Some people shouldn't use botox, such as women who are pregnant or breast-feeding and people with certain kinds of medical problems, including, in Kinney's view, some kinds of musculoskeletal and neurological conditions.
People contemplating the injections should choose their doctor carefully, making sure they are trained and experienced in performing the procedure and are willing to discuss expected results and risks openly.
That said, there is something for patients and doctors alike to smile about: Like its skin-smoothing benefits, botox-related problems are temporary. No need to fear botox-based lawsuits, doctors joke, because by the time the patient gets to an attorney, the side effects have worn off.
Botox as Starter Surgery?
Botox might be a good starter surgery, says Kinney, for those who aren't ready to go under the knife. "Get started, get to know your surgeon, see if you have a similar approach to staying beautiful."
With all of botox's promise for patients whose wrinkles appear when they smile or raise their eyebrows, it's of no use, however, for sun-damaged skin and gravity-grown jowls. For these concerns or facial creases that have been etched permanently over years, some choose to combine botox with facelift, fat injection, laser or chemical peel or eyelid surgery.
Plans for plastic surgery aside, staying beautiful requires an overall healthy lifestyle, Kinney emphasizes, which includes giving up smoking, eating right, exercising and using sunscreen. It may be true what existentialist author Albert Camus wrote in 1957: "After a certain age every man is responsible for his face" — and in the name of taking charge of your own countenance, dermatologist Poitras exhorts the use of botox along with sunblock. But he frowns on the idea of a life sans smiling to shun those dreaded wrinkles — much too depressing a price to pay for a furrow-free brow.