Minor Renovations

I can’t scowl anymore. I try all the time, but my forehead just doesn’t respond. I’m starting to feel like a pushover – I can’t muster disapproving or angry looks and no one has told me that I look "fierce" for a while. And it’s all because of Botox.

At the age of 37, I’m blessed with good skin. Most people tell me I don’t need any "work" done, so why would I willingly go to a plastic surgeon and submit myself to him sliding fine gauge needles into my face? Simple. I want to be 23 again. I want to be a young stud with his whole life ahead of him, not some sad guy who’s staring at his fortieth birthday party.

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And so I find myself sitting on Dr. Kwek’s examining table. A Botox man himself, Dr Kwek unabashedly admits that he’s tried it and instills confidence in his patients with "I’m-living-proof-that-it-works" logic. Sure enough, he has only few wrinkles that are properly placed to accentuate his good looks. And I decide right then that that’s what I want – wrinkles that look good.

Before he brings out the needle, the doc takes a "before" photo of me scowling. Had I known this was my last scowl for months, I would have given it my all.

Botox stings when it goes in. It feels like the time I got stung on my back by   a huge black wasp – a combination of pinching, burning and stinging. As Dr. Kwek’s confident, glove-wrapped hands pinched off parts of my forehead, and as the needle made its way into my face, all I could think was, ‘When is this going to stop? He’s sticking that frigging needle into my skull! They said it would hurt like ant bites! Shit, they meant big-ass ants!’

Only a few mercifully short moments and it was over. "Don’t play with it, and keep the area clean for a day or so," the doc instructs. Other than that, I’m off the hook. There shouldn’t be any side effects and I can go about my usual activities. In other words, I can go have a stiff drink to celebrate my bravery.

I’m not sure yet which impulse is stronger: the fear of painful, rather pricey shots in my face, or my very primal need to remain handsome to young, hot nubile babes. But we’re veering into very philosophical questions about my vanity and virility and that’s another story altogether. All I can say now is never underestimate the power of the male mid-life crisis.

Ah, Botox to that! Right now I look good.

botox factIt’s being touted as the fountain of youth in a syringe.

For about $600 to $1,500, anyone can temporarily hide those laugh lines, frown crinkles and crow’s feet that burden most human faces past the age of 35.

The miracle comes in a small, sterile glass vile that contains a scant amount of white Botulinum Toxin Type A powder, better known under its brand name, Botox. When mixed with a few units of saline solution, it is the hottest craze in plastic surgery.

The side effects are few and bad syringe operators cause the most problems. Think about it this way: The face has 27 closely packed muscle groups in the forehead, around the eyes and in the cheeks. One wrong shot and you could have a very frozen or droopy expression for weeks or months.

"Botox is a neurotoxin, a protein, that relaxes or freezes the muscles where it is injected," said Dr. Leslie B K Kwek of Dr. Kwek Plastic Surgery. "In my professional experience, the only risks are in the hands of the doctors. If you visit a doctor with little experience, you can freeze the wrong muscle groups. Then you have a problem. Thankfully it’s temporary."

Suffice to say, Botox is anything but a permanent solution to age lines. The effects last anywhere between four to six months per treatment and as the body slowly metabolizes the Botox, the wrinkles begin to reappear. Then it’s time to return to your friendly surgeon for more of the viscous miracle liquid.

botox bottle"I generally don’t use Botox anywhere below the eyes lids. If you do, you risk freezing the wrong muscle groups and you can run into problems," adds Dr. Kwek.

Botox has been a windfall to doctors, mostly plastic surgeons and dermatologists who perform the procedure. One tiny vile of Botox from Allergan costs only about $600 and can be used on several patients. At an average cost of $1,000 per patient, each vile nets a tidy profit. And if a patient gets hooked on a wrinkle-free face, that means he or she can spend up to $3,000 per year on Botox alone.

However expensive that may sound, it’s a lot less expensive than traditional plastic surgery. A facelift can exceed $15,000 and involves having the skin on your forehead literally cut from the skull, lifted up, trimmed, and replaced. It takes weeks to recover from and, from what former patients have told me, is extremely painful. Even the most masterful surgeon will state that there is no guarantee a facelift will last. If you need an example of this, look at the very frightening, almost corpse-like Michael Jackson in his latest music video.

Produced by Allergan, Botox is a derivation of the bacterium Clostridium Botulinum, also known as Botulinum Toxin A. Numerous medical studies have shown that the simple neurotoxin is easily absorbed by the body and has few side effects. For more than a decade now, it has been used to treat other ailments like crossed eyes and migraines.

The actual procedure is brief. The doctor loads up anywhere between 10 to 20 units into a syringe with a fine gauge needle and carefully injects it into the areas of the face that have the most wrinkles or bags. It takes about four days for Botox to take effect. Once it does, most patients notice a gradual easing of wrinkles, as well as an inability to create the expressions that caused the wrinkles in the first place.

The most common complaint from Botox patients is that it can hurt like hell when it’s being injected. The injections are done directly into the face, an area of the body known for dozens of fine muscle groups, nerve endings and thin skin. However, it hurts a lot less than plastic surgery and if you miss your old wrinkles they’ll return in just a few short months.

This article originally appeared in Twenty4Seven