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September 30, 2008

Beginners Botox

Hoping to look 28 forever, Ning Chao submits to the needle.

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Botox procedures

Photo Credit: Digital Vision/Getty Images

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On the eve of my 29th birthday, I got Botox. Let's just call it a present to myself ($250 is a lot cheaper than the latest Louboutins anyway), a sanity-saving panacea for the panic of seeing a new decade so close on the horizon. Wanting to stop time, I found myself on a recent morning sitting on the edge of a paper-covered examination chair (the business-class version of what you'd find at the dentist's office), with dermatologist Dr. Francesca Fusco scrutinizing my forehead while she asked me questions about my job and family and told jokes to make me laugh — all so she could watch how my face naturally moved. Then, four quick pricks later, I was done.

The pain was minimal. In fact, I didn't really feel a thing. The target? A short line I called my writer's wrinkle (from inquisitive eyebrow raising during interviews) that had been threatening to stretch across my forehead since age 24. I walked out of Fusco's office less than a half-hour later (the consultation took about 20 minutes; all four shots, one minute max) with a dull headache and instructions not to lower my head for the next four hours, or risk the toxin migrating down to my brows and causing eyelid droop.

This awkward precaution is what gave my friend Liz's youthful secret away at a lunch two weeks prior to my big day. Fresh from her appointment with Fusco, Liz gingerly raised the menu to her face to read it and then wouldn't look down at her food while eating. When I asked what was wrong, she said she had just gotten injected. "Botox? But you just turned 28!" I exclaimed, scanning her face for zombie-ish paralysis or any other signs of artificial age-control. But her face moved and her brows raised like normal, and she sheepishly admitted that she had been going under the needle for the past four years.

"I started doing it to treat my migraines, which I used to get once a week and had to take daily medication for. But now I don't need the pills, and I don't have any lines on my forehead," Liz revealed. "Women our age are scared to get Botox because they don't want to look like Joan Rivers, but my mom's been doing it for years and she doesn't have a frozen face. Her lines are now gone — she doesn't even need a filler" (as in collagen or hyaluronic-acid injections).

Botox's preventative aspect was proved in Beverly Hills plastic surgeon Dr. William J. Binder's groundbreaking 2006 twins study, in which he injected one identical twin with the toxin for 13 years (from the age of 25). The result? The treated twin looked at least five years younger, in spite of living in sun-damaging Malibu (her sister lived in Munich). "Muscles move and form folds in the skin. If you do that long enough, you'll get imprinted lines from the collagen breaking down," Binder explains. "Botox stops this process by preventing the muscles from moving." He also assures me that despite controversy earlier this year, Botox is the safest drug he's ever used — and he's been using it since the late '80s.

But when is the right time to start the shots? "It depends on your skin type and how much you move your face. Thinner complexions" — typical for women with lighter hair, eyes, and skin tones — "will develop more lines, faster," says Binder, who doesn't recommend treatment for teenagers (even if they live in Beverly Hills) or anyone who doesn't see lines yet, because if you can't predict where the patient will form wrinkles, you won't know where to inject the toxin.

Patients typically start treatment around a "9" birthday (29, 39, 49), according to New York City dermatologist Dr. Anne Chapas. "This is when people reflect on their lives," she says. "They think about what they've accomplished in the last decade and wonder if they look the same." I can certainly relate. With my dream job and apartment (which I own, thank you very much), I've come a long way since my 20-year-old, new-college-graduate self, but that doesn't mean that I don't want the smooth, glowing skin I had then (albeit with less acne).

"If you ask a 13-year-old when people get old, they'll say 30," says Pennsylvania psychologist and dermatologist Dr. Richard Fried. "We're bombarded with unbelievably unattainable images of airbrushed models and celebrities, so we all look into a circus fun-house mirror whenever we see ourselves. The human tendency is to accentuate the negative and minimize the positive. We've been sold a very destructive philosophy that somehow when you're past 30, you start deteriorating. Any thrill, passion, or excitement has fizzled, and you're just biding time until you croak. Doing something as simple as Botox can be enormously liberating and help fight the negative messages."

It's no surprise I'm not alone in my quest for eternal youth. In 2007 almost 400,000 Botox procedures were done on patients ages 19 to 34, according to the American Society for Aesthetic Plastic Surgery. Chapas estimates that 15 percent of her Botox patients are in their mid- to late 20s. And Liz alone has convinced at least four other 20-somethings (not counting me) to submit to the needle.

Fusco calls my early-adopter treatment "baby Botox," a diluted dose that will get rid of my little wrinkle but won't leave me expressionless. Still, I'm nervous about my foray into cosmetic "work." Will I become a plastic-surgery junkie? What if my already-arched brows rise to perpetually surprised Spock-like V's? Fusco reassures me that she'll inject less than usual and I can come back in two weeks — it takes two to five days for the muscle to stop contracting and up to 10 days for the wrinkle to smooth — if I want more. But two weeks later, when she e-mails me to ask about my "vitamin B" (she's very discreet with her Botox patients), I'm thrilled with the results. My writer's wrinkle is gone and nobody notices a change in my appearance (even when I tell them what I've done).

Two months later, my forehead is still smooth when I don't move my face, but the slightest hint of a line starts to appear when I raise my brows (similar to what I saw at age 24). Amusingly, the men I've attracted since are much younger (mostly 22- and 23-year-olds), which I hope is more of an indication of how I look rather than how I act.

Botox not for you? Try these age-defying makeup tips
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Fusco estimates that I'll need a touch-up after another month but predicts I'll require fewer treatments, less often, the longer I stick with the shots. "Over time, as people get Botox repeatedly, the muscles become trained to a certain extent and don't move as much, even when the toxin has worn off," she explains. "You may start getting injections every three months, but eventually you'll only need it twice a year." And the FDA approval of the competitive botulinum toxins Reloxin and Puretox, expected as early as the end of this year, might mean the price of injections will go down. (Right now, Botox has a monopoly, so doctors pay a premium that they pass on to their patients.)

By the time I'm due to schedule my next appointment, I surprise myself: I decide against it. The Botox helped me ease into 29, but I'm getting more comfortable with that number every day (and frankly, I miss meeting men my own age). So when will my next booster shot be? Probably the day before my next birthday.

Wrinkle-relaxing alternatives (no needle necessary)
Peter Thomas Roth Un-Wrinkle Night Cream
Avon Anew Clinical Deep Crease Concentrate
Good Skin Tri-Aktiline Instant Deep Wrinkle Filler
Rodial Glamotox Active Daily Moisturizer
SkinMedica TNS Line Refine
Freeze 24-7 Eyecing Fatigue-Fighting Eye Cream
Derma Doctor Immobile Lines Instant Topical Line Relaxer


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