CHRONIC MIGRAINES

You may be a candidate if you experience 15 or more headache days per month for at least three months, with eight or more migraine-type days as described above.

Diagnosis is confirmed by your family physician or neurologist. If preventive therapy is appropriate, they can refer you to Copeland MD Aesthetics for a consultation regarding BOTOX® treatment.

Chronic migraine is highly disabling. Many patients experience headaches on 15 or more days per month, often lasting four hours or longer.

In clinical programs, approximately 70% of patients receiving BOTOX® achieved a 50% or greater reduction in headache days by around week 56. Treatments are convenient—performed every 12 weeks—and most private insurance plans approve the medication portion once criteria are met (coverage varies by plan).

BOTOX® is injected into 31 standardized sites across seven specific head and neck muscle areas, including the forehead, temples, back of the head, neck, and shoulders.

• Standard dose: 155 units
• Optional additional dosing: Up to 40 extra units (maximum 195 units total) based on individual pain patterns

A typical visit lasts 15–25 minutes.

Most patients describe the injections as brief pinpricks with mild pressure. After treatment, you may notice:

• Mild tenderness or stiffness in treated areas
• Small bumps at injection sites
• Occasional bruising

Most people return to normal activities the same day. Rarely, patients experience a short-lived, flu-like feeling.

Some improvement may occur after the first treatment cycle, but benefits typically build over two to three cycles (approximately 24–36 weeks).

Each treatment is designed to last about 12 weeks, which is why injections are scheduled every three months for ongoing prevention.

Common side effects may include:

• Injection-site pain or tenderness
• Bruising
• Headache
• Mild neck pain or stiffness
• Eyelid heaviness if forehead muscles relax more than expected
  

Less common or rare side effects include allergic reactions, rash or hives, chest pain, heart rhythm changes, muscle weakness, difficulty swallowing, voice changes, or breathing issues. Seek urgent medical care if severe symptoms occur.

We use precise dosing and anatomical mapping to minimize risk.

Do not receive BOTOX® if you:

• Are allergic to botulinum toxin
• Have an infection at the injection sites

Tell us if you:

• Have a neuromuscular disorder (e.g., myasthenia gravis, Lambert–Eaton syndrome, ALS)
• Are pregnant or breastfeedin
• Have upcoming surgery requiring general anesthesia
• Take medications affecting neuromuscular transmission (e.g., aminoglycoside antibiotics)

Please disclose all medications and supplements.

Consultation:

Covered by OHIP — bring your valid Health Card.

Medication coverage:

Most private drug plans cover BOTOX® for chronic migraine once criteria are met (historically high approval rates; coverage varies).

Procedure fee:

$250 for the injection procedure, physician time, and supplies (typically not covered by private drug plans).

How to book:

Ask your family doctor or neurologist to refer you to Copeland MD Aesthetics with your headache history and prior treatments. Once we receive the referral, we’ll schedule your assessment and, if appropriate, your first treatment.

We’ll confirm your diagnosis, review your migraine history and previous therapies, and create a clear, evidence-based 12-week prevention plan—with realistic expectations, safety-first care, and no pressure.