Botox backlash: Evidence reveals the so called ‘miracle jab’ may actually GIVE you wrinkles

By Alice Hart-davis
Created 6:39 PM on 9th May 2010

Miracle cure? Botox injections could create new lines

Over the past 15 years, Botox has been embraced by thousands of women – and men.

The market in the forehead freezing drug is worth almost £18 million in the UK alone.

But one of its least-known, and most deliciously ironic, side-effects is that if you use it a lot, or have it injected by an inexperienced practitioner, Botox can actually give you wrinkles.

Cosmetic experts have noted that knocking out some of the facial muscles can bring others into play.

In a piece for the Journal of Cosmetic Dermatology in 2002, Dr David Becker, an assistant professor of dermatology at Weill Cornell Medical College in New York, observed that ‘wrinkles caused by untreated muscles of facial expression paradoxically can become more prominent’.

‘Paralysis of a set of muscles,’ he suggests, ‘might lead to recruitment of other muscle groups in an attempt to reproduce the conditioned activity being blocked – resulting in more prominent muscle activity in adjacent regions.’

In other words, your face will still find a way to make expressions by using different areas than where you’ve had Botox, leading to more lines.

The main place where these wrinkles appear is across the bridge of the nose. These ‘bunny lines’, as they have been christened (twitch your nose like a rabbit, and you’ll get them, too), have been seized on with glee as one more clue to guess which celebrity has been Botoxed.

You may have seen them on the faces of Dannii Minogue and Amanda Holden. These beauties have lovely smooth foreheads . . . and peculiar little wrinkles across the nose which pop up when they smile.

Bunny lines: Amanda Holden, left, and Kylie Minogue show the signs of Botox through wrinkles across the bridge of their noses

Some people have them naturally, but increasingly, bunny lines are being seen as a dead giveaway that the person in question has submitted to the needle.

Leading cosmetic dermatologist Dr Nick Lowe, of the Cranley Clinic in London, says: ‘If you inject the forehead with Botox, the muscles at the sides of the nose and on the lower bridge of the nose often act a bit more strongly, just because the adjacent muscles have been reduced in strength by the injections. That’s why you get bunny lines.

‘You could always pre-empt the problem by getting your nose Botoxed, too.

‘I routinely inject the nose,’ says Dr Lowe, ‘particularly if I’m injecting around the eyes to soften crows’ feet. If you inject crows’ feet and leave the bunny lines, the muscles that cause the bunny lines can also increase the under-eye lines.’

Generally, botulinum toxin type-A wrinkle- relaxers are considered very safe. Originally used to treat debilitating neurological diseases such as post-stroke spasticity, blepharospasm and foot spasticity assocciated with cerebral palsy, Botox is classed as a prescription drug.

When used for cosmetic purposes, it’s in far smaller quantities. Side-effects such as lowering brows and drooping eyelids are rare, but in smaller ways Botox can distort a face, making it look not quite right; a bit ‘off’, somehow.

Botox was first used in the Eighties to treat uncontrollable blinking and misaligned eyes

This distortion becomes clearer when we see faces that remain immobile as their owner’s voice goes through a whole range of emotions, but even when Botoxed faces are at rest they can look faintly peculiar.

Five years ago, this look might have puzzled most of us. But now we know what it is, Botox has become something of a joke and has become less acceptable.

‘As we age, we should still want to look like ourselves,’ says make-up guru Bobbi Brown.

Her campaign, Pretty Powerful, is all about showing how much we can improve our faces with a dab of concealer and a dash of lip gloss, and makes a point of featuring real, un-Botoxed women.

‘Botox is a poison,’ she says: when we are so careful about what we put into our bodies, why do we want someone to shoot poison into our faces?

‘I tried Botox once, a couple of years ago, between my eyebrows. I didn’t like it. I looked unnatural. Going down this route is a bit like weeding your garden. When do you stop? A face without lines lacks warmth and personality.’

So are we likely to start seeing a rash of new wrinkles in publicity photographs and on TV? Who knows?

In an ideal world, such minor signs of ageing might just become fashionable – the mark of a genuine, as opposed to Botoxed-and-airbrushed, type of beauty. We can but hope.

Botox can actually make you look older

The fact that Nicole Kidman’s face no longer moves is testament to how much Botox has taken over the cosmetic surgery industry. Nothing against Nicole Kidman, I love her, but if every A-list Hollywood star doesn’t stop injecting their faces soon, we as viewers, might be forced to face reality sooner than we thought. You see, Primpers, a recent study has revealed that Botox might actually make you look OLDER. Yes, older.

Let’s face it, after seeing what Botox (and a plethora of other procedures) has done to Carla Bruni, it’s no surprise, is it?

This debate is not a new one. Botox enthusiast Dr. Fredric Brandt has been arguing with research dermatologist Dr. Nicholas V. Perricone for ages over this topic. In an interview with Marie Claire, they had clear cut differences on the topic, with Dr. Brandt, the world leader in Botox injecting (probably due to the amounts he uses on himself) defending the procedure but saying botch jobs are due to poor technique. “It matters how and where, precisely, you inject it. Depending on the administering doctor’s skill, you’ll see the occasional “Dr. Spock” eyebrows — and in the worst cases, crooked mouths or droopy brows with heavy eyelids,” he said.

However, Dr. Perricone begs to differ, claiming “Someone who’s been on Botox for a while is going to look like a wrinkle-free older person.” And by older he means they’re expressionless and their facial features are flattened. NOT GOOD, Primpers.

There is now new evidence, thanks to an article in the Journal of Cosmetic Dermatology by Dr David Becker, an assistant professor of dermatology at Weill Cornell Medical College in New York, that suggests Botox could potentially give you more wrinkles, too.

Here’s why. Your face is a funny thing. It likes to move. Back in the day, they never thought humans would inject themselves so that their face wouldn’t move, so you know, we’re not really meant to be frozen in time. As a result, our face finds other ways to move and in turn, you get wrinkles in new places, like around your nose. You may be stopping wrinkles in one place, but you’re getting them in another. You can’t fight it, Primpers. Unless of course, you inject your nose, too. Erm, me thinks not.

Dr David Becker’s findings revealed (courtesy of The Daily Mail) that ‘wrinkles caused by untreated muscles of facial expression paradoxically can become more prominent. Paralysis of a set of muscles might lead to recruitment of other muscle groups in an attempt to reproduce the conditioned activity being blocked – resulting in more prominent muscle activity in adjacent regions.’

What this may cause, Primpers, is an increase in wrinkles in other areas of your face. Especially around you nose. Like this…

Here’s the look I’m talking about…

It’s a tough situation to be caught in. We’re an anti-ageing society with increasing pressure to look perfect no matter what age we are and while some of us are happy to turn our backs on Botox, there’s a large proportion who are lining up for the stuff. I guess it’s time to consider the options, you know, really think about it and frown if you want to. That’s if your face will allow you to, of course.

Tell me Primpers…

What do you think of Botox?
Are you worried it’s going to make you look older?

Botox causes more wrinkles?

Photos: Above, “bunny lines” on the noses of actresses Renee Zellweger, left, and Nicole Kidman, right. (Getty Images photos) Below right, actress Kim Cattrall and her “bunny lines.” (Photo courtesy of Daily Mail.)

NEW WRINKLES FOR OLD

Botox injections in one part of the face can cause new facial wrinkles to appear elsewhere.

Local cosmetic doctors have seen it happen in their patients. It’s also visible on faces of celebrity Botox enthusiasts such as Renee Zellweger, Nicole Kidman (pictured above) and Kim Cattrall (pictured at right).

Here’s how it happens: After a Botox session, a patient tries to make a facial expression, but Botox-injected muscles can’t move. Nearby muscles contract instead, causing new wrinkles. The process is called “recruitment” of the nearby muscles.

“We have all seen muscles adjacent to site that we have treated being ‘recruited’ and causing an adjacent wrinkle,” said dermatologic surgeon Dr. David Sire of Fullerton. “Usually a small injection of Botox [into the newly contracting muscle] corrects this problem.”

Plastic surgeon Dr. Joseph Cruise of Newport Beach explained:

The human body is made to adapt. … When one muscle is injured, other muscles will quickly take over and assume the functions of that lost muscle. The same holds true for muscles that are paralyzed by Botox. Surrounding muscles will act more intensely to “pick up the slack”. This may cause new wrinkles to form in areas adjacent to the original wrinkle.

Dermatologist Dr. David Becker, an assistant professor at Weill Cornell Medical College in New York, described the phenomenon for the latest edition of Journal of Cosmetic Dermatology.  It’s a topic he has been discussing since at least 2003.

In the dermatology journal, Becker noted that Botox shots to eliminate wrinkles around the eyes can lead to “bunny line” wrinkles at the bridge of the nose. That’s a common look for Botoxed celebrities, such as those pictured above.

When that news broke, bloggers and tabloids had fun with headlines such as “Wait a minute—Botox actually GIVES you wrinkles?” and the inaccurate “Botox can actually make you look older.”

The same process can cause elevated “Joker” eyebrows, said plastic surgeon Dr. Val Lambros of Newport Beach:

The classic place where you see recruitment is in the forehead. When you inject … in the center of the forehead, the outer brow will try to compensate and elevate and you wind up with the Cruella de Vil eyebrow. [Pictured above at right.] It’s a classic post-injection look and is easily treated.

Those arched eyebrows have been prominent feature of Nicole Kidman (pictured below right), at least in the past. Her cosmetic doctor seems to have adopted improved injection techniques that avoid the arched look in recent years.

Sometimes what look like new wrinkles are merely old wrinkles that a patient didn’t notice until Botox smoothed away more prominent ones, said dermatologist Dr. Vince Afsahi of Tustin and Newport Beach.

In general, patients like what Botox does for them, said Dr. Christopher Zachary, chairman of the UCI Department of Dermatology.  But he added, “The use of botulinum toxin is an art, and not an exact science. Some patients do vary in their response.”

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