August 4, 2025 • 11 mins
Like manicures and blowouts before, more and more people are turning to injectable maintenance treatments.
Botox, short for Botulinum toxin, is an anti-wrinkle treatment that's trickled down to more and more Kiwis, after being widely received as a celebrity-exclusive treatment.
Dr Sarah Hart joined the Afternoons team to discuss further.
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Speaker 1 (00:09):
You're listening to a podcast from News Talk sed be
follow this and our wide range of podcast now on iHeartRadio.
Speaker 2 (00:16):
Botox it has gone from a niche beauty treatment to
a blockbuster phenomenon. Its use is almost doubled from twenty
nineteen to twenty twenty five and is now accessible to
anyone with a few hundred dollars and a dream of
line free skin yees.
Speaker 3 (00:31):
So it's mainstream and people are saying liking it to
just a manicure, manicure or a haircut. But why don't
get it? I've asked lots of people why they do it?
So paralyzes part of your face, but to what end?
Why is a paralyzed face better than a non paralyzed face.
Speaker 2 (00:48):
It's a good question. And joining us right now to
hopefully answer that is doctor Sarah Hartch is a cosmetic
doctor with almost twenty years experience. Doctor hart very good afternoon,
she thanks for joining us.
Speaker 4 (01:01):
Oh, thanks for having me on. That's a great question
that you're asking there.
Speaker 3 (01:05):
Well, let's start right at the basics here. What is botox?
Speaker 4 (01:11):
So Botox is a protein that is produced by a
bacteria that lives in our soil called Cloustrilian botulinum, and
a very clever man discovered how to purify that and
use it in tiny amounts to relax muscles many many
years ago.
Speaker 3 (01:27):
So what I don't get about that is does it
get rid of wrinkles or does it just stop making
more wrinkles? Stop you making more wrinkles.
Speaker 4 (01:36):
Well, it actually gets rid of wrinkles. And it was
first discovered that it could do this by was an
oomologist using it to treat spasms around the eye, and
her patients came back going, oh my god, this stuff
is great. This this made me look really happy. I
don't have brown lines anymore. Can I have a little
bit more of it on the other eye type thing?
Speaker 3 (01:55):
Right?
Speaker 4 (01:55):
And she thought her husband was a dermatologist and she
thought this is interesting, and so she ended up treating
patients around that area just for wrinkles and did a
great study that can had it with salty water and
showed that the botox made a big difference for the
brinkles compared to us just injecting salty water. And that
(02:16):
is when it was born to treat brinkles.
Speaker 3 (02:19):
Wow. And so you say around the eyes, because I've
always thought forehead is where people go, but we're on
the face. You can have the forehead around the eyes
wherever these rings are.
Speaker 4 (02:27):
Yeah, yeah, well yes, so it's it's interesting. So for
many many years, about twenty years, it's only been the
useful frown lines, fore headlines and crow feet, so as
you say, upper face, foreheading and crow feet. But you know,
just last week it actually got a proof for treating
the neck as well in New Zealand. So first new
use for cosmetic use approved in over twenty years.
Speaker 3 (02:48):
Do you get do you get? Because you can get
turkey neck like George Lucas, but do you get wrinkle
neck as well?
Speaker 1 (02:54):
Well?
Speaker 4 (02:54):
In the net it's more it's approved for tretis treating
the prominence of those bands on the neck. I don't know,
did you ever watch Coronation Street with Deirdre She used
to have these vertical bands on her neck in the
botox before.
Speaker 3 (03:10):
Can you do as much as you wander? Does it
get dangerous? Because you know it's paralyzing be of your
face and neck and eyes, and can you just blast
it everywhere and as often as you want?
Speaker 4 (03:20):
Well, the amount that you're giving is ridiculously small. So
one vial of botox one hundred units of botox, which
is more than enough to do five people's frowns as
actually a quarter of a billionth of a gram of botox.
Speaker 3 (03:34):
Oh wow, so powerful.
Speaker 4 (03:36):
The amounts that we're putting in is ridiculously small, And
the amounts that we put in for cosmetic is a
lot less than amounts that you put in for what
we call functional botox, for botox to stop dure grinding,
for bladders, for neck spasms, for cerebral palsy, all of
those much bigger body muscles have much larger doses of
botox than what we're putting to the small muscles of
(03:57):
the face. So relatively speaking, the dose that you use
for cosmetic botox is smaller than you use the botox
for all of the other uses it has.
Speaker 3 (04:06):
In this article in the New Zealand Herald, it's saying
that it's become more and more mainstream and people are
liking it to just getting a manicure or a haircut.
Is that your experience? And secondly, are people proud of
getting botox now? Is it losing its I guess stigma?
Speaker 4 (04:24):
Yeah, Look, I think that there is a trend towards
trivialization of botox that I think is not a good one.
This is a prescription medicine. This is a powerful drug.
If it's used wrongly, it can cause side effects. I
think the thing that would concern me the most is
the providers that are basically dodgy and overseas in Australia
(04:47):
and in the UK, people have got botulism from providers
that are not registered, using unregistered formulations, not botox, but
some kind of counterfeit copy and inadvertently giving someone a
thousand times more than they should and those people ending
up with botulism. So, you know, you do want to
(05:08):
be careful about who you go to. You do want
to go to someone that has good training and that is,
you know, a healthcare professional. You don't want to be
going to botox parties. You know there's something that Yeah, yeah,
And I do think this stigma has a decreased markedly
over the years. You know, when I first started doing
(05:30):
these treatments twenty plus years ago, people were super secretive
about it, and then gradually with each successive generation they've
become less secretive. And I liken it to how women
used to talk about having their hair colored, and they
used to be like for the boomers, they used to whisper,
oh my god, she's like not a natural blonde, and
(05:52):
they'd be mortified if someone knew they color their hair.
But me, as a gen X, I really don't care
if someone knows I color my hair, and just it's
become normalized and no longer something that is scandalous or stigmatized.
And so depending on what generation you're treating, my older generation,
definitely it's definitely something private, much less so with my
(06:14):
younger generation patients.
Speaker 2 (06:16):
As a doctor, let's talk about the younger generation. Do
you see genuinely that to me, it just feels a
bit weird that people in their twenties will come in
to get this botox injection to get rid of lines
that arguably at that age they yet to encounter. Is
that what you're seeing that the younger generation are coming
in for these sort of treatments.
Speaker 4 (06:35):
Well, not to me, I personally have my patient peakers
fifty four. Fifty to fifty four is the top of
my bell curve for patients, which matches my age. But look,
I do have had patients in the early twenties come in.
I had one lovely lady come in who said, I
want botops and I said, why you've got no lines,
(06:57):
and she said, well, all my friends are doing I
think that I should. And it was really important that
I educated her that there is no need to do
botox when you do not have a line. You know,
start early in your early twenties. In my opinion too early.
I do have the occasional patient in the mid twenties
who has a very strong familial line who already has
(07:19):
a line at rest. I think that's reasonable to treat,
but usually they don't need anything but the smallest dose.
But people thinking that it's essential to start early and
it's somehow magically going to stop their face aging that
needs to be put to rest because you know it
can treat a line when the line has come. You
(07:39):
don't need to start before the line comes. And I
just think it's a waste of money for the younger generation.
They really don't need to be doing large doses of
botox in their early twenties.
Speaker 3 (07:50):
What about men and men getting botox. I'm looking at
Titus's face and it looks like a leather handbag that's
been left out in the rain. Could I get.
Speaker 2 (07:57):
I've had a hard line?
Speaker 3 (07:57):
I get about you for a thirty eight year old
tyler to get his face done, so I don't have
to look at this rentally mess over there.
Speaker 4 (08:04):
Well, here's a much more appropriate age, So that would
be a tick in terms of men. So it's really interesting.
I asked some of my questions just quickly.
Speaker 2 (08:12):
God help you us here. It's going to be a
tough ass, but carry on.
Speaker 4 (08:16):
I've got a lot of botox, so I've got three
percent male patients. I've got colleagues to have five percent.
My male colleagues tend to have about twenty percent. But
a lot of them also also injectibles like PRP for
hair loss, so they're doing hair loss as well. So
it's still Botox is still absolutely a minority for males.
(08:36):
It's still way more popular for women. Males are generally
much more interested in hair loss and jawline, which botox
has much less of an activity in that area. For women,
we still want that smooth, feminine looking skin, you know,
smooth skin as seen as feminine. Men can have deep
crows feet, you know, remember Sean Connery. You know that
(08:57):
crinkle around the eye. So from a skin smoothness point
of view, it's generally perceived as less important for men
to have smooth skin, but I do. I definitely have
male patients who really appreciate not having Gordon Ramsey lines
in their forehead, you know, So there's definitely a place
(09:19):
for it.
Speaker 3 (09:19):
No exactly what you mean by Gordon Ramsey life. We're
talking to doctor Sarah Hart. Now, what's the difference between
filler and botox? Because you know the lips, the Kim
Kardashian lips and that kind of thing. Is that different
from botox?
Speaker 4 (09:36):
You know what? Completely different? The only similarity between them
is that you use them to approve appearance and that
you inject it. So philla is a gel that you
physically inject into the tissue to change the contour. So
it's a carbohydrate, whereas botox is a protein. And most
fillers are made from hyaluronic acid. And so the fillers
(09:56):
more about changing contour. I mean, you can use a
very dilute version of a filler to improve skin hydration
and fine lines, and then they're called a skin booster.
But fillers are generally too projected cheek make a look
bigger projected chin, So it's about contour rather than wrinkles.
Speaker 3 (10:15):
Are they better and worse botox people because my mate
won't let his wife, well, he won't pick his wife
up from the botox anymore because he says she looks
like she's been stung by bees. So are they? Are
there people that are better and worse at doing it?
Speaker 4 (10:29):
Yeah? Look, so I would say there's different styles of
doing it so that it's possible to do botops and
fill it in a style that's incredibly natural, and generally
you'd be using smaller doses and you're stopping before you
change the contour too much, so you can usefully to
support lost volume under the skin rather than create too
much change. But then there's also a trend more the
(10:53):
Instagram Can Kardashian trend of changing the face or glamorizing
the face, and some providers prefer that approach. So it's
really important to pick a provider that has a similar
aesthetic to you and that they're god ale of treatment
is in line with what you're wanting.
Speaker 3 (11:11):
Yeah, because you can get stung by bees for free,
you don't need to pay for that one if that's
what you're into.
Speaker 2 (11:15):
Yeah, Sarah, thank you very much for your expertise. Really
appreciate it, and we'll catch up soon.
Speaker 4 (11:23):
Yep, my pleasure.
Speaker 2 (11:23):
I love you to chat all right. That is doctor
Sarah Hart, Cosmetic Doctor.
Speaker 1 (11:27):
For more from News Talk st B, listen live on
air or online, and keep our shows with you wherever
you go with our podcasts on iHeartRadio
You're listening to a podcast from News Talk sed be
follow this and our wide range of podcast now on iHeartRadio.
Speaker 2 (00:16):
Botox it has gone from a niche beauty treatment to
a blockbuster phenomenon. Its use is almost doubled from twenty
nineteen to twenty twenty five and is now accessible to
anyone with a few hundred dollars and a dream of
line free skin yees.
Speaker 3 (00:31):
So it's mainstream and people are saying liking it to
just a manicure, manicure or a haircut. But why don't
get it? I've asked lots of people why they do it?
So paralyzes part of your face, but to what end?
Why is a paralyzed face better than a non paralyzed face.
Speaker 2 (00:48):
It's a good question. And joining us right now to
hopefully answer that is doctor Sarah Hartch is a cosmetic
doctor with almost twenty years experience. Doctor hart very good afternoon,
she thanks for joining us.
Speaker 4 (01:01):
Oh, thanks for having me on. That's a great question
that you're asking there.
Speaker 3 (01:05):
Well, let's start right at the basics here. What is botox?
Speaker 4 (01:11):
So Botox is a protein that is produced by a
bacteria that lives in our soil called Cloustrilian botulinum, and
a very clever man discovered how to purify that and
use it in tiny amounts to relax muscles many many
years ago.
Speaker 3 (01:27):
So what I don't get about that is does it
get rid of wrinkles or does it just stop making
more wrinkles? Stop you making more wrinkles.
Speaker 4 (01:36):
Well, it actually gets rid of wrinkles. And it was
first discovered that it could do this by was an
oomologist using it to treat spasms around the eye, and
her patients came back going, oh my god, this stuff
is great. This this made me look really happy. I
don't have brown lines anymore. Can I have a little
bit more of it on the other eye type thing?
Speaker 3 (01:55):
Right?
Speaker 4 (01:55):
And she thought her husband was a dermatologist and she
thought this is interesting, and so she ended up treating
patients around that area just for wrinkles and did a
great study that can had it with salty water and
showed that the botox made a big difference for the
brinkles compared to us just injecting salty water. And that
(02:16):
is when it was born to treat brinkles.
Speaker 3 (02:19):
Wow. And so you say around the eyes, because I've
always thought forehead is where people go, but we're on
the face. You can have the forehead around the eyes
wherever these rings are.
Speaker 4 (02:27):
Yeah, yeah, well yes, so it's it's interesting. So for
many many years, about twenty years, it's only been the
useful frown lines, fore headlines and crow feet, so as
you say, upper face, foreheading and crow feet. But you know,
just last week it actually got a proof for treating
the neck as well in New Zealand. So first new
use for cosmetic use approved in over twenty years.
Speaker 3 (02:48):
Do you get do you get? Because you can get
turkey neck like George Lucas, but do you get wrinkle
neck as well?
Speaker 1 (02:54):
Well?
Speaker 4 (02:54):
In the net it's more it's approved for tretis treating
the prominence of those bands on the neck. I don't know,
did you ever watch Coronation Street with Deirdre She used
to have these vertical bands on her neck in the
botox before.
Speaker 3 (03:10):
Can you do as much as you wander? Does it
get dangerous? Because you know it's paralyzing be of your
face and neck and eyes, and can you just blast
it everywhere and as often as you want?
Speaker 4 (03:20):
Well, the amount that you're giving is ridiculously small. So
one vial of botox one hundred units of botox, which
is more than enough to do five people's frowns as
actually a quarter of a billionth of a gram of botox.
Speaker 3 (03:34):
Oh wow, so powerful.
Speaker 4 (03:36):
The amounts that we're putting in is ridiculously small, And
the amounts that we put in for cosmetic is a
lot less than amounts that you put in for what
we call functional botox, for botox to stop dure grinding,
for bladders, for neck spasms, for cerebral palsy, all of
those much bigger body muscles have much larger doses of
botox than what we're putting to the small muscles of
(03:57):
the face. So relatively speaking, the dose that you use
for cosmetic botox is smaller than you use the botox
for all of the other uses it has.
Speaker 3 (04:06):
In this article in the New Zealand Herald, it's saying
that it's become more and more mainstream and people are
liking it to just getting a manicure or a haircut.
Is that your experience? And secondly, are people proud of
getting botox now? Is it losing its I guess stigma?
Speaker 4 (04:24):
Yeah, Look, I think that there is a trend towards
trivialization of botox that I think is not a good one.
This is a prescription medicine. This is a powerful drug.
If it's used wrongly, it can cause side effects. I
think the thing that would concern me the most is
the providers that are basically dodgy and overseas in Australia
(04:47):
and in the UK, people have got botulism from providers
that are not registered, using unregistered formulations, not botox, but
some kind of counterfeit copy and inadvertently giving someone a
thousand times more than they should and those people ending
up with botulism. So, you know, you do want to
(05:08):
be careful about who you go to. You do want
to go to someone that has good training and that is,
you know, a healthcare professional. You don't want to be
going to botox parties. You know there's something that Yeah, yeah,
And I do think this stigma has a decreased markedly
over the years. You know, when I first started doing
(05:30):
these treatments twenty plus years ago, people were super secretive
about it, and then gradually with each successive generation they've
become less secretive. And I liken it to how women
used to talk about having their hair colored, and they
used to be like for the boomers, they used to whisper,
oh my god, she's like not a natural blonde, and
(05:52):
they'd be mortified if someone knew they color their hair.
But me, as a gen X, I really don't care
if someone knows I color my hair, and just it's
become normalized and no longer something that is scandalous or stigmatized.
And so depending on what generation you're treating, my older generation,
definitely it's definitely something private, much less so with my
(06:14):
younger generation patients.
Speaker 2 (06:16):
As a doctor, let's talk about the younger generation. Do
you see genuinely that to me, it just feels a
bit weird that people in their twenties will come in
to get this botox injection to get rid of lines
that arguably at that age they yet to encounter. Is
that what you're seeing that the younger generation are coming
in for these sort of treatments.
Speaker 4 (06:35):
Well, not to me, I personally have my patient peakers
fifty four. Fifty to fifty four is the top of
my bell curve for patients, which matches my age. But look,
I do have had patients in the early twenties come in.
I had one lovely lady come in who said, I
want botops and I said, why you've got no lines,
(06:57):
and she said, well, all my friends are doing I
think that I should. And it was really important that
I educated her that there is no need to do
botox when you do not have a line. You know,
start early in your early twenties. In my opinion too early.
I do have the occasional patient in the mid twenties
who has a very strong familial line who already has
(07:19):
a line at rest. I think that's reasonable to treat,
but usually they don't need anything but the smallest dose.
But people thinking that it's essential to start early and
it's somehow magically going to stop their face aging that
needs to be put to rest because you know it
can treat a line when the line has come. You
(07:39):
don't need to start before the line comes. And I
just think it's a waste of money for the younger generation.
They really don't need to be doing large doses of
botox in their early twenties.
Speaker 3 (07:50):
What about men and men getting botox. I'm looking at
Titus's face and it looks like a leather handbag that's
been left out in the rain. Could I get.
Speaker 2 (07:57):
I've had a hard line?
Speaker 3 (07:57):
I get about you for a thirty eight year old
tyler to get his face done, so I don't have
to look at this rentally mess over there.
Speaker 4 (08:04):
Well, here's a much more appropriate age, So that would
be a tick in terms of men. So it's really interesting.
I asked some of my questions just quickly.
Speaker 2 (08:12):
God help you us here. It's going to be a
tough ass, but carry on.
Speaker 4 (08:16):
I've got a lot of botox, so I've got three
percent male patients. I've got colleagues to have five percent.
My male colleagues tend to have about twenty percent. But
a lot of them also also injectibles like PRP for
hair loss, so they're doing hair loss as well. So
it's still Botox is still absolutely a minority for males.
(08:36):
It's still way more popular for women. Males are generally
much more interested in hair loss and jawline, which botox
has much less of an activity in that area. For women,
we still want that smooth, feminine looking skin, you know,
smooth skin as seen as feminine. Men can have deep
crows feet, you know, remember Sean Connery. You know that
(08:57):
crinkle around the eye. So from a skin smoothness point
of view, it's generally perceived as less important for men
to have smooth skin, but I do. I definitely have
male patients who really appreciate not having Gordon Ramsey lines
in their forehead, you know, So there's definitely a place
(09:19):
for it.
Speaker 3 (09:19):
No exactly what you mean by Gordon Ramsey life. We're
talking to doctor Sarah Hart. Now, what's the difference between
filler and botox? Because you know the lips, the Kim
Kardashian lips and that kind of thing. Is that different
from botox?
Speaker 4 (09:36):
You know what? Completely different? The only similarity between them
is that you use them to approve appearance and that
you inject it. So philla is a gel that you
physically inject into the tissue to change the contour. So
it's a carbohydrate, whereas botox is a protein. And most
fillers are made from hyaluronic acid. And so the fillers
(09:56):
more about changing contour. I mean, you can use a
very dilute version of a filler to improve skin hydration
and fine lines, and then they're called a skin booster.
But fillers are generally too projected cheek make a look
bigger projected chin, So it's about contour rather than wrinkles.
Speaker 3 (10:15):
Are they better and worse botox people because my mate
won't let his wife, well, he won't pick his wife
up from the botox anymore because he says she looks
like she's been stung by bees. So are they? Are
there people that are better and worse at doing it?
Speaker 4 (10:29):
Yeah? Look, so I would say there's different styles of
doing it so that it's possible to do botops and
fill it in a style that's incredibly natural, and generally
you'd be using smaller doses and you're stopping before you
change the contour too much, so you can usefully to
support lost volume under the skin rather than create too
much change. But then there's also a trend more the
(10:53):
Instagram Can Kardashian trend of changing the face or glamorizing
the face, and some providers prefer that approach. So it's
really important to pick a provider that has a similar
aesthetic to you and that they're god ale of treatment
is in line with what you're wanting.
Speaker 3 (11:11):
Yeah, because you can get stung by bees for free,
you don't need to pay for that one if that's
what you're into.
Speaker 2 (11:15):
Yeah, Sarah, thank you very much for your expertise. Really
appreciate it, and we'll catch up soon.
Speaker 4 (11:23):
Yep, my pleasure.
Speaker 2 (11:23):
I love you to chat all right. That is doctor
Sarah Hart, Cosmetic Doctor.
Speaker 1 (11:27):
For more from News Talk st B, listen live on
air or online, and keep our shows with you wherever
you go with our podcasts on iHeartRadio
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