By Dave Warner
Remember the tale about Spanish explorer Juan Ponce de Leon sailing to Florida in search of the fountain of youth?
He was by far not the only human being in history who has tried to find some magic potion to stay Forever Young, as the song has it.
In modern times, the search has led many to what is officially known as OnabotulinumtoxinA. You probably know it best as Botox, although that is a brand name and there are other brands, but in popular usage, the name Botox has come to symbolize the ancient explorer’s dream.
Meet Ann Ross, 48, of Hollister, in northern California, who has been using Botox for about 5 years now. She’s a believer.
“It is absolutely the greatest thing that can happen to a woman my age,” she said, explaining that she began using it when her mother rather gently suggested one day that she might want to start wearing her hair in bangs.
She went to the hairdresser, who saw lines on her forehead, and said, “Forget the bangs, get Botox.”
Botox for cosmetic purposes isn’t everyone’s idea of a great time, though. Deborah Mullaney, 58, a friend of Ross who also lives in Hollister, tried it once, several years ago.
But she never went back.
She said she came out of the shots for her forehead and the space between her eyes with one eyebrow higher than the other.
“I think they over-injected me,” she said of the physician who administered the treatment.
Nowadays, she just doesn’t think she needs it, but she allowed that she might go back for another treatment at some stage.
Ross, however, has stuck with Botox. Initially she asked some friends about getting injections, and ended up in a commercial establishment near San Francisco. But that was a 90 minute drive, and she became tired of it, so now she sees a medical doctor near her hometown. She said she feels more comfortable with a doctor administering Botox, instead of a nurse at the place she used initially.
These days, she pays $350 every six months for injections for her forehead, for crow’s feet around her eyes, and for the space between her eyes, which according to Philadelphia plastic surgeon Ivona Percec are very common areas for treatment.
That’s money out of her pocket, because medical insurance tends not to pay for cosmetic use of Botox.
That is, insurance tends not to cover it for cosmetic uses. Botox has other medical uses as well – severe underarm sweating, uncontrollable tightening of the neck muscles, some eye problems and migraine headaches among other things.
All of that for a substance that comes from the same toxin that causes the food poisoning condition known as botulism. Essentially, it works by paralyzing some muscles and blocking some nerves. Bottom line: wrinkles don’t form.
And that suits Ross just fine. The effect is not so obvious that friends and colleagues recognize immediately that she is a Botox believer.
“If it is being done properly, people just say ‘you look nice today,’” she said, suggesting that they don’t really know why they like her appearance, they just do.
The mother of three said that before she began using Botox, she was looking stressed and tired.
Now, she said, she looks calmer.
That is consistent with an observation by Percec, of the Perelman School of Medicine at the University of Pennsylvania.
“You can have Botox with natural looking results,” she said. She said, too, that the issue of Botox patients not being able to frown easily can be true, but that it’s up to a physician to tailor the treatment, by administering, say, a half dose to prevent that outcome.
She said doctors routinely administer Botox, but she would be comfortable too with a well-trained nurse under the supervision of a physician doing it as well.
Percec said the treatment is no longer appealing only to women.
“I would say a majority are female,” she said, “But we are seeing more and more men come in for Botox.”
Overall, she said, patients don’t frown as much when they use Botox.
“They feel like they are more relaxed, more refreshed,” she said.
That can be true for patients of nearly all ages. She said children are sometimes injected with Botox for therapeutic reasons, such as muscle spasms in several parts of the body, including the gastrointestinal track. It is also used for some secondary symptoms from cerebral palsy, she said. And older adults – she used 80 as an example – can use it too, provided they don’t have other medical issues, such as some auto-immune disorders, or take blood thinners.
Some places charge more than others for Botox. In Philadelphia, Percec said the cost is typically more like $750 every three to four months, rather than the fee cited by Ross, on the west coast.
Whatever the cost, Botox treatments are popular – some estimates say it is one of the top five nonsurgical cosmetic treatments. Percec said treatments now account for some 20 to 30 percent of her practice, and she thinks that is typical for a plastic surgeon these days. She said some older doctors, nearing retirement, are depending almost entirely on Botox treatments in their practices.
Ross also said that early in her treatment she suffered briefly from a side effect that she called “eye drop,” which she described as a slightly drooping eyelid. She rated it as a minor problem that disappeared fairly quickly.
Some experts list a wide range of other possible side effects, including:
- You know that expression doctors like to use? “This might sting a little.” Sometimes it does, at the point where the needle goes in.
- Headaches or drowsiness, vision changes, dry eyes.
- Sweating.
- Seizures.
- Irregular heartbeat, shortness of breath.
- Itching, a rash or the hives.
Percec said, however, that in her experience, the most common side effects are: headaches, upper eyelid drop, and bruising around the site of injections.
As enthusiastic as some are about Botox, others issue some cautions.
“Botox Cosmetic is not magic,” says a statement from the University of Illinois Medical Center. “Botox Cosmetic will not radically change your appearance or make you look like you’ve had ‘work done.’ It will not make you look 20 years younger.”
The statement said typically treatments last for up to four months. It takes up to a week after the injections for the results to show.
Ross doesn’t need any convincing about any of this.
“I would recommend it to everybody who can afford it,” she said. “I just think it looks better.”
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