What really happens when you get Botox?
I have tried as hard as I possibly can to stop myself from frowning, screaming and getting mad at my kids and my husband. Why you ask? Is it because I am trying to be more grounded and Zen about life? Oh hell to the no. It’s because I am in a mad race against father time to keep the lines on my forehead from getting increasingly more furrowed and deep. I figure if I frown as little as possible, stay out of the sun and basically keep my face as expressionless as can be, it will go a long way in staving off those wrinkles. And yet each morning when I wake up- there they are staring back at me and all of a sudden a little voice goes off in my head saying,“ Just do it Melissa, just get Botox and train your wrinkles away.” And then my dog lifts his leg and pees on the bathroom floor (knowing full well that I have my gaze directed upon him) and those furrows on my brow inevitably get deeper.
So yes, at 42 I am definitely ready to train my wrinkles to stop wrinkling and try a neuromodulator. I know I am not the only woman my age who desperately wants to get angry without fear of deepening her wrinkles - and take the Botox plunge. Of course most of us have heard horror stories about women whose faces look frozen post-Botox treatments and therefore feel torn and not sure if getting said injections is the best course of action. So, rather than endlessly debate with myself, I went straight to the source, Dr. Kenneth Rothaus, a board-certified plastic surgeon, to finally get the wrinkle-free lowdown on Botox.
According to Dr. Rothaus, wrinkles on the skin are a direct result of the action of the facial muscles. Quite simply, he added, Botox prevents the muscles from contracting and with the paralysis of the muscles the wrinkles are softened or eliminated.
“In my experience, neuromodulators work very well on the forehead and crow's feet and the glabellar wrinkles (vertical lines between eyebrows)," says Dr. Rothaus. “Other areas that can respond well to small amounts of neuromodulator are the upper lip and the chin. I find the neuromodulators to be less effective in the neck. Botox does however wear off, and its effects last about three to four months, so it is frequently used repetitively.”
While its effects may only last four months - Dr. Rothaus adds that for those patients who keep to a regular schedule of Botox injections, the interval between injections gets longer and longer. He adds that he assumes they develop some atrophy of the muscles with time.
“The good news is if the muscles are paralyzed, new wrinkles will not develop, however the bad news is the component of the aging process that is treated by Botox is different than that treated by a facelift," says Dr. Rothaus. “Therefore, the use of Botox won't obviate the need for a facelift, but patients will look much better in the time leading up to their facelift.”
Dr. Rothaus also shares that when it comes to neuromodulators, while Botox is the name we most commonly know, there are others like Dysport and Xeomin. When it comes to his experience with the others he states that, “The onset of Dysport might be a little quicker than Botox. Similarly one might see the effects of Xeomin a little quicker than those of Dysport. As far as persistence of the effect, Botox might last a little longer than Dysport and Dysport might last a little longer than Xeomin. This is just my opinion and experience though and ultimately it might depend on the patient.”
When it comes to the side effects of a neuromodulator, Dr. Rothaus shares that if a patient were to read the package insert with Botox, they may find many side effects, but in practice Botox is a very well tolerated product.
“The most likely side effect from an injection is a bruise or hematoma and some local, temporary swelling. Although Botox can be used to treat headaches, on rare occasions some patients actually experience a headache after the injection,” adds Dr. Rothaus. “The most distressing complication patients might see is a drooping of the eyelid (ptosis). Of course, this disappears after the Botox wears off.”
Speaking with Dr. Rothaus illuminated some myths I had regarding Botox and also helped me to temper my expectations post-treatment. I am now officially ready to take the neuromodulator plunge!
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