Health & Fitness
The Botox Question - Is It Time?
To Botox or not to Botox? Susan Ellis, MD, explores common cosmetic questions. Ask your question at askthederm@thedermgroup.com. Her practice is located at 310 Madison Avenue in Morristown.
The most interesting thing about the Cosmetic side of my Morristown Dermatology Practice is that it's just so relevant. Almost all of the women I meet (and several men) want to look great, not necessarily "flawless", but good for their age. The two questions I am asked the most about Botox are: when should I start, and will it look natural. Of course both of those answers are highly subjective, but after 11 years of practicing aesthetic dermatology, I can shed a bit of wisdom.
When to start? While I don't usually recommend Botox cosmetically for women in their 20's, I do for some in their mid-30's. Are they looking "wrinkled"? Not really, but the great thing about neuromodulators is that if you catch the wrinkle while it's still only caused by movement and consistently relax the muscle making that movement, you have a good chance of never having that wrinkle becoming permanently etched. However, most women don't begin until their 40's and 50's when wrinkles at rest start to appear. We also get a great result with a little bit of Botox in the crows' feet area and those pesky forehead lines. At this point, too, is when the face begins to lose some volume, and the conversation then turns to fillers, which can beautifully restore what is lost.
How much is too much? Most of my cosmetic patients want to look like themselves, but on a really good day! Every day we hear the same thing: "I don't feel angry and tired but that's how I look." I am first and foremost a medical dermatologist; not a syringe-happy "Housewives of New Beverly Hills" doctor. My only goal is for my patients to look refreshed, alert, and great for their age. Our approach is always conservative, as it's always better to add more later than to live with more than you want.
