Botox or Bust?

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ips and tucks are certainly not just for celebs and prime-time soaps anymore. Thanks to technological advancement during the last few years, cosmetic enhancement doesn’t necessarily mean going under the knife. Eighty-one percent of cosmetic procedures done in 2005 were nonsurgical. And the beauty buzzword on everyone’s lips—or forehead, to be exact—is Botox. In fact, Botox injections were the number one cosmetic procedure last year. FOXNews.com reports that a recent (albeit unscientific) survey found more women over 30 would prefer Botox injections to a trip to Paris. Shocked? Well, if your face can actually show your surprise, you probably aren’t one of the millions of people who are getting regular Botox cosmetic injections in the United States.

Background on Botox

Botox is the trade name for botulinum toxin produced by Clostridium bacterium. It works by freezing muscle contractions. When muscles in the brow and forehead are injected with Botox and cannot contract, wrinkles smooth out and the eyebrows appear lifted. It targets major furrows, crow’s feet and wrinkling between the nose.

But what about what we don’t know? Does it hurt? Can Botox really stop wrinkling? Is it affordable? Before you furrow your brow and create a new fine line, Glow Salon and Med Spa’s Rizwan Bukhari, M.D., a board-certified vascular surgeon with extensive experience in injectable cosmetic therapy, answers common questions and busts those Botox myths.

Myth or Truth?

Botox prevents wrinkles.
Truth: Still hot, young and not a wrinkle in sight? Before you stop reading, Botox may not just be for your mom anymore. According to Dr. Bukhari, Botox was once targeted for people in their 40s, 50s and beyond who already had wrinkles and wanted to look better. However, more people are turning to Botox in their 20s and 30s to prevent wrinkles. Where there is muscle contraction, there is the potential for dynamic wrinkles (seen only when you are smiling, raising your eyebrows or otherwise animating your facial expression), which Botox targets.

“The thing that people are starting to promote is to try to approach the problem before the wrinkles actually start to become permanent in the skin, such as in the mid to late 30 and early 40s,” he says. “The recommendation is going in for Botox at that time in order to prevent wrinkles that occur. If you get Botox starting at that age every four to six months or whenever the Botox begins to wear off, you can prevent the actual furrow or skin line that causes the wrinkle, thereby delaying the wrinkles that may become more permanent as a person ages.”

Can’t spot those wrinkles yet? Dr. Bukhari has younger clients make common expressions—smiling and squinting, for example—and then hold them for several seconds. When you relax, you can see the lines or even small wrinkles that go away after a few seconds. Over time and repeated expression of the face, these are the wrinkles that will become permanent.

Botox can cause droopy eyelids or the outer corners of the brow may end up higher than inner ones.
Truth: According to Dr. Bukhari, while the chances are very slim, a possible complication of Botox injections is droopy eyelids from the Botox leaking into nearby muscles or from being injected in the wrong place. “If too much Botox is injected, most of the time on the outside of the forehead or too low close to the eyebrows, you can end up with a droopy eyebrow affect,” says Bukhari. “The physician doing the injection needs to be especially careful about that.”

Botox injections are painful.
Myth: Popular due to their minimally invasive nature and zero downtime, Botox injections aren’t as painful you might think, according to Dr. Bukhari. The needles used aren’t much bigger than acupuncture needles, and while the procedure doesn’t require anesthesia, most physicians will ice the area to numb any pain—which a lot of returning patients don’t even need.

Botox works for everyone.
Myth: Dr. Bukhari says that there is a small percentage of the population that is resistant to the toxin; therefore injections will not be effective. However, if you are resistant, the Botox will not be harmful.

Botox is pricey.
Truth: While much more affordable than cosmetic surgery, Botox injections can certainly add up. The results last only 4 to 6 months and injections can range from $400 to $500 per treatment (depending on where you live and who your practitioner is).

Botox will poison your body.
Myth: Dr. Bukhari says that typically one vial of Botox has 100 units of the toxin and it is rare that an entire vial is ever used per person. The lethal dose of Botox is 2,800 units, which is well over the average dosage used. Dr. Bukhari emphasizes that Botox horror stories are usually a result of unregulated black-market botulinum toxin. Botox in the United States is FDA-approved, well-regulated and safe.

Botox leaves you with a frozen, expressionless face.
Myth and Truth: Dr. Bukhari reminds us “not to confuse a bad face lift with generally well-done Botox.” He says, “Botox, when done correctly and in the correct areas, is not meant to remove complete expression from the face. I explain to patients that you can always come back and do touch-ups and put more Botox in, but if you put too much in now, we can’t take it out or reverse it.” He says too much Botox can leave the face devoid of expression, so the goal should be to just limit the wrinkles created from expressions. Conservative treatment should result in a less drastic change in the face and a few wrinkles remaining even after treatments.

South Asians typically do not get Botox injections.
Myth: Dr. Bukhari has observed that the acceptance and popularity of the procedure among the South Asian community has paralleled that in the general population. However, it is true that factors that further aging skin—smoking and sun exposure—are habits that are less common among South Asians, thereby slowing the aging process and delaying the need for Botox treatments.

And women aren’t the only ones on the Botox bandwagon—men are getting interested, as well. “What we’ll see as the price of Botox comes down and as people’s awareness of it increases and as younger people begin to try it, we’re going to continue to see increasing numbers of Botox [treatments].” With its incredible popularity today, there’s no surprise or shock there.