Perhaps due to the immoble foreheads of one too many reality stars out there, Botox gets somewhat of a bad rap, but for those in the real world who have tried out the treatment, it's unlikely that you'll notice they got anything done. "I say this all the time—if they would have named it something other than 'Botox,' it would have gotten a better acceptance, and it got a bad twist early on," says Dr. Stafford Broumand of 740 Park Avenue Plastic Surgery in New York City. "It's all about moderation, and should be viewed more as maintenance, to look the same, rather than a way to look dramatically different. You don't drive your car into the ground and get it fixed every 10 years—you do regular maintenance to keep it running like new."
The impacts are more than just aesthetics, especially for those who have excessive sweating and use Botox to deactivate their sweat glands. It seems like people talk about Botox all the time, and whether you're into the idea or not, even just talking about it draws up negative connotations. Of course, it's not for everybody, and if you don't feel the need for it, then you can obviously feel free to pass, but to clear up any misconceptions, we asked Dr. Broumand to give us a crash-course on the treatment, and how to tell if it's right for you. Read on to get all the info you'll ever need on Botox, whether you're considering it (no judgment!) or if you're the slightest bit curious about the treatment.
What Is Botox, and What Does It Do?
"Botox is a compound made by bacteria, which is a botulism toxin," Broumand explains. Though the concept sounds scary, when used in very controlled doses, the practice is safe. The compound is injected into a specific area, and once inside, it binds itself to receptors in your muscle, affecting the nerves within. "So as a result, when your nerve releases a chemical to make that particular muscle fire or trigger, it can't," he adds. "The function decreases, and the wrinkle that forms when the muscle contracts will diminish, or go away completely. It's not a static thing, though. Your body regenerates those receptors over time."
Is It the Same as Filler?
Not at all. While Botox impacts the muscle, filler does exactly as its name suggests: it's used to fill wrinkles or even out any mismatches in volume on the face. "Products like Juvederm or Restalyne can be used to fill lips, and fill in certain creases around the face," Broumand explains. If a particular line or wrinkle is too deep to be treated with Botox, filler can temporarily diminish its appearance, and results last nine months on average.
Where Is It Used?
The most common places Botox is injected are the crow's feet around the eye area, glabella creases between the eyes, brow furrows, and in horizontal wrinkles on the forehead. Dr. Broumand has also used it along the jawline to counteract bone loss and to correct a downturned lip. "You can inject it strategically to elevate the lip—sort of like a Mona Lisa effect rather than a frowning look," he tells us. The most-surprising area? Into the armpit. When injected into the sweat glands, Botox can completely halt sweat and odor for months. "It's game-changing for some people, and is one of the most impactful non-cosmetic treatments for Botox," Broumand adds.
Who Should Get It?
Most people are able candidates for the treatment, but Dr. Broumand urges his patients to be realistic, and not get too aggressive or unreasonable with the treatment. "It's a good way of averting fine wrinkles, but I don't want young people to be negatively influenced into believing it's necessary," he says. "People can start in their late 20s or early 30s, and it's more about maintenance—if there are issues that are arising and can be resolved with medical treatments, then by all means, but we never want to change the character of a person's face." The idea is to keep the patient looking the same and unaffected by age, rather than Real Housewives levels of different.
How Long Does It Last?
Immediately after getting the treatment, Botox will take anywhere from one to 10 days to kick in, and on average, it lasts about three to four months as that's the amount of time it takes your body to regenerate new receptors within the muscle.
How Can I Find a Practitioner to Inject It?
Though many people can inject Botox, that doesn't mean they should. "Go to someone who is board certified in plastic surgery to make that assessment. You want to have a doctor who understands the anatomy of the face," Dr. Broumand says. "Going to someone who is qualified and consistent is so important. We document everything we put in and where so that we can see what those results are. It's scientific in the way that we do it so that we can come up with a result that's best for you." If you narrow your choices down by sheer convenience and cost, only to go to someone who hasn't been board certified in plastic surgery, the results are often varied. Additionally, ask questions about where the botox is being injected, and be vocal about what you hope to accomplish in getting botox.
Should I Avoid Doing Anything Afterwards?
In general, no. If your practitioner has done the procedure correctly and precisely, the Botox isn't going to move anywhere. There's barely any downtime as the needle marks fade within minutes. "It's injected, it diffuses a couple millimeters, it binds to the receptors, and that's it," Broumand reassures us. "I tell people to wait 40 minutes before any activity so there's no bruising, then they can do whatever they want. It's not going to track anywhere if someone starts doing yoga poses."
Can You Really Build Up an Immunity to Botox?
Though people claim this can happen, it's extremely rare. "I can count in the 15 years that I've been doing this, maybe two people saying they've developed an immunity, but I don't know if it's because they didn't come in frequently," Broumand says. Alternately, those who do get Botox on a regular basis are likely to see decreased muscle activity, so they may not need as much the next time around, or won't have to come in for as many touch-ups. "As you treat the muscles that cause the wrinkles, they get smaller and less vigorous, so you aren't as likely to form the wrinkles and won't need it so frequently," he adds. "You'll get to a point where you need less Botox to achieve the same results you've been getting."
What Should I Do If I Get a Botched Botox Job?
Again, this is where finding a qualified practitioner is extremely important, as you're less likely to end up with botched results. Though you could ask your practitioner to take a look, we wouldn't recommend getting additional Botox to fix the issue as it becomes a balancing act with one area wearing off quicker than the others. Luckily, just like everything else in life, the change isn't permanent. "I would just give it time," Broumand advises. "The brow will eventually reposition itself, the eyelid skin wil thin out, and you do get your original look back."