Do I Need Botox?

Do I need botox?

For everyone it seems to come at a different age—a dreaded wrinkle.  It first happened to me in my early 30’s.  I was wedding planning and working out the details in my sleep, which manifested itself as a furrow between my brow.

At a previously scheduled appointment with my dermatologist for a mole check, she noticed my new furrow and inquired about what was going on.  I told her it seemed to be happening when I slept and I couldn’t figure out how to stop.  She suggested she put a little Botox there to prevent it from becoming deeper, and just like that, my furrow was gone. Apparently the muscle retraining overlapped my stress being eliminated and that specific wrinkle never came back.

Now ten years later, I have new wrinkles.  I’ve been working hard to embrace them, but truth be told, Botox is on my mind again.  Many of my friends use it effortlessly and frankly, I see a difference—both good and bad.  Different meaning they don’t have wrinkles, but different also in that it seems to have changed the way they look.  Maybe this would have happened anyway, but I can’t stop thinking about what’s going to happen somewhere else on my face if I can’t express myself by wrinkling my forehead.

So back I went to my favorite dermatologist resource, Dr. Erin Moore MD to get some answers.

Me: Dr. Moore, I’m feeling some personal pressure to soften this furrow between my brows? Is it time? What’s your recommendation on when to start using Botox?

Dr. Moore: Most patients are a little hesitant to ask when they should start Botox, and I quickly assure them that many people (men and women) get regular Botox injections, and usually you can’t even tell.

I never tell someone that they need Botox or that there is a specific age to start injections—everyone is different. I have patients in their 20s and patients in their 70s who come for Botox injections. If you are aiming to prevent lines (such as a frown line between the eyes or horizontal lines on the forehead) it is important to start before the line are etched in or present when you are not moving the face. This is usually somewhere between age 25 to age 40, depending on your natural facial expressions, genetics and sun exposure. If you naturally furrow your brow when you concentrate or raise your eyebrows frequently then you will need to start earlier with small amounts of Botox.

Me: Are there particular areas on the face where it’s better to use Botox than others?

Dr. Moore: Botox is FDA approved for use in the forehead (specifically between the eyes for frown lines) and around the eyes for crow’s feet. All other locations are considered off label. Botox is commonly used in the forehead for those pesky horizontal lines. It is safest and most often used in the forehead and around the eyes. Small amounts can be used around the mouth for peri oral wrinkles (commonly called smokers lines), the chin (for pebbly or dimply chin), to help the mouth turn up (rather than frown) and for helping reduce visible gums when smiling (a gummy smile). Botox can be used to decrease the size of the chewing muscles (called the masseter muscle) to give a smooth appearance to the jawline and to help soften prominent neck muscles

Me: When would you tell someone not to get Botox?

Dr. Moore: If you have deep lines that are present when you are not moving the face (etched in lines) then Botox may not be able to reverse the creases. Botox can help soften the lines but often people are disappointed because they want deep lines to be erased with the first treatment and that is not realistic. It is not recommended to have Botox if you are pregnant or nursing or have a history of neuromuscular disorders such as myasthenia gravis.

Me: Are there alternatives to Botox?

Dr. Moore: There are different brands of cosmetic botulinum toxin – Xeomin and Dysport, which work in the same manner (temporary relaxation of muscles by injection) but have slightly different chemical properties. There is no cream or laser that provides the same result as Botox.

Me: We once heard about acupuncture to reduce wrinkles. Is this possible?

Dr. Moore: I am not familiar with acupuncture reducing wrinkles.  Maybe the needles were dipped in Botox? (hahaha)

After deliberating for some time on whether to get Botox for my furrow and forehead wrinkles, I went for it. Dr. Moore injected a small amount into my forehead (I can’t remember how many shots).  I’ll be honest, I don’t love needles and I felt kind of weird after, wondering if it was a bad idea given that I eat so healthy and use non-toxic products, but now a week later, I’m pleased that my forehead is smoother.  Will I do it again? Probably.  Or maybe I’ll embrace Lauren Bacall’s quote “I think your whole life shows in your face and you should be proud of that.”

Disclaimer: This information is not intended to diagnose or treat medical conditions. It should not replace evaluation from a medical professional.

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