Botox: Everybody's getting it, but nobody's talking about it. Which is unfortunate because A) culture of shame much? and B) the dearth of information leads to a lot of no good, very bad facial freezing, and time wasted wishing eyebrows would even out again. Which is why I asked four doctors who specialize in the field for the truth about making Botox last longer, how to avoid looking like Kim Cattrall pre-transformation in Mannequin, tips to minimize bruising, and other good stuff. Here's the real deal on all your (hopefully not literally) burning Botox questions:
How can I get Botox without looking like I've, you know...had Botox?
"It's always better to get less than you think you 'need', then come back for a follow-up if you decide you want more later. I never want someone to overdo it," cosmetic dermatologist Dr. Paul Jarrod Frank advises.
Is leaning forward or getting on a plane going to mess up my Botox?
"They used to tell people not to lie down for four hours or not to get on an airplane for a day," according to cosmetic dermatologist Dr. Elizabeth Tanzi. "All those issues have been debunked. It's perfectly fine to put your head down, it's fine to put makeup over the area—it's fine to do everything."
How can I reduce my risk of bruising?
Down arnica tabs (maybe): Arnica might provide all-natural help for bruising and swelling, so several of the doctors recommend their patients take them for a few days before and after their treatment. "There aren't any great studies to back up its efficacy, but a lot of people swear by them, and unless you're allergic, they certainly can't hurt," Dr. Frank adds.
Skip the gym: "I tell my patients I'd prefer they not exercise on the day of treatment," Dr. Tanzi recommends. "Not because it's dangerous or bad for the Botox, but because it increases their risk of bruising."
Also, don't take blood thinners if you can: All the doctors say they tell their patients to avoid aspirin, Motrin, Aleve, ibuprofen, fish oil supplements, and omega 3s for a week before coming in if possible—they all thin your blood, which makes bruising more likely.
Is there any way to make my Botox last longer?
Maybe—Dr. Tanzi says studies suggest that moving the muscles you just had injected may actually help Botox last longer. As a bonus, making a bunch of weird faces while you're walking back from the doctor's office will probably also help you avoid interacting with anyone.
Is there a "better" angle for someone to inject Botox at?
"The angle of injection is only really important around the eyes," says plastic surgeon Dr. Stafford Broumand,"You want a very superficial injection, just barely under the skin." Dermatologist Dr. David Colbert agrees: "If you inject really superficially, you're less likely to see bruising, too." And the only way to get just barely under the skin is to come in at an angle. So if you go for a consultation about crows' feet and the doctor says he injects Botox the exact same way on every facial area...well, maybe look for another doctor.
Also make sure your doctor isn't treating you under that low faux-mantic medispa lighting. "You want to make sure you have good, bright light so you can see all the small veins under the skin and avoid them," Dr. Colbert warns.
How much Botox should you use, really?
Apparently much less than Groupon deals would suggest. Most of the doctors said that, while the actual units vary patient to patient, they generally use Botox very lightly in their younger patients (those in their twenties and thirties), and never with a heavy hand in general. A doctor might initially use around 10 units in someone's forehead, because younger patients' muscles react very well even at lower doses. That way, your forehead still moves normally, but the muscles are suitably relaxed.
If you're worried about looking unnatural, the doctors all agreed that the most important thing to do is find a licensed dermatologist or plastic surgeon, go for a consultation before you actually go ahead with the procedure, and tell the doctor expressly that for you, less is more. If they still aren't listening at that point, you should leave.
Sanja Miletic photographed by Jamie Nelson.