Experts Share Their Favorite Injection Memories and Techniques for National Botox Day

Attitude Adjustment

“One of my earliest Botox patients frowned so strongly that she looked like she had mountains between her brows. Botox worked well for her and ‘flattened’ those mountains of frown. After a year of treatments, she announced that she’d gotten a promotion at work because in the words of her supervisor, her ‘attitude had improved’— in fact, she hadn’t changed, but removing her permanent frown signaled a more positive attitude to everyone else!”

—Nanuet, NY dermatologist Heidi Waldorf, MD

Symmetry Savior

“I like to use Botox to treat people who have suffered from facial nerve paralysis, such as Bell’s palsy or Ramsay Hunt syndrome which is what Justin Bieber was diagnosed with. You can actually treat the side of the face that has not been impacted by the nerve injury, and relax those muscles in order to create a symmetrical face. This helps people who are dealing with this condition regain their confidence with how they look and feel, which is a rewarding use of Botox for me.”

—Melville, NY dermatologist Kally Papantoniou, MD

Instant Gratification

“Just yesterday I had a long-term Botox patient return after not seeing her for a year or two due to undergoing treatment for breast cancer. She was so excited to get her Botox treatments started again since they help her feel better and look happier.”

—Fresno, CA dermatologist Kathleen Behr, MD

Easing Into It

“My favorite is doing a micro-Botox approach over multiple visits. I feel like it lasts longer. I prefer a less-is-more approach with Botox because you can certainly put a ton in and and help freeze your patient, but down the line, the skin can get sort of translucent and a little thin and so you don’t want that. So you really want to balance what you do with neurotoxin injections.”

—New York dermatologist Orit Markowitz, MD

Early Adopters

“I just did it on a 19 year old male patient yesterday because he knows what’s coming—prevention is key. He has creases on his forehead and his dad has those same creases which are so deep and he doesn’t want that. We just sprinkle a little all over for it to relax everything and so long term he’s going to have a great outcome because he started so young. I say that for women also, and I do micro-Botox especially on the neck. Some of my patients who have really beautiful necks started Botox in their 30s and just I just sprinkle it all over like a light painting.”

—Baton Rouge, LA dermatologist Ann Zedlitz, MD

Rosacea Reducer

“Botox has a cornucopia of applications, from excess sweating from armpits to face to scalp, to eliminating teeth grinding to reducing rosacea and some types of acne to stopping migraines in their tracks. It’s a close to a universal panacea.”

—Beverly Hills, CA dermatologist Ava Shamban, MD

Clenching Cure

“A common request in my practice is to address TMJ and/or to contour the face by slimming the jaw. Neurotoxins such as Botox can help resolve TMJ pain and curb grinding and clenching of the teeth. I have patients who have broken teeth in the middle of the night from grinding their teeth! Botox can also slim the masseter muscle to create a slimmer appearance in the lower half of the face.”

—Beverly Hills, CA facial plastic surgeon Kimberly J. Lee, MD

Mood Enhancer

“I have had patients who are going through a tough time, whether it is a divorce or loss of a loved one, who make that appointment to do something for themselves. Many times they choose Botox Cosmetic as a pick-me-up. I usually see them back after two weeks for a follow up, especially if it is their first time and it’s amazing to see the transformation. They comment on how they don’t look so angry, their wrinkles have softened and people comment to them that they look rested but don’t know what they have had done. It is also well documented that Botox Cosmetic can improve mood and I see that all the time. Some of it could be a facial feedback mechanism that with Botox we can’t make angry faces when our Botox is in full effect!”

—Rochester, NY dermatologist Lesley Loss, MD

Surgery Scapegoat

“If anyone has had plastic surgery of any kind, people who aren’t in the industry or in the specialty will often say ‘Oh, that person has had a ton of Botox!’ Botox is mistakenly used in general for anyone who has had any obvious or sub-optimal plastic surgery or fillers. When, in reality, it is frequently not Botox at all, but surgery or other modalities—but, Botox gets blamed for everything! “

—Wayne, NJ facial plastic surgeon Jeffrey B. Wise, MD

Self Service

“What I’ve learned from injecting myself is I can watch and see what the effects of certain things are. I remember one time having a patient say ‘I have all these bunny lines and I don’t know why. I never used to have bunny lines.’ Then I had done my own Botox and was driving and facing the sun without sunglasses on. When I looked in the mirror, I noticed I was crinkling my nose because I was trying to squint. The Botox had impaired my ability to squint laterally so I was squinting medially using my nose. That’s when I realized that you can recruit other muscles when you’ve relaxed muscles.”

—New York facial plastic surgeon Lee Ann M. Klausner, MD

Gateway Treatment

“Botox, to me, is what changed all of aesthetics and nonsurgical aesthetics. It’s the gateway drug to all of nonsurgical aesthetics and it has transformed the acceptability of having cosmetic intervention and has allowed people to feel comfortable with doing things. I remember before it was released I had gotten it from my collagen rep and I used it to smooth the ‘number 11’ lines and my partner at the time said, ‘Why didn’t you do your forehead, too? You still look angry.’ It wasn’t long before I got rid of him and got rid of those forehead lines, too.”

—Delray Beach, FL dermatologist Dr. Janet Allenby