Meet the woman at the other end of the needle.
Botox. Yes, it's a toxin. Yes, it's had its rep propped up and dragged down. And yes, we keep on using it. For every overdone Meg Ryan, there's a subtle Linda Evangelista; for every Nicole Kidman, well, there's a Nicole Kidman: There's no arguing she's flawless, perhaps frozenly so.
The good doctors interviewed here are no frozen faces. They are all about making the most of their patients' assets, without taking the syringe to the max. And for many dermatologists across Canada, it's also their own dermo drug of choice. They happily inject themselves with what Dr. Frances Jang of Vancouver calls a "hugely preventative" procedure -- from their furrowed brows, down to their chest, indeed right down to their knees. The average cost of Botox treatments at Skinworks, where Dr. Jang plies her trade, is from $300 to $700, depending on the number of areas treated (for example, crow's feet, frown lines, forehead lines, lip lines, etc.) and the degree of muscle activity in these areas, which varies from patient to patient.
These doctors are their own best advertisements. Jang looks nowhere near her 50-plus years -- but she manages to look real nonetheless. Winnipeg's Dr. Victoria Taraska is approaching her 40th birthday, sporting a few subtle smile lines as evidence of the good life, but without a trace of some of the harder ageing wrinkles that would otherwise have made an appearance by now. When I visited Dr. Lisa Kellett on Avenue Road -- midtown Toronto's Botox Boulevard -- I was struck by how fresh and youthful she looks at the age of 40 and with four young children.
Sign me up. I'll have what they're having.
These women are pioneers of sorts, not afraid to experiment with the toxin in hopes of further slowing down the tick-tock of age. They post photos of their faces on their Web sites, as evidence that it really works.
Sure, there are occupational hazards. Sipping through a straw after a shot in the upper lip is suddenly a dangerous sport, and chewing food after a shot to the jaw can be a messy business. But just for a brief time. The benefits, all agree, outlast the few days of minor facial-muscle malfunctions.
Now, almost 20 years after its introduction, Botox is a household name. In 2005, according to Botox maker Allergan, the almost 3.3 million treatments performed made it the most common cosmetic procedure available. It is certainly the most common treatment in dermatology.
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JANIS CAMPBELL, MD, FRCPC
Laser Rejuvenation Clinic & Spa, Calgary
laserclinics.com Age 54
How long have you been using Botox? Since the '90s.
Do you do the work yourself? I do all my own reno work. I give great injections!
How often do you use it? Generally, every four to five months.
For what areas of the face do you use it? I start at my forehead and work down to my neck. You can use it to ease lines but also to adjust brow height, the degree of folds about the nose, the eye aperture, chin banding, crow's feet, bunny lines, chin creases, lip lines.
Are there new applications you are recommending to your patients?
Most options that patients consider new are those other than the forehead, frown and crow's feet. I recommend using Botox to make the face more symmetrical, or using it in combination with injectable fillers. Why do you use it? It's a unique tool that can soften the face in a natural way. And it has an excellent safety profile.
What do you think is next? I like to use Botox prior to excisions on certain areas to help minimize scarring. What is the most requested application area by your patients? The most requested site of treatment is the frown.
LISA KELLETT, MD, FRCPC
DLK on Avenue Toronto
dlkonavenue.com Age 40
How long have you been using Botox? I started using it at 35. Do you do the work yourself? I have my nurse, Diana, inject me. I'm much too picky to do it on myself, as I like it to be perfect and it's hard to do it backwards in a mirror! How often do you use it? Every three to four months.
For what areas of the face do you use it? Crow's feet, to turn the corners of the mouth up, vertical lip lines above the upper lip and-- ready for this? --neck, chest, knees. Also, I've had four pregnancies so I have developed a really great way to use it on the stomach.
Are there new applications you are recommending to your patients?
That depends on the patient, as every patient is an individual and I listen to their areas of concern first before recommending anything. Why do you use it? It is effective, safe, easy and fast and it makes me look well rested.
What do you think is next? I think the areas I inject for myself (neck, chest, knees) will become more commonplace.
What is the most requested application area by your patients? My specialty is an eye lift with Botox. It's safer and cheaper than surgery, takes only 10 minutes and you can go right back to work!
FRANCES JANG, MD, FRCPC
Skinworks, Vancouver
skinworks.ca Age: 50+
How long have you been using Botox? Since the '90s. I use it for general lifting in combination with other things, like fillers. My first area was the frown line-- the "number 11" between the brows.
Do you do the work yourself? I direct my nurses on my face, but I do all my patients myself.
How often do you use it? For my crow's feet, every three months or so, for my frown lines, about every six months.
For what other areas of the face do you use it? To lift and reshape eyebrows and on bunny lines (the diagonal lines on the nose created when you wrinkle your nose). Also for the strong masseter, or chewing, muscles -- you can feminize a square face, more typical of Asians, to make it more oval (it may weaken the way you chew for a little while). And my neck:When you get older you get these vertical sinewy lines or platys-mal bands that can be softened. Are there new areas you are recommending to your patients? The Nefertiti lift: The Egyptian queen was always depicted as having a clean jaw line. As we age, that outline starts to get lost with a little jowl. You can help re-establish or just keep that clean jaw line with Botox. You don't want to do this too late either, ideally in the 40s and 50s. It's hard to do non-surgical treatments when the patients gettoo advanced. Nubbly chin, or what I call the apple-dumpling look -- it must be done before that apple dumpling becomes permanent.
If the patients are in their 30s or 40s, I recommend softening the number 11s. Botox in this area is hugely preventative. After a while, you just don't age--but the bottom part of your face starts getting older. I suggest using Botox in the upper third of the face, and with a combination of fillers in the lower third of the face. Also, as people get older, the mouth starts to turn down. Botox will relax the muscle and keep it from its downward turn so the mouth overall would look better, not grumpy!
Why do you use it? It makes me feel better, and I do it for a living, so I must present to my patients the certainty that it's safe and effective. I wouldn't do something on my mother or my sister or my patients before I would do it on myself. If I look like a hag, people would wonder about the hype. It really does make you feel better, like you've done something about it.
What do you think is next? The artful combination of using Botox in small doses to relax the muscles where they are too active, and to always combine with fillers and laser treatments that can retexturize the skin and even out the skin tone. What is the most requested application area by your patients? The Botox brow lift, which opens up your eyes.
VICTORIA TARASKA, MD, FRCPC
First Glance Aesthetic Clinic, Winnipeg
thefirstglance.ca Age 39
How long have you been using Botox? Seven years on myself; 12 years on my patients.
Do you do the work yourself? Usually I do it myself, but the odd time I'll get staff to do it.
How often do you use it? Every four to six months.
For what areas of the face do you use it? Forehead, upper lip, crow's feet, frown lines, brow lift. Also, armpits -- to stop sweating.
Are there new applications you are recommending to your patients?
Yes, to improve mouth frowning, to treat bunny lines, to improve jowls or neck muscles, gummy smiles and brow lifts. I also tell them, don't be scared of Botox! Jokes about Botox scare people off from having great cosmetic results. Anyone who cares about preventing ageing should have Botox and should not be fearful of it. It is easy, simple and the safest cosmetic procedure, if done by an expert injector. Almost all women over 35 should start Botox and some may need it earlier.
Why do you use it? It works, it's safe and the best way to prevent wrinkles. If I promote a product, I should believe in it myself. Every woman who is starting to see wrinkles appear that they do not want to become permanent should use it. If they wait too long and the lines are etched in already, then they need more expensive, potentially more painful, cosmetic work.
What do you think is next? You may see Botox used for shingles pain, headaches, sweating and maybe even rosacea.
What is the most requested application area by your patients?
Frown lines, then the forehead, crow's feet, brow lift, upper lip lines.
Published by the National Post on Saturday, September 6, 2008 - Written by Vivian Vassos
