Botox addiction: the Brow lift is your Botox detox!

A collage of photos of a patient before and after a Brow lift
Botox Detox: The Brow lift procedure

Standing in the grocery line I usually look at the scandal rags, searching for Plastic Surgery articles. They usually focus on some surgical disaster such as overblown lips, saggy skin after lipo, excessive skin stretching, etc. Anyways, this week, one of these  magazines featured the Housewives of Orange Country and their Botox addictions. Tamra, the 44 year old O.C. Housewife who has a 23 year old son and 3 other small children has been doing Botox injections consistently for 3 years. So have many actors and actresses.

Perhaps the most notorious Botox addict must be Nicole Kidman, whose forehead is as smooth and glassy as a porcelain doll. She has been criticized for wooden acting, but don’t blame her – It’s the Botox!

As a matter of fact, a patient of mine who is a character actor told me that the problem of the inexpressive over-botoxed face is worse in Television, where close-ups are more common. Apparently, a face with expression is hard to find these days. My sources tell me that it gotta be so bad that casting directors were casting in England looking for actors who could actually show emotions in their face. You see, in England they are not addicted to Botox.

Forehead, frown and crow’s feet wrinkles are caused by muscles of facial expression. Repeated use of these muscles creates a fold in the skin. Botox works by temporarily weakening these muscles of facial expression. Botox can get rid of these wrinkles, but will also affect facial expressions. Botox does look great in pictures, but the minute the person starts talking, you notice something is off. At parties, somebody is always asking me “did so and so have Botox?” They are usually right…

In my own Plastic Surgery practice, Botox is a quick and easy fix. Injected properly, Botox does smooth out wrinkles to create a more youthful appearance. However, after you start using Botox a lot, it loses its advantages. The first is that your face becomes inexpressive. The second is the cost. If you have been doing Botox for 3 years, you could have paid for a minimally invasive procedure that gets rid of the forehead wrinkles, frown lines, and crow’s feet , but does not weaken our muscles of facial expression. With this minimally invasive procedure, people can actually tell whether you are happy, sad, angry, or just chilling out.

So what is the cure for those that are botox addicted? Is there a Botox Detox, where you never have to do Botox again?

Yes! The Botox Detox procedure is the endoscopic brow lift. The brow lift not only permanently smooths the forehead wrinkles, but you get the added advantage that your upper eyelids become lifted to yield a long lasting, youthful, and refreshed appearance.

The modern day brow lift or forehead lift is a two hour procedure done through small incisions behind the hairline. An endoscope is used to lift the brow to a more youthful position. The procedure can be done under IV or twilight anesthesia in an outpatient surgical facility. Recovery is very quick- within one week you should be back at work. During the postoperative week, you will have minor bruising which can be covered with makeup.

Up until the mid 1990’s, the traditional brow lift procedure involved long incisions across your hairline in order to lift the brow. The use of the endoscope in the brow lift procedure changed all of that. The modern day endoscopic brow lift avoids the pitfalls of traditional browlift, (your mother’s brow lift) because it works by dividing the muscles that bring down the brow from those that elevate it, not by stretching the skin or elevating the hairline. Furthermore,  the brow lift allows you to maintain natural expressions.

With the endoscopic brow lift (forehead lift) there are no long scars, no hair loss, no abnormal sensations in the scalp. The result is a very natural repositioning of the brow to a level set by the brow elevator muscles. You get a refreshed, youthful appearance with a slight lifting of the upper eyelids.

In contrast to those physicians whose patients have a pattern of returning office visits, I think more like a surgeon. I like to do a procedure that delivers a long lasting result to the patient. If Tamra had had an endoscopic brow lift 3 years ago, she wouldn’t need to keep paying for Botox. Her brow would show some life-like expression instead of a smooth mask where only the mouth moves. But perhaps that is the Hollywood way, where looking “done” and spending money is a career move.

For Botox Detox, the smart money goes for the Brow Lift. The wrinkles are gone, but not the expressions that let others know how your heart feels.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L Rodriguez on American Society of Plastic Surgeons

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