We let expectations play a huge role in our happiness and satisfaction. If you go out to eat and order a cheeseburger, you expect a cheeseburger to arrive at your table. When the waitress brings you a cheese pizza you’re not happy. Why? You like cheese pizza, cheese pizza would curb your hunger. Why aren’t you happy about getting a cheese pizza? Because you expected to receive a cheeseburger. Even if the cheeseburgers at the restaurant aren’t quite as tasty as the cheese pizza you would still be more satisfied with the cheeseburger because its what you expected to eat for dinner. The same holds true with Botox (or any neuromodulator, I inject Botox, Xeomin and Dysport brands). If you expect your lines (no, we don’t say wrinkles) at rest to be erased with Botox then you’re not going to be satisfied after your money is spent on an injection. On the other hand, if you know what you’re paying for and that’s what you received it could be the best money you’ve spent all month. So here’s an effort to tell you what to expect from Botox so you can really enjoy all of its potential benefits. You can treat multiple conditions with Botox; migraines, twitches, hyperhidrosis, the list goes on and on but for the purpose of this post we are going to talk about what it’s famous for in dermatology-lines in motion.

Lines in motion versus lines at rest. It’s important to understand the difference between “lines in motion” and “lines at rest”.  If you stare into the mirror without expression and see “11” lines between your eyebrows (a region we call the glabella) these are lines at rest. Now, say you don’t see those lines but then you scowl or make a mean looking face and these “11” lines appear, those are lines in motion. Botox prevents your muscles from being able to make your mean face which is the motion that makes lines at rest.  Over time, if you keep up with your botox then you will see lines at rest soften. Soften, not disappear.  Expect lines at rest to stick around.  Expect lines in motion to disappear.  So remember, without botox lines in motion become lines at rest.  This is why we call botox health maintenance, preventative.

Botox lasts three to six months. In our clinic we usually say pray for six months but expect three months.  For some it could be more than six months and for others it could be less than three months.  Don’t expect one injection to be all you need in a lifetime.  That’s like going to the gym once and thinking thats all your body needs.  Sure it helps, I mean it’s better than never going to the gym, but we all know that one workout will not make you in good shape either.  Expect multiple treatments.

Botox  won’t freeze all expression. Don’t expect to get Botox and be completely expressionless.  While trying to talk my husband into some “bro-tox” he told me he was reluctant (in slightly different vocabulary) because he didn’t want to walk out into the sun and not be able to squint.  He feared he would walk outside and have to say “ouch my eyes, its so bright out here” and just look silly.  No this won’t happen.  Botox won’t unnaturally freeze you when used properly.

Botox has complications. Ask your injector for the full list of complications and make sure your injector has the resources to deal with complications.  When you choose a skilled healthcare provider complications risks are lower.  The most common problem is bruising. Some people never have had a bruise after botox while others get slight bruising every time they are injected.  Don’t plan to get Botox on your wedding day, expect a bruise.  What a pleasant surprise when you don’t have any bruising.

Botox can start working in 1-3 days but isn’t in full effect for two weeks.  Some people notice one area kicking in quicker.  It is what it is at two weeks.  Thats when to see your injector again if you’re not satisfied.  Another reason not to come in on your wedding day, expect two weeks for full effect.

Interested in Botox?  Have more questions?  Come see us at Johnson Dermatology!  I love doing cosmetic consultations.

Here are my before and after Botox pics:

Crow’s feet before…..

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It’s time to reflect on 2013 and be resolute in 2014. While pondering what I wanted my first blog post EVER to be, I tried to think of one thing I wanted my patients to do for their skin this year; quite honestly, what I wanted to do better for my skin this year. Well, I couldn’t think of just one so I’m going to suggest twelve. That’s right, I’m an over achiever and I expect the same from others. So this year, instead of doing one good thing for your skin, do one good thing each month. And here they are, in no particular order, the twelve months of Skin Resolutions.

1. Wear sunscreen. Its the most obvious so I had to make it first and get it out of the way. And for those of you that feel invincible to skin cancer, it has cosmetic benefits too! If I had a dollar for every time I’ve heard “no one ever told me about sunscreen back in my day”, well I’d be relaxing on a beach (in the shade) right now drinking a cool drink with an umbrella in it instead of working. So, here’s someone telling you right now please wear your sunscreen in 2014.

2. Number one isn’t enough sun protection. You need to avoid sun exposure during the sunniest times of the day and wear your sun protective clothing while outside. I’m a lake girl so I know it isn’t easy but in 2014, I can do better and so can you!

3. Unless you are pregnant, trying to become pregnant, or breastfeeding you should be using a retinol at night. They shrink your pores, even skin tone, prevent acne, prevent fine lines and much more. You need instruction on which one is right for you and how to use it or you might fail to reap its full benefits so check with your dermatologist.

4. Stop with the scrubbing and harsh exfoliators. Yes, its true those little beads are bad for your skin, contrary to some popular beliefs. So in 2014, don’t irritate and inflame your pores with scrubs and exfoliators, please!

5. Throw away your magnifying mirror. Sorry ladies, it’s not good for your skin’s self esteem. I mean if you need that thing to see a tiny imperfection does it really matter anyway?

6. Get a full body exam this year by a dermatologist. Your skin is the largest organ in your body so get it checked out this year. It’s only fair that if you get your blood pressure checked, you should also get your skin checked.

7. Start moisturizing your skin as soon as you finish showering. With what you ask? Good ole petroleum jelly.  It’s not as greasy as you expect after your skin sucks up all that moisture. Smooth like butter, aaahhhh.

8. Promise to never even look at a tanning bed again. The skin Gods say that every time you lay in a tanning bed you increase your risk of melanoma by 20%.  Actually it’s the Skin Cancer Foundation that said it so you should listen to them, even if you don’t listen to me.

9. Don’t pick, pop or squeeze a single pimple this year. If you do, it will stay around much longer and scar your pretty skin. Resist temptation this year, you can do it!  And, if you have a hot date, then go see your dermatologist and they will try to help you out in a less destructive way.

10. Listen to your dermatologist before deciding on which products to spend your money. Sorry to say, the high school girl working the make-up counter this summer may not be advising you on what we call evidence-based practice. Evidence-based practice means we advise you on what the research shows works.  We aren’t simply trying to sell you something.

11. Love your skin this year. Look at yourself in the mirror and say “My skin is beautiful” and believe those words. Don’t be so hard on yourself.  This year, don’t judge yourself, especially not your skin.

12. Watch your moles closer this year. Take a picture of your moles every three months. Compare the pictures to each other and see if you have any moles that are changing in size, shape or color. If you have a changing mole in 2014 it needs to be evaluated by a dermatologist.

Hope everyone has a skintastic next 12 months! Happy New Year!

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