The Guide To Getting Good Botox

Sanja Miletic photographed by Jamie Nelson

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.

—Lacey Gattis

Sanja Miletic photographed by Jamie Nelson.

Let’s Talk About It! JOIN IN
  • therealblonde

    I'm on blood thinners and my botox doc doesn't want me to stop taking them (he says there's a good reason why I'm on them, so why risk it) - but I've never had a bruise after a treatment.

  • April

    So far I've missed the memo on getting Botox in your 20s...is this for real?

    • Robin Sparkles

      It seems crazy but it's pretty much very small amounts for preventative purposes. Like he said, younger people's facial muscles react better so it's more of like a "hey, chill" to the wrinkle causing muscles than a freeze. There was a study a few years ago where they took a set of twins and began injecting one in her early twenties with small amounts, and then waited with the other to start until her thirties and the difference was incredible. The one who had been getting the small injections looked so much younger and not in a creepy over botoxed age, just very fresh and natural. It's pretty interesting.

    • Franquie

      At our office, we call it "baby Botox". Botox treats dynamic wrinkles. The theory is that if you paralyze the muscle that causes the expression and stop the crease from ever forming, you'll never have a wrinkle there. Both my parents have forehead lines & like them, I have a very expressive upper face so I knew I was cursed. I started Botox at 25 and 7 years later there aren't even faint creases. I've also always been sun adverse & used retin-a since I was 15.

      As I tell my patients, it's much easier to change the oil in your car than to replace the engine.

    • baby face

      There is nothing wrong with that. I mean there is no need to do your entire face, but if you are starting to have deep lines forming, it's better to minimize them now that later. I have a deep crease between my eye brows that appears when I have a migraine or in general pain and just makes me look pissed off and angry.

  • Caro

    I'm a big proponent of less is more. I'm early 30s and got it three times to relax the muscles between my eyebrows juuuuust enough so that at rest, the lines were gone and bitchface was minimized, but I could still make expressions. Sadly I found the injections hurt more each round, though, from "that was nothing" the first time to "owwww what the -" the third. I hear that does happen for many people.

  • http://thecoveted.com/ Jennine Jacob

    I concur about the using less than you need. I had deep 11's in my early 30's and got 18 units twice a year (they suggest every 3 months, but I never felt I needed that much) Because I was pregnant and now nursing, I haven't done it in two years. My 11's are coming back but not as deep as they were when I first started seven years ago.

    Also, to stretch out the time between visits, I'd use Frownies which help... some say they work without botox, but I've never found that to be all that true.

    • Adrienne Angelos

      Maybe having this question means I need to do more botox research, but did you 11's disappear right when you got the injections or was it a gradual decrease? I'm mid-20's and I can tell that 11 lines are going to be my main wrinkle concern as I age, and botox definitely sounds more appealing if you're saying that yours are smoother than they were when you were pre-botox.

  • Kat

    What is the optimum dosage (in cc's) for forehead wrinkles, as well as the dosage for the furrow between the brows if you are @40?

  • lis

    Can botox help with oily skin....the same way botox paralyzes overactive sweat glands.

  • Elizabeth Walker

    Damnit do I really need to get some now? I'm 25. The idea of finding someone that is actually good at injecting Botox in a minimal way is #stressful.

  • http://www.lipglossandabackpack.com/ LGandaB

    I'm going to Peru this summer and I've heard that Lima is a really popular place for Botox. I probably won't have the guts to go through with it, but I think it would be kind of hilarious to be able to answer the question, "What did you do on your trip to Peru?" with "Oh, I just got some Botox..." I've got one forehead wrinkle that isn't horrible, but I'd rather it not get any more noticeable...

  • Alyssa Furnell

    Excellent read! Glad I’ve stumbled upon this post. Actually, I have been on the lookout for the best face enhancement procedures available in the market.The crow’s feet around my eyes are just extremely annoying to look at and I’m desperately looking for the best solution right now. Upon looking, I’ve also found http://goo.gl/ZyzHOXI, another great source of information similar to this post. Thanks for this!

  • EE

    I am 28 and started doing minimum units three years ago. I see a fantastic specialist Marissa Abdo in Santa Monica, California. The best advice I can give is to do your research, find the best injector that fits your needs, and do not go with the cheaper deal (you may end up spending more to have it fixed by another doctor or nurse). Several of my girlfriends (and even some guy friends) are now on board! Just a couple times a year will keep you looking refreshed, especially for those who are extremely expressive.

REPLIES

Dearest ITG Reader,

We're working on something new that's launching this fall and we want you to be the first to know.

xo, Emily