Ask the doctor

Q: Is there anything nonsurgical I can do to improve wrinkles around the eyes, such as "crow's feet"?

a: Yes! Botox can help dramatically with these wrinkles. Botox is a noninvasive injection, performed every three or four months, which decreases the ability for wrinkles to form. Additionally, it benefits the appearance of the eyes by widening them slightly and improving the arch of the eyebrow, if done by a skilled injector.

Q: Isn't it better to do something permanent versus Botox?

Additionally, it doesn't carry the risks that surgery can have. The main risks of Botox are headache, temporary drooping of the eyelid (rare) and bruising. The nicest thing is that it is temporary, so if you don't like the results, it will go back to "normal" after about three or four months.

Q: Where else can Botox be used?

a: Botox is used for many areas, both facial and nonfacial. We use it on the forehead wrinkles, chin area, smoker lip wrinkles and neck bands. It has many other uses for conditions ranging from sweating to wry neck. Additionally, new uses for Botox are being discovered just about every month. Recently, there was even a report on Botox use for a diabetic stomach ailment. Clearly, it is a very versatile and safe drug, having been used in nearly a million patients for more than 30 years.

Q: Will I look "paralyzed" if I use it?

a: No, but results also depend on the skill of the person who is injecting you. If done correctly, Botox makes you look refreshed and relaxed, by avoiding excess muscular activity in areas of overuse (between the eyes, forehead, crow's feet). One of the most common misconceptions is that it will either make the area look unnatural or won't allow expression. While that can happen if huge amounts of Botox are used, it is very uncommon, especially if you go to a reputable dermatologist for treatment.

Q: Can I use Botox if I am pregnant or nursing?

a: Botox is not recommended while pregnant, as it has not been tested in pregnancy. As for nursing mothers, I always leave that decision up to the pediatrician. Anecdotally, most of my patients' pediatricians don't seem to have a problem with its use while nursing.

Joel Schlessinger, M.D., F.A.A.D., F.A.A.C.S., answers your questions about facial rejuvenation and antiaging therapies. A board-certified dermatologist and president of the American Society of Cosmetic Dermatology and Aesthetic Surgery, Dr. Schlessinger is in private practice in Omaha, Neb., and is the founder and owner of http://LovelySkin.com/, one of the largest purveyors of skincare products on the Web. He is a member of the Dermatology Times Editorial Council. Please e-mail your questions directly to Dr. Schlessinger at skindoc@LovelySkin.com
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