Seeing as she’s the beauty director of Vogue UK, you might assume Alexandra Shulman to be an enthusiastic champion of various cosmetic procedures, but in this fascinating editorial in today’s Daily Mail, she claims to have never had a single bit of “work” done.  Women are getting Botox and facelifts and Restylane injections, she says, because we want to look younger…but the fact that we’re emphatically not getting any younger makes every tweak a more insistent form of denial.  It’s a wonderfully valid point…but can’t you take it even further and then cast the net of derision over the entire anti-aging products industry?  When you boil it to the core—which is ultimately a terror of aging—what’s the difference between Botox, eyelifts and the bimonthly purchase of peptide and antioxidant creams?

My favorite quote comes at the very end of the article: ‘We broke through the glass ceiling, and we broke the gender barrier, with a tremendous amount of effort, and now we all want to look like Atomic Kittens (a UK pop band),’ she said. ‘Where is the emancipation in that?‘

After I wrote last week’s post about Botox, I wanted to get a doctor’s opinion, so I turned to Dr. Jeffrey Benabio, a dermatologist in San Diego who writes a fantastic blog called The Derm Blog.  His take:

“Botox® has taken a beating lately. First the FDA said it’s investigating Botox safety issues, and now an Italian study shows that Botox might get into your brain. So is Botox dangerous?

How Botox works is a little complicated — I wish Jolie taught pharmacology at my med school; Susan and Larry are a lot simpler and more interesting than synaptosomal-associated protein.

When Botox is injected into the skin, it is taken up by the nerves and blocks the release of neurotransmitters, shutting off those nerves. When you try to contact a muscle (or even smile in some cases) the muscle never gets the signal, so it doesn’t move.

So what about Botox in your brain?

Results from the Italian study found that Botox injected into the rats could flow backwards up the nerve from the skin to the brain.

What does this mean?

The study was done in rats, not people. We do not know if Botox would do the same thing in humans. Even if some Botox did get into our brains, there is no evidence that it has any meaningful effect, good or bad. Also, there is no evidence that it causes or increases the risk for any brain conditions, including Alzheimer’s disease. In fact, Botox can be an amazing treatment for people with brain conditions such as cerebral palsy.

Botox is a wonderful and powerful drug. In treating wrinkles, there are few treatments that can compare to its results. It is, however, a drug with side effects and risks. We probably don’t know yet what all the risks are and will certainly we be hearing more about this topic. The good news is that bloggers like Jolie will help you make informed choices.”

A few days ago, I posted about Botox, and in the comments section a recent Journal of Neuroscience study that’s received attention was referenced.  The media pounced on this study…however, certain details have been magnified and others minimized for the sake of sensationalism, er, information.  This blog lays out the crucial information; I had to reread it about seventy-five times to process, but the gist is below:

Botox is the market name for a type of botulinum toxin (botulinum toxin type A) made by Allergan.  Others exist, like Myobloc—Botox is simply the most popular.  Botox et al. aim to paralyze facial muscles, stopping movement; you already know this.  To move muscles, your nerves release a neurotransmitter (acetylcholine, but let’s just call it Susan) that sends signals to the brain.  There’s a critical molecule in this process, necessary to make Susan do her signaling thing; let’s call this molecule—SNAP-25—Larry.  (Hey, why not?) Botox alters Larry, stopping him from releasing the muscle-moving Susan.  (God, I already have a headache just rereading this.)

This recent study did not measure levels of Botox; levels of Botox after injections are so minute and hard-to-detect that the study had to measure Larry, instead.  What the study actually found was that altered versions of Larry affected by the Botox moved back and forth between Susan’s homebase and neurons controlling whisker movement (lab rats, I remind you).  The Botox itself was not measured.

All of the hullabaloo is resulting because this study discredits (or strongly appears to discredit!) Allergan and the FDA’s earlier claims that botulinium toxin type A was completely broken down once injected.  It now appears that traces remain–minimal, but there all the same. Does the study prove that the Botox “poison” seeps into your brain?  No, it does not.  It does, however, proves that traces of Larry are found and altered in the brain as a result of Botox injections.  And, yes, I do think that’s troubling.

Here’s my take on Larry versus Botox: it’s a small distinction, but a crucial one.  In science, “God” is in the details, after all. To be fair, this study not only piqued my interest but gave me serious pause; I now have my ear firmly to the ground, waiting to hear further results.  I’m not, nor have I ever been, an alarmist—it’s simply not in my nature.  (I’m open-minded and fact-weighing to a fault; call it my Libra rising!)  Will I stop using Botox based upon this one study?  No, I admit—I will not. Will I stop using Botox if conclusive evidence comes to light showing that all users are at a statistically significant risk of (insert terrible medical horror here)?  You bet your ass (and all your frown lines!)

Q: How young is too young for Botox?  I think I need it, but I don’t want to look frozen.  I’m scared of looking like a wax mummy!

I hear this question on a weekly basis, but as a beauty girl living in LA, I think I’m a little biased.  (This is much to D.’s dismay, who clucks like I chicken when I come home after a fresh batch of treatments every six months or so.  She says, ”Be natural!” I say, “…and embrace the angry frown-line between my brows?  Mais, non!”  For a better perspective, I put the Botox Q to my docs at Profiles Beverly Hills, Dr. Jason Litner and Dr. Peyman Solieman.  This week, Dr. Litner takes it:

“We are so glad to hear you say that! In Hollywood, looking like a wax mummy is bordering on perfectly acceptable these days. But–at least in our opinions–these blank stares are giving Botox a bad rap. Remember that Botox is a tool, and that same tool can be used to make delicate refinements…or to turn your face to stone. It’s all about how much is used and where it is placed.

Injecting Botox is not rocket science. That’s why you can find someone to inject Botox on practically every street corner. But there’s an art to consistently (and safely) creating a natural un-frozen appearance that just makes you look and feel better. To achieve the look you want with finesse, you should see an experienced injector. Be honest with what you want…all too often patients come in saying they don’t want to be frozen only to complain a week later that they can still move their forehead.More and more women and men are seeking Botox and other non-surgical treatments at an earlier age. Most patients begin in their early 30’s. We occasionally see an actress in her 20’s who is trying to look younger for a particular role. Some patients also have hereditary early aging or a stubborn frown line that may benefit from Botox at a slightly younger age.   (Note: like Jolie!)

There is also a lot of mythology surrounding Botox. You will not get addicted, though you may really like the look. Your wrinkles will not be worse than ever after it wears off…if anything, Botox can help prevent new and worsening wrinkles if you are fairly good about keeping up with it. If you think you need it, at whatever age, please be sure the doctor you discuss it with is experienced.” (So no Botox at the mall, please!)

Check out the last part of my Bella Sugar interview here!  We dish about the best drugstore brands, the pros and cons of Botox, and whether loving beauty makes you shallow.  (Answer: um, kinda…but there’s really nothing wrong with that.)

I’ve always been adventurous with beauty, regardless of whether it causes my friends and family to think I’ve gone off the deep end (Botox? Two foot long extensions? Bring it!).  I figure, as a beauty expert, how can I write about it if I haven’t experienced it, no?  Of course, this mentality often leads me into murky beauty waters.  Like today.  When I tried Restylane.  (I can’t even say “had.”  I have to say “tried,” as if I were down in South America sampling Class A narcotics with smugglers, or something.)  Restylane is a temporary filler often used on the nasolabial folds (those creases around your mouth) and to plump lips; it’s more subtle and less temporary than other fillers with bigger molecules like Perlane, Juvederm or Radiesse.  As with my Botox “experiment” this summer, I decided to have Restylane on a whim, temporarily going insane and forgetting important details such as “I hate needles” and “I’m a complete baby when it comes to pain.”  So, yeah…today was not exactly the most fun day of my life.  My “smile lines” are extremely tender, slightly swollen, and still a bit red.  I’m told the swelling will subside in a couple of days, however, so I’ll be sure to report back!  (And perhaps next time I will pause before I decide to sacrifice my still-very-line-free-cheeks in the name of beauty.)