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The new rules for injectables
I’m sitting in a treatment room at Toronto’s Glow Medi Spa holding a stress ball. Dr. Diane Wong, a cosmetic physician, has given me this squishy distraction because she’s about to administer my first Botox injection. A lot of people, she explains kindly, tend to get nervous around needles. TBH, I’m more worried about the side eye from my friends and loved ones. When I overshared that I wanted to soften the lines on my face, people looked at me like I was personally responsible for the melting of the polar ice caps. That’s because I’m only 32, which apparently is the new 16 or something.
My skin doesn’t feel 16, though. The rude fluorescent lights in my condo elevator first alerted me to the cross-stitch pattern under my eyes a few years ago. Then I discovered that the lines on my forehead no longer pulled a vanishing act after eight hours of sleep. So this summer, I finally worked up the nerve to book my Botox.
Wong says that I’m right on time. Today, most of her clients seeking their first Botox or filler treatment are about 30. “They’re starting to realize that it’s much easier to prevent wrinkles than treat them once they are there,” she says. “Once the skin actually creases [deeply], it’s much harder to reverse the lines.” I know what you’re thinking: Of course a Botox doctor thinks this – like how your MIL actually believes your husband is as smart as Steve Jobs and as handsome as Tom Hardy. But, it turns out, she’s onto something. A dermatologist friend refers to this approach as “baby Botox.” The premise? Injecting Botox, or its siblings Dysport and Xeomin – neuromodulators that block the nerves that move our facial muscles, essentially relaxing them – prevents the skin from folding into previously inevitable wrinkles.
The Canadian Society of Plastic Surgeons doesn’t track stats on plastic surgery or injectables, but south of the border, Botox (and its ilk) was the number one non-surgical cosmetic procedure in 2015, according to the American Society of Plastic Surgeons. There were over 6.7 million injections. The use of fillers is climbing much faster – by 8 percent last year. The most popular fillers are Juvéderm and Restylane, injections of gel-like hyaluronic acid that plump and lift sunken areas like the cheeks and the folds between the nose and mouth. “We now know that part of anti-aging is not just tightening the skin; it’s about replacing volume,” says Dr. Jessica Wu, a dermatologist based in Los Angeles. Both Botox and fillers are now also being used to sculpt the face as an alternative to expensive plastic surgery. (Fillers start at around $600 and last about a year; Botox starts at around $350 and lasts three to four months.) Consider the “Barbie lift,” pioneered by Dr. Barb Loiskandl of Laser Health Works Laser + Cosmetic Services in Barrie, Ont. She injects filler five centimetres into the hairline across the top of the scalp for an instant tightening effect. “These little boluses of product tent the tissue back up and give it a lift,” she says.
Techniques like Loiskandl’s are technically “off-label,” which means that Health Canada hasn’t approved the injectable for that specific part of the body. This sounds ominous, but Botox and fillers have been tested for years and assessed in peer-reviewed journals around the world, and that includes these off-label uses. For example, doctors are now using fillers to tighten loose skin along the jawline, plump veiny hands and even correct an asymmetrical nose. Botox can reduce turkey neck and narrow the face when injected into the jaw muscles. A doctor recommended the latter procedure to me, and I wasn’t even offended. I get the draw of having a mug that’s more ScarJo than Mr. Strong – and I know I’m not alone. We want Angelina’s lips or Kerry Washington’s jaw and collectively are willing to spend billions (seriously) to get them.
Social media may be partly to blame; its negative impact on self-esteem is well documented. And in a 2013 poll, the American Academy of Facial Plastic and Reconstructive Surgery found there was a 31-percent increase in requests for plastic surgery based on how a person would appear online. Wu has seen this shift first-hand. “[More and more], younger women are coming to my office to show me wrinkles and crow’s feet,” she says. “I assume this is due to the popularity of selfies and Instagram, where you see lines you ordinarily would not [notice] in the mirror.”
Still, you don’t want to start too young: Injectables can have the opposite effect if you do, creating an ageless – but not necessarily youthful – appearance. “At a certain age, eliminating expression can make you look older,” says Wu. “Even children have smile lines and expression lines when they raise their eyebrows. If I tell people to frown and I don’t see a crease, I’ll tell them to come back in a few years.” As for my creases, by the time you read this article, they’ll still be MIA. Wong softened my lines just enough so I feel like a real human, not a Stepford version of myself. And I’ve already had another round of Botox – side eye be damned.
Don’t forget about us…
1) Hands: The backs of your hands get plenty of sun exposure and need daily sunscreen protection. Seeing changes? Try Eve Lom Time Retreat Hand Treatment to treat discoloration ($63), at sephora.com.
2) Neck: This skin is thinner and drier than the skin on your face, and staring down at your phone all day puts stress on the area – a recipe for prominent lines and sagging. Try StriVectin TL Advanced Light Tightening Neck Cream ($99), at shoppersdrugmart.ca.
3) Eyelids: Magicstripes are transparent silicone patches that temporarily lift drooping eyelids sans surgery ($38), at thenaturalcurator.com.