The Guys Guide to Botox
We’ve got a rundown on Botox, because there comes a time in every no-longer-young man’s life where he studies his reflection and thinks “have those forehead lines always been so creased?”
Of course, many men couldn’t care less—bless them. If thats you, feel free to just smash this tab closed. Nobody needs to undergo any sort of cosmetic procedure.
The rest of us care quite a bit. Perhaps that’s because we’re all aware of the remedy, which has been in plain sight for two decades now: Botox.
These injections can prevent these lines from showing and from impressing themselves deeper into your resting face. And before you write it off with some joke about “not being able to emote”—well, sure, it does restrict muscle movements, but it’s not like you gotta plug up your entire face. Start with the brow, if that’s what really bothers you, or the crow’s feet at the corners of your eyes. It’s all up to you. And the best part is, that the pros have gotten damn good at this.
But before you get Botox, it’s worth knowing more about it. So, we tossed some of the most common Botox questions to NYC-based cosmetic dermatologist Dr. Michele Green.
The word “Botox” is a portmanteau: it’s a neurotoxin produced by the bacteria Clostridium botulinum. And yes, that bacteria is a type of botulism—like the bug people can get from homemade canned foods. But don’t let that concern you: It’s completely safe to inject, says Green, assuming that a board-certified dermatologist like her is driving.
“Although Botox is a neurotoxin, it is safe for injection because it is injected in very small quantities directly into muscle, where it acts as a neuromodulator to paralyze overactivity,” she says. It was approved 20 years ago by the FDA, and remains a staple in cosmetic procedures.
Once injected into the face, Botox blocks the neurotransmitters that contract muscles associated with various facial expressions (specifically, the release of acetylcholine from nerve cells to muscles). In doing so, it “freezes” the area to prevent the formation or proliferation of wrinkles.
It’s not permanent. Your body will steadily metabolize the Botox, and muscular function will return. You should count on Botox “lasting” for 3-4 months, says Green, though this varies.
“Some patients who have gotten frequent Botox injections have noticed the effects lasting longer between sessions and this is because the muscle shrinks due to disuse.” That being said, some people who get constant, repeated Botox might notice that its effects lessen with time, due to the body recognizing and metabolizing it much faster, having developed antibodies against it. “If you are noticing that your Botox is not lasting as long as it should, or it is not as effective as it was in the past, speak with your dermatologist about potentially switching to another neuromodulator, such as Dysport or Xeomin.”
Green adds that your wrinkles may take a little while to reappear even after the Botox wears off, since they haven’t been forming the wrinkles for a few months and need some time to fall back into their old ways. For this reason, many people perceive their Botox as lasting weeks longer.
Botox is used in many ways besides preventing “photo aging” in the face, says Green. “Other uses include blepharospasm (uncontrolled blinking), strabismus (lazy eye), hyperhidrosis (excessive sweating), migraines, and bruxism (teeth grinding), among others in a similar fashion by blocking the release of acetylcholine.” Specifically, when it comes to hyperhidrosis (excessive sweating), Botox blocks the nerves that stimulate your sweat glands.
Green’s male patients most commonly receive Botox on the glabella (between the eyebrows), forehead, masseter (common to cure teeth grinding and build jaw definition), crow’s feet (around the eyes), and chin (to smooth inconsistencies or build definition).
Botox is approved for people 18 and older, but that doesn’t mean you should be getting it at that age. Green tells her patients to wait until their mid-to-late 20s and early 30s before getting Botox. “It is often unnecessary to inject someone under 25 for cosmetic reasons unless they have strong wrinkles that are negatively affecting their self-esteem or if they have a medical condition that Botox can treat, such as teeth grinding or migraines,” she says.
Botox will have little to no benefit at such a young age, since your wrinkles are often not set in. Besides, collagen production only starts declining around 25 years of age, so your skin should be fairly resilient until that point. People who should also avoid Botox are anyone pregnant or expecting, as well as those with neuromuscular disorders, or at heightened risk of keloid scarring.
Botox is quick. You don’t even need any anesthesia, and a trained doctor will only need a few minutes to inject and set the Botox.
Dr. Green notes that prices for Botox vary vastly, for many reasons. “The price of Botox will depend on several factors: geographic location, the experience of the injector, placement, and volume. The more experience an injector has (and the higher the cost of living in the neighborhood you are getting injected in) will increase the price of Botox. Some clinics charge Botox injections per unit while other offices charge Botox per area. Larger areas like the armpit will require more Botox than your forehead and therefore, will be more expensive.”
To play it smart and safe, set your baseline expectations around a couple hundred dollars, minimum. Anything below that may indicate you’re cutting corners on experience and reliability. And you’ll have to wait 4 months or more for your face to return to normal, regretting the coupon clipping of it all for all those minutes between. Seriously, don’t skimp!
Botox may be the first and most popular neurotoxin approved to reduce wrinkles, but it isn’t the last. As mentioned, some people develop resistance or tolerance to Botox with repeated use, in which case they can opt for alternate uses of the botulinum toxin—most notably Xeomin or Dysport.
“Xeomin offers all the same cosmetic benefits as Botox in terms of smoothing out any fine lines on the forehead, around the eyes, and between the eyebrows and is comparable to Botox in terms of both onset and duration,” says Green. “It can even be a better alternative at times since it is the pure form of the botulinum toxin and is less likely to cause allergic reactions.” On the other hands, “Dysport is much more dilute and spreads quickly compared to Botox, which makes it ideal for larger surface areas like the forehead.”
Fillers are not the same thing as Botox, although both are used to reduce the appearance of wrinkles. “Botox functions by paralyzing the underlying muscles to prevent wrinkles, while dermal fillers, which are often made of hyaluronic acid, fill in wrinkles and give volume to the face,” Green explains. So, if someone suddenly has plumper lips or cheeks than the day before, it’s possibly because they got fillers. A flat, porcelain forehead? That’s Botox.
Fillers often last longer than Botox and their results can last from at least six months to 18 months. They can be used together to restore a youthful appearance.
In the week or two prior to your Botox, avoid taking any anti-inflammatory drugs (like aspirin), as well as any multivitamins and foods rich in antioxidants (including red wine.) All of these things can inhibit blood clotting, and while they’re ultimately good for the body, you don’t want to increase the chances of bruising from the procedure. It’s smart to ask for a clear list of dos and don’ts prior to your specific treatment, because your dermatologist will be able to tailor the list to your unique situation.
After injection, you need to stay upright for at least four hours. “Bending and laying down can cause the toxin to migrate and can also increase your risk of bruising at the injection site,” Green explains. “If you easily bruise, it is recommended that you take arnica pills three to four days before your treatment to reduce bruising, minimize swelling, and stimulate your body’s natural healing process.”
Avoid exercise, excess sweating, and any makeup use on the same day as the injection. Use a gentle cleanser to wash your face that same day, and hold off on using any products that have active ingredients like retinol. Lastly, do not massage or apply any pressure to the injection site for the first 72 hours.
In a recent video on his YouTube channel, doctor-turned-startup founder Ali Abdaal shares everything he has learned as an…