Botox or Laser- Which is Better?

Question:  My Mom  reads your blog and  has been talking about getting Botox  or the “lunchtime laser.”  I want to get  her a treatment for Christmas but don’t know which one to choose.  I can afford  only one  and I want  her to see the biggest results.

Answer:  What a great question and you’re a great daughter! Both  Botox and  Intense Pulsed Light  laser  ( also known as the lunchtime laser) will make a major  difference in her appearance.  The choice depends on the condition of her skin.  If she has spent many  happy hours in the sun, its likely that she has lots of freckles and dark patches.  An Intense Pulsed Light treatment  will literally vaporize this aging pigmentation and leave her skin younger and refreshed.  The results are permanent but brown spots will return if she goes out without sun protection.  If she was not a beach bunny and  her skin  has   lines along the cheeks, forehead and  and around the eyes, Botox will erase them– for about 3-4 months.   Because lasers leave the skin extra sensitive for a few days,  you can also give her a stocking  filled with a gentle cleanser ( eg Cetaphil), sunscreen ( Neutrogena for Sensitive Skin)  and soothing water spray ( eg Dermalogica UltraCalming Spray).

The Right Tool  at the Right Time

Which anti-aging tool to use  and when to use it  was the fundamental question   behind the No-Nonsense Beauty Blog.   Initially, I planned to start with  Retin A  to reve up the circulation and skin growth, add Botox to reduce lines and polish things up by removing  large freckles and age spots with a laser.  But  as it turned out,  lasers work best on darkest spots, so I started the anti-aging journey  by removing them with a   traditional laser and then continuing with  my  plan. 

But in the past  few years since I started, there have been so  many new options  that  my new plan has become  an exploration  of new forms of Retin A, new lasers and new machines that  deal  both singly and in combination with a slew of aging issues.  At a recent dermatology  conference at Mount Sinai, the experts  came up with an effective anti-aging game plan  that started with   gentle lasers like Intense Pulsed Light  to brighten and Botox to smooth the skin.

I’d love to hear which treatment you chose.  Happy holidays!

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Q & A– Botox No-Shows

Question:  Why doesn’t Botox  work  for  me?  After an injection I see a difference  for a week or two, then I’m back to where I started.

Answer:  Such an appropriate question since  this year is the 10th anniversary of the FDA approval of Botox– the  trade name  for the neurotoxin that is arguably America’s favorite anti-aging tool.  When  properly injected, it relaxes the facial muscles including frown lines on the forehead and crow’s feet around the eyes.  Botox can also make changes to the face that makes  the eyes look wider and raise the eyebrows.

The key word here is “properly”.  The face has 40 different muscles- some move up and some  move downward.  The injector  has to know where to position the shots to get the desired impact.

According to Fifth Avenue cosmetic surgeon Dr Paula Moynahan, there are  several possibilities to  your lack of response. 

1.  The injector  is not hitting the right spots on the face.  Botox needs to be in the area of a specific muscle in order to relax a targeted  wrinkle or lift a sagging spot.

2. If you were been tempted by an offer of a discount Botox treatment, it may have been over diluted.  This could make the injection less effective with little  or short lived results.  The  Botox arrives as a hard film at the bottom of a bottle.  The physician adds liquid to the bottle to reconstitute the neurotoxin.  To save  money, an injector may add  extra  dilutant to make the dose go further.

3.  And then there are the people  who are genuinely resistant to Botox.  FYI Botox is actually a brand name and there  is a second FDA approved Botulism A  product called Dysport.  Dr Moynahan  suggests that people who are resistant to Botox  may have  different results with Dysport.

Keep in mind that as good as it is, Botox cannot reverse all the natural and environmental signs of aging.  It needs to be a part of an anti-aging  game plan that includes Retin A and IPL to clarify the skin’s surface, lasers to erase freckles and facial hair and Zoom tooth whitening trays.  And to preserve all these anti-aging  efforts, never  leave the house without a sunscreen.

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No-Nonsense on the Radio

True story.  I was at  a blogger meetup at the HBA, a huge beauty expo, when I was introduced to a very pretty young woman with  a popular  blog called Aging Backwards.  I was a bit put off. What  would this young woman know about aging?  When she told me her age I was shocked– and impressed.  I decided that  if she could look like that at her age she certainly   knew her stuff. Her blog is now part of the Fashion Flash group and Jackie  also  co-hosts the  The Ageless Sisters, a well-known radio show with Cynthia Rowland –  and this week I was   delighted to be a guest.  The Ageless Sisters  asked such  great  questions that I   uploaded  the full interview to share it with you.  From Invisalign to the new BB creams to the No-Nonsense  beauty diet,  The Ageless Sisters steered   the conversation into  useful  fact-  filled areas. 

  In a short interview  I had to boil down my  beauty philosophy to four key points. Since   I can spend  an hour  discussing the differences between  AHA’s like glycolic acid and Retin A, time limitations made me focus on what is really important.  Compressing  a file of info into  the top four tips is a great way of getting to the most critical facts for  just about any subject.  From buying a car to writing a resume to choosing the name of a baby,  selecting the four  top  ideas is a relevant way  to cope  in a busy world with a short attention span.    Let me know what  you think.

The Ageless Sisters also presented at Beauty Bash last October, demonstrating Facial Magic, their exercise routinue  to firm up the skin.   It was  amazing to see the entire audience  trying out the exercises  that Cynthia and Jackie  were showing on the stage.   I could genuinely feel  the  muscles  under my jaw working to build up contours. And FYI,  without Botox or fillers their skin is smooth, taut and free of lines and wrinkles. 

Click here to hear the Ageless Sisters Radio Extravaganza

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Microdermabrasion or Botox– Which is Better?

Question–  In a few months I’m turning 50.  After half a century, my skin is looking tired and I want to give myself a birthday present.  Which would be better, microdermabrasion or Botox?  You seem to really like both of them.

Answer– Happy birthday!  I do like both  microdermsabrasion and Botox, but  they are very different  anti-aging tools and  deal with different  problems.  Microdermabrasion  takes of the top dead layer  of skin cells to leave the skin smoother, brighter and softer.  In addition, removing these old cells actually stimulates the lower levels to grow.  Researchers have noticed that  mens’ skin seems to age more slowly than women’s– and they believe that part of the reason is the daily  shave which encourages the growth of  fresh new skin every day.

Botox injections at  problem areas  can erase fine lines and wrinkles, especially around the eyes and  forehead.   It can change contours of the face, while microdermabrasion changes the texture and color of the surface of the skin.  The two tools actually work very well together– microdermabrasion  to improve the texture and color of the skin and Botox  to deal with contours that are a half a century old. 

Your question actually gets to the heart of my anti-aging journey–  which tools and techniques  work and how to combine them to get the best possible results.  I decided to start on the dark spots and splotches  from sun damage- first with Retin A and then with microdermabrasion.  When the skin’s surface looked smooth and fresh,  I added Botox to erase the lines at the sides of  my mouth and around my eyes.  You can see these results  on  the No-Nonsense Beauty BLog Facebook Page.  Just click on the Facebook  icon.

Microdermabrasion, as  much as I love the immediate results, lasts only a few days.  For long lasting  results, I suggest starting with a low dose   nightly Retin A  cream.  You should see very nice results within six weeks.  The skin will  look fresher and clearer.  Then  try the Botox to deal with the after effects  fifty years of laughing and talking.  And here’s to  another wonderful fifty years.

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Question: What can I do to look fabulous in less than a week?

Question: I just found out that my old crush is coming to the holiday office party this week. I want to look  amazing.  Would you suggest  IPL or Botox?

Answer:  Both  procedures are very effective, but I would be concerned about doing them right before an important event, especially if its the first time you’ve had them.  Although its called the “lunchtime laser”, IPL can leave red splotches and scabs  that will take a few days to heal.  Botox injections can  hit  a little blood vessels and produce  pretty big bruises.   Rather than doing a full court  press on your face,  If you need to look amazing immediately I would start with  a home microdermabrasion kit  from Clarisonic, DDF, or Neutrogena.  They will polish and refresh your skin and make an incredible difference, especially  if  its not something  you do everyday.    Then  make certain that  you hair is freshly colored, cut and blown  out professionally for the  night of the party. And  I trick I learned  in college,  stop by a cosmetics counter and get a professional makeup.  There’s no charge, but I always  buy a lipstick or shadow since  most stylists work on commission.

If you really want to own the room, make sure  your outfit is new and reflects  current  style trends.  For really great holiday fashion tips check out  Fabulous After 40.

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Its Faux Tox Friday!

Question:  Do  Botox  creams really work?

Answer:  Its sounds  like  a back room  beauty product– Botox in a gel that  you simply  apply  to the skin.  But its really happening.  A true  Botox  topical gel is  deep in clinical trials and results are very encouraging.   The gel is applied to  the skin  by a physician and delievers about 25% of the impact of a Botox injection.  According to Reverance Therapeutics which is developing the gel, more than 200 patients have been treated with it and it  has been shown to be both safe and effective.   It will be approved for treatment of wrinkles around the eyes and offer  a reasonable  option for those of  us who cringe at  injections. I’ve heard that the price  for applications will be  significantly less than true Botox, about $150/treatment. 

However keep in mind  that  you won’t be able to use it at home.  Every application will have to be done in a doctor’s office.  Its still in clinical trials and probably won’t be available for another year.  But its very nice to know its coming.

Currently there are a number of  existing  products that claim to  have Botox-like effects.  They often contain  ingredients  like argireline  which  is supposed to inhibit a unique protein in the cells that sends  signals from nerves to muscles.  At least that’s the way its supposed to work.  Most experts  are not impressed with the results and I am going to wait  for the real thing.

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Its Fashion Flash Monday

This week the host of Fashion Flash is Staness of Menopause Makeover. Menopause is more than  just the end of your period, much more.   This amazing site has the health, diet and fitness info you need to deal with these changes.  This  time of life can radically alter metabolism.  I’ve always had to  count calories and could only stare enviously as my skinny friends ate anything they wanted.  Menopause  now has made us equals. Formerly trim friends  now  have to learn  new ways of eating to  keep their weight down– and Menopause Makeover offers  the tools they need.

And when you’ve explored Menopause Makeovers (  try her Noble Prize worthy  recipe for low carb,high  protein waffles), check out a new beauty book by one of the most respected dermtologists in the world.  Dr Neil Sadick has written 12 text books, contributed more than 70 chapters to medical texts and  is listed year after year in New York’s” Best Doctors”.   His book, “The New Naturals” is a wonderful resouce explaining the newest  anti-aging techniques– and how to combine them for the best results.  In addition to the standard Botox and Laser options, Dr Sadick details  the pros and cons of cutting edge therapies including  stem cell therapy, the vampire lift and Thermage.  Dr Sadick also  believes that herbals  and supplements  have an important role in anti-aging beauty care and he devotes a chapter to explain his recommendations.

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Big Girl Botox

I’ve already dipped my toe into Botox treatments with “baby botox” injections into the marionette lines on the sides of my mouth. I was very happy with the results, but not convinced that Botox could offer me more benefits. After all, my bangs hid any forehead wrinkles and I didn’t see crows feet at the corner of my eyes. But when Dr Marmur gently suggested that the Botox could make my eyes look bigger, I was in. First she had me make angry clenched faces to see where my muscles contracted. Then she pressed an ice bag against different areas of my face and injected selected areas. As before, I LOVED the feeling of relaxation that comes with Botox. In fact, I had been struggling with a headache for the past few days ( I get occasional migraines) and within seconds of the “tox shot” I could feel the pain totally fade away. Nice bonus.

It can take up to a week to see full results of the treatment, but I saw amazing changes within three days. I did not think that I had crows feet at the corners of my eyes, but I was looking in the mirror when my face was at rest. In the pre-shot photo (above), Dr Marmur had me smile and there they were, deep and numerous creases and wrinkles, also known as “crinkles” After Botox– no crinkles. (right)
I especially valued the fact that Dr Marmur did not point out all of my sags and wrinkles, but let me appraoch anti-aging at my own speed.
I also treated had the areas between my eyes and under my chin and will be sharing those results in the next few weeks.

The effects of Botox lasts 3-6 months. Its no surprise that good Botox results depend heavily on your doctor’s skills. Dr Marmur actually teaches physicians how to use Botox and fillers. One of the best ways to find a talented doctor is from recommendations of friends who have had good results. You can also check the credentials of a dermatologist or cosmetic surgeon who is offering anti-aging options. Look at their education ( medical school, post grad training), hospital affiliations and publications.

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Real Time Beauty Questions

Sometimes anti-aging  ingredients and skin care  product descriptions sound like a review sheet  for  a medical board exam.  This week  questions about two  anti-aging ingredients sent  me to Pub Med, the  NIH online medical library for the answers. 

Question 1– What is Idebenone?

This is a synthetic antioxidant that is designed to mimic CoQ10, a naturally  occurring oxidant found in our cells.  (FYI  CoQ10 which is responsible for energy, decreases as  we get older).  Idebenone is an especially powerful antioxidant, perhaps the most powerful antioxidant in our anti-aging arsenal. Antioxidants in general  help prevent aging by dealing with free radicals in the cells.  Our biggest sources of  free radicals are cigarette smoke, alcohol and sunlight.  It certainly makes sense to put antioxidnts into a sunscreen where it can do hand to  hand combat  with the sunlight induced free radicals.  At night  they can play a role in repairing  the skin from its daily exposure   to free radicals.  All good, but antioxidants are  only one piece of the anti-aging skin puzzle.

Idebenone is found in Prevage which is available in two strengths.  Prevage MD is at 1% strength and only available at doctor’s offices.  Elizabeth Arden makes  a .05% Prevage serum available at department stores.   Has anyone had experience with either type of Prevage?  Did you see a difference in your skin?

Question 2– What is Argireline?

This peptide is supposed to mimic benefits of Botox.  Both argireline and Botox interfere with a protein that is  important  for nerve transmision.  But only Botox can directly affect the nerve cells that send signals  from nerves to muscles to contract.  Without this signal,  muscles relax and so do wrinkles.  Argireline does not affect the nerve cells,  and  does not directly affect  nerve cells.  My dream team of dermatologists are not impressed with argireline, citing lack of studies that show it works.  Their conclusion– if you want  a Botox effect on the skin, use Botox.

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Is Fashion Flash Monday!

After a long grey cold winter  all our blogers are  bursting with fashion, health and beauty ideas.  And with pictures of the Royal Wedding ( and those hats) splashed across the media, we can’t help but think of wedding wear.  This week,  the host is Jodell of Black Cat Plus who provides wonderful wedding fashion advice. 

 And after you have explored  the Fashion Flash sites, grab a copy of New Beauty magazine. This thick mgazine is always bursting with new and detailed beauty information.  This month a favorite article looks at celebrities  who overdo  cosmetic procedures.  They include recent photos include Daryl Hannah, Meg Ryan, and Nicolette Sheridan  which show what happens  when  good people  get too much Botox and fillers.  I  have to admit that looking at the distorted appearance of once  beautiful  women  has  made me wary of  fillers and “tox”.  I figured that if these women who had access to the  best beauty services had  such disappointing results, what chance did I have  to avoid these  problems.  Reading what  went wrong and how to correct  these problems gave me renewed courage to get fillers– and a better sense of what to discuss with my dermatologist.

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