Roughly a week and a half ago, we opened the floodgates: We asked you to ask us all your deepest, darkest questions about Botox with the promise of answers from the one and only Lisa Goodman, doyenne of GoodSkin LA and the injectionist that ITG has pledged sole allegiance to. Today, the answers have arrived. Below, find a primer on getting good Botox, talking to your practitioner, and retraining your muscles to age well. Not everything is answered here, but most of the big stuff is. Anything more minute and you're going to want an in-person consultation. In the meantime, this should suffice. Take it away, Lisa:
Let's get the facts out of the way—how long does Botox last and how often do I need to get it?
"Botox can last anywhere from 3-4 months depending on the patient and the number of units used," Lisa says (with a caveat for men—stronger muscles means less longevity when it comes to fillers, so expect closer to 2-3 months between appointments). If you're looking to do less over time, but still see effects, you're Lisa's perfect client—this is where we get into muscle-retraining. In the beginning, she says, stick to a 3-4 month time frame to give your muscles a chance to change the way they move your face. Then assess your progress and go from there.
What should I know before getting Botox the very first time?
Lisa says it depends on your provider's philosophy, so make sure to do your research and always do a consultation first and get injected later. That said, Lisa adds, "Remember—it’s not a lifelong commitment and [Botox] can prolong your overall anti-aging process. Just because you do it once, doesn’t mean you will be addicted to it or that you must continue to do it for the rest of your life. Also remember that getting Botox for one year, one month, or even one time doesn’t indicate that you will have any negative side effects.
When is it too late for Botox to save a wrinkle?
Easy. "When it is etched into the skin at rest," Lisa explains. So what to do then? "That's when you need to supplement with filler and skin treatments to create collagen to help diminish that line/wrinkle."
Are there side effects if I stop getting Botox?
"No adverse effects at all if you decide Botox isn’t for you."
Is preventative Botox real?
"Depends on what you're trying to prevent," Lisa says. "For example, if you are receiving Botox primarily for wrinkle treatment, then by weakening the muscle and limiting the movement, you will indeed prevent wrinkles from forming." But wrinkles aren't necessarily the tell-tale signs of aging. What you're really looking to do is prevent sagging. Commit this to memory! It'll help you get the "right" Botox. Lisa explains: "If you are 'over-weakening' muscles that hold your face up, then sagging can become worse over time. However, this is not true for muscles that pull down. By weakening muscles that pull down, your face can stay up longer. So, if you are receiving treatment solely for forehead wrinkles, you may inadvertently cause other muscles to compensate. This could cause or increase the rate of brow sagging." So think long and hard (with an unfurrowed brow) about what you want less of—a few forehead wrinkles or drooping face muscles.
When does Botox make more sense than filler, and vice versa?
A complicated question that Lisa handles with ease: "First things first—the cause of aging has to be properly diagnosed [by your practitioner]. By addressing the cause, you are more likely going to get the desired results because you aren’t going for a 'quick fix.' If your concern is due to muscle issues [i.e. movement and development], Botox makes more sense because it treats the muscle. But if your concern is due to bone or volume loss, filler will deliver the desired result. This is why we tell clients not to choose treatments based on what their friend had, or by what they see via advertising."
I have an expressive face—how can I keep looking like myself but still get Botox?
Another chance for Lisa to say skip the quick fix. Getting good Botox is all about doing what's right for your face and how your muscles move. Whoever you're seeing for injections, "it’s also imperative that they evaluate you when you are moving your face, not just when it’s at rest. Discuss this with your practitioner and make sure that over time, they are adjusting the way they are using the Botox to fit your needs." One size does not fit all–it doesn't even fit you, really.
Can Botox fix my necklines from looking down at my phone?
"Yes, but again, it depends on placement of the Botox and the number of units used. Necklines are not only caused by looking down, but also from an overactive platysma muscle. If you treat the platysma muscle with enough Botox in the right area, you retrain your posture, prevent sagging, and also decrease the horizontal necklace lines. Since treating my neck, I have personally seen my necklace lines soften and I can assure you that I still look down at my phone way more than I should." While you're at it, read this on your phone.
Are there Botox benefits I don't even know about?
Sure are! Lisa lists excess sweating, flushing, acne, teeth grinding, jaw clenching, and migraines all as maladies that might be remedied with a little Botox. Of course results may vary depending on what you're suffering from. But it really is magic what a little bit of modified poison can do, huh?
Photographed by Tom Newton.
Not into needles? Try the non-surgical route.
