“What’s wrong?  You look angry!”  My husband’s words took me by surprise, because I wasn’t angry at all.  It was a sunny day, and I was multitasking, feeling productive, and simply standing in the kitchen, thinking about the laundry that needed to be switched from the washing machine to the dryer.  He had remarked about this a couple of times, and I had simply told him that I wasn’t angry – and I genuinely wasn’t!  However, after a couple of those comments, I realized my “thinking face” had turned into an occasional furrowed expression.  Closer inspection in the mirror (we all do it, right?) made me realize that those lines were starting to become more pronounced.  Was I really furrowing that often?  I decided to look into my options for preventing this from becoming my permanent expression.  Remember Mom saying that if you stretched your face or did your silly expression too often, that it would “stay that way”?  Turns out, she may have been speaking a little bit of truth.  I made an appointment for Botox.  Although my husband and I are very transparent about things, I decided to wait and see if he noticed anything before telling him.  After all, every good science experiment has a control, to see if it truly makes a difference.

I chose to have my brow treated, and I received five tiny injections in the muscles of my lower forehead.  The thread-size needles felt like small, brief pinches, and I excitedly went home and waited to see when Happy-Looking Wife would appear in the mirror.  Botox usually takes 3-4 days for a subtle change, and 7-10 days to reach its full effect.  Fast forward one week later.  The kids were in bed, and hubby and I were sitting down and talking about our days, and he commented that he was glad I seemed to be having a better week than the prior week.  I asked what he meant, and he said, “Oh, I don’t know…there’s just something different about you…you just seem more relaxed and you don’t look angry anymore.”  I laughed and told him about the Botox, and he said he really liked its effect.  Jokingly, I told him we can continue my Botox plan, or we could go see a counselor to talk about “how mad I wasn’t,” and he affirmed my Botox plan.  

Chances are, you know someone who is “getting Botox,” although you likely do not know who they are.  Most patients want to look “young, not done,” and while we have ability to greatly impair muscle contraction with a lot of units of Botox (some patients want us to do this because they want to minimize their expression for their career position/role), most patients receive Botox to soften their lines and maintain expression.  More and more men are trying Botox, too.  Here’s the skinny…

Botox works by blocking the nerve pathway of a muscle, which prevents the muscle from contracting, and in turn, treats the wrinkles/lines caused by the muscle contraction.  The neuromodulator that does this (“onobotulinum toxin A”) is wrapped in proteins and is slowly broken down over time – approximately 3 months.  During that three months, the muscle contraction is minimized, creating a softened, refreshed look.  After three months, it slowly wears off and returns to what it looked like prior to injections.  Some patients maintain their Botox and repeat injections every 3-4 months.  Others come in prior to a reunion, wedding, or special event for a single treatment.  We also offer private parties, so you can gather your friends and experience Botox together.  

Botox dosing is measured in “units,” and the cost of Botox is “per unit.”  The recommended amount of units for the glabella (the central lower brow and inner eyebrow area) is 20 units, but we have some patients who have smaller brows and are treated with fewer amounts of units of Botox.  If we can obtain a softened expression with fewer units of Botox, we are happy to do that!  After all, using fewer units saves you money!  At the same time, we can’t give you a tiny brush with a spoonful of paint and ask you to paint an entire wall.  There is a minimum amount needed to adequately treat an area, so we try to determine what your minimum amount is, and start with fewer units.  If we treat with fewer units and you don’t fully achieve your desired results, we can always add additional units in a week or two.  

Botox is used to treat various areas of the face.  Lines on the face are caused by a perpendicular muscle movement.  The most common area is the brow/glabella, with the sides of the eyes, or “crow’s feet” lines as the second most common area.  Look in the mirror and furrow your brow, as if you were scowling or angry.  Glabellar treatment with Botox treats the lines between your eyebrows (also known as “11 or 111 lines,” depending on how many lines you have).  If you don’t have etched-in lines there yet, it’s a great time to start Botox to prevent etched-in lines.  If you do have etched-in lines, Botox may minimize and soften the line, but we may also recommend filler use.  Botox will also create a more “eye open” look, which will help you appear refreshed.  Now squint, as if you were looking into the sun.  The lines to the outer sides of the eyes may fan out or cause a grouping of lines that appear to look like a crow’s foot.  These are called “lateral canthal lines” and are also treated with Botox, sometimes with as few as 4 units to the side of each eye.  The lines created by squinting will be minimized.  Now look in the mirror and raise your eyebrows.  Horizontal lines across the forehead are treated with Botox, too.  See “Before and After” pictures here.

Men and women are being treated with Botox.  A slightly elevated arch, similar to a gull-wing appearance, is desirable for women.  Men naturally have a flatter brow, and injections for men are given to treat wrinkles and maintain a straighter brow.    

We would be happy to meet you, evaluate your areas of concern, and discuss what Botox would do for you, specific to your anatomy, expression, muscle activity, and medical history.  We will also discuss our recommendation for number of units to be used and cost associated with this.  We encourage our patients to consider participating in Brilliant Distinctions, which offers savings with each treatment.

We recognize that Botox isn’t for everyone.  There are certain medical conditions that would contraindicate its use, and we will review your medical history and medications prior to recommending Botox.  Botox has been used for decades, and its safety is well demonstrated in scientific studies.  We purchase our Botox directly from its manufacturer, Allergan.  Doing so assures we are receiving pure Botox, so you never have to worry about impure substances that appear in news articles.  

We are part of Allergan Partner Privileges and the Botox company’s Brilliant Distinction rewards program.  If you choose to enroll in Brilliant Distinctions, there is no fee for this.  We enter the lot number of the vial used for your Botox treatment, and the Botox company will reward you with points that can be redeemed for credit towards your next Botox treatment.  Points can also be earned with and used for Latisse and Juvederm fillers.  

Our injections are performed by Leslie TenBrink, a family nurse practitioner who has received specialty training in esthetic medicine, including Botox/neuromodulator certification through the Esthetic Skin Institute, Allergan Corporation and Merz Corporation.  She looks forward to meeting you to discuss Botox and other cosmetic services our practice offers.  Schedule now!