Why I'll Never Look Back After Trying Botox

Originally published in Refinery29

About a year ago, shortly after I turned 45, I started (finally) thinking about getting Botox. I had never done anything particularly ambitious or aggressive when it comes to skin care or disguising my age. A glycolic peel here, a few rigorous facials there, and a slacker-style Retin-A practice were about as fancy as I would get. I have healthy skin, take above-average care of myself, and despite every now and again considering lowering the bulb wattage in my bathroom vanity light, I was feeling pretty happy with how I looked.

But then, something began to happen...or likely had already been happening for some time, but I conveniently chose not to notice. Some sagging under my eyes, particularly the left one, deeper folds around my mouth (my friend Malerie calls them "puppet lines," like a lot of people, which isn't as off-putting as the clinical name, "nasolabial folds" — charming, right?). And, most disconcertingly, this deep, getting-deeper-by-the-day chasm between my eyebrows. It wasn't even a crease or a line anymore — it was a groove so deep, it looked like a scar. A scar that made me look like I was in a constant state of worry or impending doom. Which, if you knew me, wasn't entirely untrue, but this bothered me regardless. Because, not only did it make me look angry and irritated all the time, it made me look OLD. For the first time ever, I started looking in the mirror, and saying, "Geez, you look so…OLD."

I remember Jane Fonda once saying that she finally decided to get some work done in her early 70s because she was sick of looking tired all the time when she didn't feel tired all the time.

I was too young (or, perhaps, just not saggy enough) to know what she was talking about when I read this. But, I totally get it now. I think the hardest part for me, and probably a lot of people, about getting older isn't at all the fear of no longer looking 20 or 25. Most of us wouldn't go back to that time even if we could. It's the idea that the inside isn't being accurately reflected on the outside — what we and the world see every day isn't really who we are. And, for all its flaws (for lack of a better word), this is where something like Botox can be pretty handy.

Despite it being the bona fide gateway treatment to a "younger-looking you," Botox's reputation still surprisingly precedes it. Since its arrival on the derm scene in 2002, it is now one of hundreds of "revolutionary," scientifically proven anti-aging and preventative treatments, injectables, and products that can easily help people like you and me stave off serious surgical procedures — for a few more decades, at least.

So, while Botox has paved the way for mainstay injectables and fillers like Restylane and Juvéderm, as well as newer anti-aging therapies that use micro-currents or radio waves like Viva and Ulthera, there's still a certain shitty stigma that often comes from getting Botox and talking about getting it. Even though, today, it's also considered a progressive alternative treatment for such things as migraines and depression, Botox is still inextricably linked to vanity, and, in many ways, a certain shame of not owning your age — your flaws, or even the message of self-confidence, individuality, and empowerment that is such a hallmark of this very site.

But, to be honest, I didn't have any shame about trying Botox. In fact, I was more ashamed of being such a chickenshit about trying it in the first place. I was in my 40s, for God's sake! And, like many of you, I have friends in their 20s and 30s who had already been routinely getting Botox as a form of preventative anti-aging (that's what they call it now, for people who aren't exactly exhibiting lines or sagging yet, but still wouldn't mind getting carded at the wine store). So, no, I didn't feel embarrassed about it or even remotely entertained the idea that I was somehow betraying my feminist convictions by considering it. (Yes, people say that, too, about Botox.)

My real hesitation came from something else. I didn't want to look weird. And, let's be really clear here about what "weird" meant to me: looking waxed, stony, eerily airbrushed — unlike myself. We've all seen the evidence on the faces of people who get too much Botox. It can be scary. Let's be honest, it's a huge reason why so many of us tune in to watch a Real Housewives reunion special — to see who did what and how much of it. But, how much was too much? Having never done Botox, I was paralyzed by the idea that even a little would make me look ridiculous, desperate even, and I would soon be wearing the same 40-something mask that everyone else was wearing.

Photographed by Atisha Paulson

But then, one day, (at the risk of sounding even older) I was reading More magazine on a plane ride, and came upon a piece about mini makeovers, meaning no surgery whatsoever. And, one woman's case in particular caught my eye (definitely the saggier one). She had been a longtime smoker, and having just turned 50, she wanted to treat herself to a fresh new look. Reading on, I discovered that Francesca Fusco, MD, of Wexler Dermatology in New York City, worked closely with this woman to hatch a plan and press the reset button on her pallid complexion. Fraxel and Botox factored prominently in her regimen and, well, her "after" pictures completely sold me. I mean, she looked amazing. In fact, she looked exactly as she did before, the person she was, but the lines, the dullness, and the general drooping around her face were all but gone. No weirdness whatsoever…just luminosity.

Yep…this was the way for me.

So, like a new groupie, I booked an appointment with Dr. Fusco, ASAP, and started googling her like crazy. With every Yelp review and article quote, I got more and more excited. And, in person, she was everything I hoped she'd be (and none of the things I feared) — cheerful, smart, inquisitive, and she talked with me for 30 minutes so she could observe me "emoting" to get a better sense of how my face wanted to move. Doctors' appointments can be stressful at the best of times, but this one was actually fun.

We talked about various treatments that might be right for me and my skin, now and down the road: Fraxel, microdermabrasion, light therapy, and, yes, Botox, which she agreed would be a good move. But, what sealed the deal for me was simply that she erred on the side of less rather than more — an approach that's not often talked about when people discuss cosmetic surgery and procedures.

She recommended we try what she called "baby" Botox on this first visit, which is a reference to the unit amount (not Botox for actual babies, I swear). "I credit many of my patients for my less-is-more, natural philosophy," says Dr. Fusco. “Over the last few years, many newbies to botulinum toxin, during a consult, stressed how they prefer a non-frozen look with ‘some’ movement. Most are okay with not being able to frown, but they want to preserve some brow-raising and some smile-squinting. By starting initially with fewer units, this is possible. The amount of ‘tox’ injected is very individualized and based on the patient’s forehead size, muscle size, brow placement, and muscle movement. It is not a formulaic approach where there is a documented, fixed amount for every forehead.”

After a quick in-office peel, she showed me, as I held a hand mirror, where she was going to apply the injections. With a little pencil, she marked tiny spots over my eyebrows, up by my hairline, and on the unrelenting perma-frown between my brows. After which, she administered the injections so quickly, I almost didn't know they happened.

And, well, that was pretty much it. After sweating the prospect and process for so many years, I can't believe how easy and painless it was. No blood, no bruising, even later on. I just had to wait a few days to see the results. And, considering her "baby" formula packed just under 20 units as opposed to the standard injection of up to 35 units, she suggested I come back the following week to review the results together and possibly tweak the recipe.

Photographed by Atisha Paulson

The whole cab ride home, I actually stared at myself in a compact mirror, convinced I could see my face transforming before my eyes. Ooh, oooh…it's working! There was even a selfie to commemorate the occasion (and let me tell you, I lack the selfie gene, so this was a first). I promptly sent the real-time evidence to my friend Gina, who stood squarely in the anti-Botox camp. A week later, however, we were all convinced. I'm not exactly sure if it was the micro dosage that Dr. Fusco prescribed or the general timing of it (read: overdue), but the effects were pretty perfect. And, the process of discovering how perfect was equally thrilling.

If you've had Botox before, you know what I'm talking about here. For the first few weeks, it's like Botox leaves a little present for you every morning — when I woke up, I couldn't wait to look in the mirror and discover what magical tweaks it had manifested overnight.

Since the best of Botox's effects take place slowly over the first two weeks, it's pretty exhilarating to see your face ever so gradually moving in reverse. Not quite The Picture of Dorian Gray…but close, and much less freaky. That's when I realized there was no going back. How could I imagine not doing this again? Something so seemingly easy and non-invasive that administered such powerful results? For the first time, I could totally see how people could end up going overboard. The initial effects are so good, too much doesn't seem possible.

Yet, we all know that too much is possible…with anything. But, that's really none of my business. I ended up looking exactly as I hoped I would: more awake, less pissed off, and much more like myself. The me I really believed myself to be. What I didn't expect — a much welcome side effect — is that the six little expertly placed injections created an overall illusion that my whole face had been lifted. The best way to describe it is, I looked more bright-eyed and "fresh." Yes, I could now completely see what all the fuss was about. I got it. Why the hell did I wait so long to do it?

Well, I'm sure I'm not the only one. While too much is made of all the cosmetic extremists out there who'll go to any length to correct every tiny "flaw," what about those of us who are too scared to do anything at all? So overwhelmed and crippled by all the options, not to mention the consequences (What if something goes wrong? What if I look like I'm trying to look young as opposed to just BETTER?), you just say screw it, when you look in the mirror and decide that gully bisecting your forehead isn't really a big deal after all. Maybe someday, you'll write a book about it like the late, great Nora Ephron.

Photographed by Atisha Paulson

Well, fuck that. I didn't want to wait until I was 70 to look the way I wanted to look. Nobody should. Done well and thoughtfully, Botox can be a safe, effective, and relatively inexpensive means of upping the ante on your anti-aging routine — stigma or no stigma. The cost of the procedure ranges depending on the person overseeing it, but in general, a round of Botox will run you anywhere from $300 to $700 per injection site (read: your forehead, crow's feet, etc.). It costs a lot more than a good facial. But, in my humble opinion, it's worth forgoing your next Zara spree or a few weeks of Seamless lunches to try it. I wouldn't say Botox made me feel younger, but it definitely made me more eager to greet myself in my bathroom mirror every morning. And, personally, I don't give a shit how much that costs. For me, that's gold.

So, at this point, I have exactly four friends and one husband who are delighted and relieved they don't have to listen to me whine and debate the pros and cons of getting Botox anymore. I've done it. It happened. And, I'm so glad it did.

My next appointment is next Friday.

Photographed by Atisha Paulson