Tox for Tots: Botox Grows Down

Right now, a typical spin through the tabloids, shiny pages gleaming with idolized celebrity faces, might elicit a response like, “Oh look at all the Botox she has!” With plastic surgery becoming both less invasive and more affordable, our aspirations to stay as young as our famous heroes are becoming easier with the advent of such innovations as lunchtime peels, injectable fillers and -- by far the most popular -- Botox. When it dawned on me how many of my contemporaries (read: those in the 25-35 age bracket) actually used Botox, significantly lowering the initial median age, I decided to get to the bottom of what I consider to be the most revolutionary beauty product since moisturizer.

First of all, that stunned, stiff, expressionless face you see staring back at you from the red carpet shots of the celebrity glossies has nothing to do with Botox. I sat down with one of New York’s authorities on facial plastic surgery, Dr. Robert Guida, who explained to me that Botox is a muscle relaxant, not a facial filler, so those tense, plump faces that look anything but relaxed aren’t, in fact, that way due to Botox, but instead can hold a variety of nips, tucks, and pockets of subdermal fluid accountable for their ethereal expressions. Dr. Guida, of the New York Center for Plastic Surgery, six-time New York Magazine “Best Doctor of New York,” and renowned authority on Botox, further explained the many benefits (both preventative and corrective) Botox can boast if used properly. But it was that aforementioned “P” word, preventative, that caught my eye and elicited a few more questions. That very week, three separate coworkers commented on my “stressed” appearance (one may have even called it “miserable") which caused me to pose the inevitable, “Dr. G—I’m 27—is Botox right for me?” The good doctor couldn’t have been any more diplomatic in his answer: “I don’t know, is it?” After explaining what Botox could potentially do to my bothersome forehead lines, both now and in ten years, I was sold.

Have you noticed a significant pattern in the age of your patients?
There’s been a progressively younger group coming in for Botox because it’s preventative, and generally, with surgical procedures, there’s more down time. They’re also more expensive, and Botox is safe, reversible, and it fades away over time.

What, if any, are the adverse effects of beginning Botox at such a young age?
I don’t know of any that have been scientifically proven. There was a minor study in Europe involving mice, but it was not well documented. I’ve been using it at least 15 years, and I’ve witnessed no adverse effects. If anything, the muscle weakens, and you look more relaxed.

Is Botox a viable preventative?
Yes, absolutely.

What are the most popular treatments in the 25-35 age bracket that people are doing, either preventatively or otherwise?
People with deeper lines on their faces and acne scarring are looking towards fillers [Juvederm, Restylane, Radiance], lasers, and microdermabrasion. In terms of actual surgical procedures, anyone with tired eyes, even 18-20-year-olds with “bags,” are looking toward undereye lifts. [Editor’s note: Dr. Guida has gained a cult following especially for his proprietary “mini blepharoplasty,” a less invasive version of the typical undereye lift that has garnered him exceptional acclaim.]

As far as “lunchtime procedures” like Botox are concerned, what do you see the future holding?
Microdermabrasion, laser, and non-ablative laser treatments that can rejuvenate the skin with no downtime. Things are only going to get better.

And more “at home” treatments, too, I’ve noticed.
Yes, they sell at home laser hair removal machines and microdermabrasion kits. They’re all relatively safe. They may not be as effective as treatments administered in a doctor’s office, or by an aesthetician, but overall, all the knowledge about these products is very good.

What are some of the biggest mistakes you see people making in, say, the 20-34 age range?
Probably two things: The main one is overexposure to the sun and tanning, and then smoking. Not social smoking, but a lot of smoking, like a pack or two a day.

How big a role does diet play?
I’m a big believer in caloric restriction, in prolonging one’s life. Only problem is you’re usually miserable the whole time and hungry. Also, activities that make you relaxed always help.

So it’s almost a mental/physical balance?
Right, and people who exercise a lot have lower heart rates. Having clogged arteries, reduced pumping blood to the brain, etc., all those things can age you.

OK, back to Botox. What are some of the most common misconceptions about Botox?
People say that it’s a toxin and a poison. “It’s got botulinum in it, and it’s going to kill me.” It’s very, very safe, but as with anything, it can be overdone. Another thing is “bargain Botox” sold at a reduced price. You can find bargain Botox, but chances are it’s highly diluted and will not be nearly as effective. So if you’re having it done at the local hair salon ... you sort of get what you pay for.

What do you see the next advancements for Botox being?
The next advancement will be a competitor. The big thing now is price, perhaps longevity. Perhaps they can come up with something longer-lasting.

Where does the popularity of Botox stand, among other injectables?
Botox is the only substance that does what it does. Fillers are one thing, but Botox is the only muscle relaxant.

Have you ever refused someone Botox?
A few older people who were highly wrinkled. I could give them all the Botox in the world, but they’d still be wrinkled. They would need a facelift or similar procedure. Their lines would go away, but everything would drop.

Amazing. Do you have anything else to add?
I think if someone’s considering Botox, they should have a thorough conversation with their doctor as to how far they want to go ... They don’t want to be rendered expressionless.

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And the results are in, two weeks and six days later, I look like I took a week off to do nothing but sleep and relax, the most severe of my worries being which Nora Roberts movie Lifetime would air next. I can still look as puzzled and confused (a.k.a. show expression) as before, but if using Botox means losing the ability to look stressed (or “miserable,” as it’s been referred to), then that’s one loss I’m willing to sustain.