per unit, is injected personally by a licensed physician (MD, CCFP) at 200 Cachet Woods Court, Suite 309, and takes about 30 minutes. It softens frown lines, forehead lines and crow's feet by relaxing the muscles that fold the skin. Results begin in 3 to 5 days, look complete at about 2 weeks, and typically last 3 to 4 months. New patients start with a $50 consultation.

What Botox is

Botox® Cosmetic (onabotulinumtoxinA) is a prescription neuromodulator approved by Health Canada for the temporary improvement of moderate to severe frown lines between the brows, horizontal forehead lines and crow's feet. It is the most studied product in its class, with more than two decades of cosmetic use worldwide, and it is a drug, which is why in Ontario it must be prescribed and the treatment must be directed by a physician or nurse practitioner.

In everyday language "Botox" is used for the whole category of wrinkle relaxers, the way "Kleenex" is used for tissues. The other neuromodulators available in Canada include Dysport®, Xeomin® and Nuceiva®. They work the same way and differ mainly in how the protein is formulated, how quickly they spread and how units are counted. Dr. Mazzuca selects the product for each patient at the consultation.

How Botox works

Lines like the "eleven" between the brows are dynamic wrinkles: they are creased into the skin by a muscle contracting thousands of times a day. Botox is injected in tiny amounts directly into that muscle, where it blocks the release of acetylcholine, the chemical signal from nerve to muscle. The muscle relaxes, the skin above it stops folding, and the line softens. Over months the nerve endings regenerate and movement returns, which is why treatment is repeated.

The skill is in the mapping, not the injecting. A face has dozens of expressive muscles that pull against each other. Relax the wrong one, or the right one too much, and the brow drops or the expression flattens. Dr. Mazzuca assesses how your muscles move before choosing where to place each unit, and she doses conservatively so that you keep expression and simply lose the crease.

What Botox treats

Cosmetic areas treated at the clinic:

• Frown lines (glabellar lines), the vertical "elevens" between the brows.
• Forehead lines, the horizontal lines that appear when you raise your brows.
• Crow's feet, the fan of lines at the outer corners of the eyes when you smile.
• Bunny lines on the sides of the nose, lip lines, a gummy smile, a downturned mouth (DAO), chin dimpling and a lip flip, all treated with small, precise doses.
• Masseter (jaw) slimming and relief of jaw clenching and grinding.
• Platysmal bands in the neck for a softer "Nefertiti" contour.
• Preventative or "baby" Botox: lighter doses to slow the etching of lines in patients who are starting early.

Dr. Mazzuca also uses neuromodulators medically for excessive sweating (hyperhidrosis) and chronic migraine. Those have their own pages.

How many units of Botox you need

Botox is dosed in units, and your total depends on the area, the strength of your muscles and how much movement you want to keep. The manufacturer's labelled doses are 20 units for frown lines, 20 units for forehead lines and 24 units for crow's feet, or 64 units for all three areas together. In practice Dr. Mazzuca often uses less than the label, particularly for first-time patients, women with fine features and anyone who wants a very natural look, and she adds at a two-week review if needed rather than over-treating on day one.

Area	Typical range	At $10 per unit
Frown lines (glabella)	12 to 25 units	$120 to $250
Forehead lines	6 to 20 units	$60 to $200
Crow's feet (both sides)	12 to 24 units	$120 to $240
Upper face, all three areas	30 to 64 units	$300 to $640
Lip flip	4 to 8 units	$40 to $80
Masseter slimming (both sides)	30 to 60 units	$300 to $600

These are ranges, not quotes. Your exact dose is confirmed at your assessment before anything is injected, and you only pay for the units used.

How much Botox costs in Markham

Dr. Mazzuca charges $10 per unit, which is in the lower half of what physician injectors in Markham, Richmond Hill and Vaughan charge (clinic prices across York Region generally run from about $9 to $16 per unit). There is no minimum area and no package requirement; you pay for what is placed. A first visit for new patients is the $50 Comprehensive Aesthetic Consultation (30 minutes), or a $20 virtual consultation (15 minutes) if you would like to talk it through from home first.

Because results last three to four months, most patients budget for three to four treatments a year. A typical upper-face patient using 40 units spends about $400 per visit, or roughly $1,200 to $1,600 a year. Botox is a cosmetic procedure and is not covered by OHIP; therapeutic uses such as hyperhidrosis or chronic migraine may be partly covered by private insurance and are discussed separately.

Who Botox is for, and who should wait

Good candidates are healthy adults who are bothered by lines that show when they frown, raise their brows or smile, and who want a softer, rested version of their own face rather than a frozen one. Many patients start in their late twenties or thirties to slow the etching of lines; others start in their fifties or sixties and see real softening of lines that have not yet become permanent creases.

Botox is not the right tool for everything. Deep lines that are visible at rest often need a combination of treatments (a neuromodulator plus microneedling or a small amount of filler), and sagging skin, hollowing and heavy brows are usually not Botox problems at all. Dr. Mazzuca will tell you if another treatment, or no treatment, is the better answer.

Treatment is postponed or avoided if you are pregnant or breastfeeding, have an active skin infection at the injection site, have a neuromuscular condition such as myasthenia gravis, ALS or Lambert-Eaton syndrome, have had an allergic reaction to a botulinum toxin product, or take certain medications (aminoglycoside antibiotics, for example). Tell Dr. Mazzuca about all medications and supplements at your consultation.

What the appointment is like

1. Consultation and mapping. Dr. Mazzuca watches you frown, raise your brows and smile, feels the strength of the muscles, notes any asymmetry, and marks the injection points. She explains what she recommends and what it will cost before starting.
2. Preparation. The skin is cleansed. Numbing is rarely needed; the needle is very fine and each injection feels like a brief pinch. Ice is available if you are sensitive.
3. Injection. A full upper face takes about 10 minutes. You can talk normally throughout.
4. Aftercare and follow-up. You leave with written instructions. Dr. Mazzuca offers a two-week review for first-time patients so the result can be checked and fine-tuned.

The whole visit is booked for 30 minutes. There is no downtime: most patients return to work or errands straight from the clinic. Small bumps at the injection points settle within 20 to 30 minutes.

When Botox starts working and how long it lasts

You will notice the muscle weakening in 3 to 5 days, with the full result at 10 to 14 days. This is why any touch-up is booked two weeks out, not sooner. Results typically last 3 to 4 months; crow's feet and forehead lines sometimes fade a little sooner than frown lines, and heavy masseters may need a first re-treatment at three months and then hold longer. Dysport tends to start a day or two faster; Xeomin is similar to Botox.

Regular patients often find that treatments last longer over time, because the muscle is used less and becomes smaller, and because the skin has a chance to recover when it is not being creased all day. The best long-term results come from a consistent schedule of three to four treatments a year rather than waiting until every line has fully returned. Spacing treatments at least three months apart also keeps the risk of antibody resistance very low.

Side effects and risks

Botox has an excellent safety record when it is prescribed and placed by a physician. Common, temporary effects are a small bruise, mild redness or swelling at the injection points and, occasionally, a headache in the first day or two. In clinical trials the most frequently reported reactions were headache (about 9% when forehead and frown lines were treated together), eyelid drooping (about 2% to 3%) and brow drooping (about 2%).

Less common problems include a heavy or "flat" brow if the forehead is over-treated, temporary asymmetry, and, rarely, a drooping eyelid (ptosis) if product migrates to the muscle that lifts the lid. These wear off as the product does, usually within a few weeks, and there are prescription eye drops that can help lift a drooping lid in the meantime. Spread of toxin effect beyond the injection site is a labelled warning for all botulinum toxin products; at cosmetic doses in the face it is very rare. Serious allergic reactions are extremely rare.

The most important safety factor is who is holding the syringe. Dr. Mazzuca is a licensed physician who manages any complication herself, and she uses only Health Canada-approved product purchased through the manufacturer's Canadian supply chain.

Aftercare: the first 24 hours

• Stay upright for four hours; avoid lying down, bending over for long periods or napping face-down.
• Do not rub, massage or press the treated areas for 24 hours, including facials, headbands and tight hats.
• Skip strenuous exercise, saunas, hot yoga and alcohol for 24 hours; they increase bruising and may affect spread.
• Gently "exercising" the treated muscles (frowning, raising the brows) in the first hour is fine and may help uptake, although the evidence is modest.
• Makeup can go on after a few hours once the injection points have closed.
• If you bruise, an ice pack and arnica help; bruises fade in 5 to 10 days.

To reduce bruising, avoid aspirin, ibuprofen, fish oil, vitamin E, ginkgo and alcohol for a few days beforehand unless a physician has prescribed them.

Botox vs Dysport, Xeomin and dermal filler

	Botox	Dysport	Xeomin	Dermal filler
What it does	Relaxes muscle	Relaxes muscle	Relaxes muscle	Adds volume or structure
Best for	Lines caused by expression	Larger areas such as the forehead; fast onset	Patients who prefer a "naked" toxin with no complexing proteins	Lines and hollows present at rest; lips, cheeks, jawline
Onset	3 to 5 days	2 to 3 days	3 to 5 days	Immediate
Lasts	3 to 4 months	3 to 4 months	3 to 4 months	6 to 18 months
Reversible	Wears off	Wears off	Wears off	HA fillers can be dissolved

Many patients over 40 get the most natural result from a small amount of both: a neuromodulator to stop the creasing and a conservative filler or collagen biostimulator to replace lost support. Dr. Mazzuca plans these together rather than treating one line at a time.

Why patients choose a physician injector in Markham

In Ontario, injectables can legally be delegated to nurses and other staff working under a physician's medical directive, and at many med spas the prescribing doctor is never in the room. At this clinic the person assessing you and the person treating you are the same person, and that person is a licensed physician. Dr. Mazzuca is an MD with CCFP certification in family medicine and additional training in cosmetic medicine, facial anatomy, women's health and longevity medicine. Her registration is publicly verifiable through the College of Physicians and Surgeons of Ontario, and treatment is never delegated.

Her stated approach is to emphasise "subtle, elegant results that refresh rather than transform, using the least invasive treatments necessary to achieve safe, natural, and lasting outcomes."

Botox near you: serving Markham and York Region

The clinic is at 200 Cachet Woods Court, Suite 309, in the Cachet Woods professional buildings near Woodbine Avenue and Major Mackenzie Drive, with free parking on site and easy access from Highway 404. Patients visit from Unionville, Cachet, Angus Glen, Berczy Village, Cornell, Wismer, Markham Village, Thornhill, Richmond Hill, Stouffville, Vaughan, Aurora, Newmarket, North York, Scarborough and across the Greater Toronto Area. A virtual consultation is available if you would like to talk before you travel.

Frequently asked questions about Botox in Markham

Sources and further reading

• BOTOX Cosmetic prescribing information: indications, labelled doses and adverse reactions (AbbVie)
• BOTOX Cosmetic Canadian Product Monograph (AbbVie Canada)
• Botox Cosmetic: uses, dosage, side effects and warnings (Drugs.com)
• College of Physicians and Surgeons of Ontario, public register, for verification of Dr. Mazzuca's registration.

Every treatment on this page is booked through Dr. Mazzuca's secure online system. New patients begin with a consultation; returning patients can book the treatment directly.

Written and medically reviewed by Dr. Monique Mazzuca, MD, CCFP. Last reviewed 2026-09-07.

This page is general information, not medical advice, and it is not a substitute for an in-person assessment. Results vary between patients, and every treatment carries risks that are reviewed with you before you consent. Suitability is determined by Dr. Mazzuca at your consultation.

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