Toxin for that better look

Let's face it. We all know of someone who's better-looking than we are and whom we suspect "got the job" or the promotion because of their looks. Countless surveys have been done to show that good-looking people go farther in life and get more handouts.

Recently, a Labour Day survey in Singapore showed that the majority of respondents - 500 men and women aged between 30-60 years were surveyed - believed that good looks gave an advantage in work.

And which body part counted the most? It seemed that respondents ranked "the whole face" and "eyes" as most important when it comes to good looks, and would consider treatment of the eyes if they had to or could do something about it. The survey was carried out by Allergan, the purveyor of Botox.

But it is a fact that the eyes are the central and the most expressive feature of the face. Ageing around the eyes starts as early as the 20s, when fine lines start to develop between the eyebrows (frown lines) and around the outer corner of the eyes (crow's feet).

These faint lines continue to deepen in the 30s and beyond, which can give a person a tired, worried or angry appearance. All of which can be minimised with Botox. No wonder then that Botox has been gaining so much ground in the last two decades as the go-to toxin for controlling one's appearance.

"By now, the acceptance level for Botox is very high - as, according to a local survey, a lot of people feel that to advance in work they need to look good; and one way to do that is with Botox and fillers. Perception has changed over the years. It's no longer taboo," says David Loh, vice-president of the Society of Aesthetic Medicine in Singapore.

Originally, Botox was used to limit uncontrolled blinking and misaligned eyes but once its age-defying cosmetic effect was discovered, that's what has made its reputation and Allergan's profits.

Regardless of its wide acceptance and popularity today, however, aesthetic doctors note that there are still "myths" and misconceptions about it.

Here are some common questions:

Can one get addicted to Botox?

Dr Loh points out that you can't biologically get addicted, but it's certainly easy to get used to looking younger. "The reality is that results are so good that people find it hard to wean themselves off Botox," says Dr Loh.

Will my face look frozen?

The "natural" look is in, versus the "frozen" look, notes Dr Loh. And since trained aesthetic doctors have been using Botox for more than a decade, skills have also improved. The most useful place to be Botox-ed is the area between the eyebrows.

"Once you ease it out a person will look less annoyed, upset, and unfriendly," says Dr Loh. The lines between the forehead occur because of strong muscle and loss of skin elasticity. "So muscles aren't necessarily at rest when you are, and the basal muscle tone is enough to crease the skin."

Botox can selectively relax the muscles between the eyebrows, and it does it quite accurately, explains Dr Loh.

How does the frozen look come about, then? "It's actually quite hard to achieve as you need a lot of Botox. Naturally, it's been exaggerated by certain personalities or caricatured in media, but really it's not so easy to achieve the frozen forehead look," he notes. In the end, it's still the experienced physician who will best be able to determine your look, he adds.

Today, it's a trend to keep some of the crow's feet at the eyes as well, as those in their 40s think they'll look "fake" without the crow's feet.

This is entirely technique and dosage dependent, points out Sylvia Ramirez of Cutis Medical Laser Clinic. "This can be avoided with the use of lower doses of Botox especially if you are new to the treatment. The key to a good Botox treatment is 'no one should know'. A good Botox treatment should result in a 'refreshed' or 'relaxed' look," she adds.

Can't creams do the job?

Dr Ramirez says that topical creams can "appear" to reduce the lines by temporarily "filling" in the wrinkles but these will never be as effective as Botox which reduces the formation of the expression lines by reducing muscle contraction. "Patients are often surprised that a Botox treatment can actually be less expensive than some of the topical creams in the market."

Will my face drop or become worse if I stop using Botox?

Dr Ramirez explains that if done properly, Botox has preventive effects. "If a person does regular Botox treatments for some time, the muscles are retrained from disuse and, for a time, that individual will notice reversal of many of the lines such as those that give a person a "negative" impression ('Angry 11's' or frown lines)."

What are some common Botox botch-ups you've seen or had to correct?

Dr Ramirez advises anyone new to Botox to ask the doctor to start with low doses, and most importantly, doctors with a long track record of injecting Botox would consistently provide great results even with small amounts of Botox.

But in her experience, the most common result that needs correction or "touch up" is the "Spock" or "Mephisto" look where there is exaggerated peaking of the eyebrows due to inadequate treatment in the lateral aspect of the forehead. "This is readily corrected with the addition of a very low dose of Botox to correct the sharp peaking of the eyebrow."

A true complication may occur when improper injection of Botox results in a droopy eyelid, explains Dr Ramirez. "Which is why it's important to go to an experienced Botox injector."

uihoon@sph.com.sg

This article was first published on June 21, 2014.
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