Botox with Brooke: Filling Between the Lines

About a year ago I was talking to a friend who’s two years older than me who had recently gotten botox for her first time and loved it. Despite “preventative botox” flooding my social media feeds and being talked about on all the beauty blogs I tune into occasionally (usually all at once when I am looking for reviews on a certain product, beauty tutorial, or procedure), my interest in Botox didn’t pique until I saw a friend with it.

I’ve always had lines on my forehead when I make certain expressions, and in the summer I tend to squint, creating semi-permanent “11” lines between my eyebrows. It was never something that other people noticed - when I first mentioned it to Christian he had “no clue” what I was talking about - but it was something that bothered me. If I had been in the sun all day and put makeup on before going to dinner that night, I would notice that the makeup - no matter how light it was - would clump into the fine line.

Not long after my 26th birthday this past October, I posted a series of poll stories on my Instagram where I asked my followers if they had gotten Botox before, if they had thought about getting it, at what age they started, and what convinced them to get it if anything. From this story, 75% had not gotten botox but 71% reported considering it and wanting more information. Of the 25% who had gotten it before, the majority had started between ages 26-30, and the most frequently reported reasons for getting Botox were: preventative, a specific fine line that bothered them, or an upcoming event such as their wedding where they wanted to feel like the best version of themselves. Outside of these polls, I received upward of 30 messages from others who had stated that they had started getting Botox, 100% of them stating that they were happy with their results and highly recommend it.

A week after opening up this conversation on my Instagram, I indulged in my first units of Botox to fill those aforementioned lines and add a little volume to my top lip with a “Lip Flip”. After reading up on Botox for hours over the weeks prior, I knew that above all else, the most important part of ensuring desired results was going to a professional who is properly trained and experienced. Knowing that, I looked no further than Christian’s older sister, Brooke Atherton, MS, RN, FNP-BC, who is a nurse practitioner in NYC by day, and aesthetics specialist by night.

I liked that I could ask Brooke a million questions and she always had an answer, and that she was conservative with my treatment, reassuring me that we can always add more but we can’t take it away if we’ve done too much. I also LOVE that Brooke offers concierge Botox, which means that you don’t have to leave your house to get it. Brooke came to my apartment and we hosted a Botox brunch with some of my closest girlfriends to learn more about Botox and indulge ourselves, which is something she will do for anyone in the NYC area. I sent over some of the most frequently asked questions from my Instagram story to Brooke to answer, and chimed in myself at certain points too.

Is there such thing as being “too young” to get Botox? What are the pros and cons of starting earlier vs. waiting?

BA: In order to understand the treatment of wrinkles, and the pros of starting earlier vs. later I think it’s helpful to understand the types of wrinkles. Dynamic wrinkles are wrinkles that appear when moving your face, and Botox is very effective at treating these types of wrinkles. When our facial muscles contract, the skin over those muscles stretches to accommodate. When we’re young, we have a lot more collagen and elasticity in our skin, which allows our skin to bounce back after stretching. As we age, we lose that ability, and dynamic wrinkles start to become more permanent. These wrinkles that are present at rest are called static wrinkles and are harder to treat. Botox is not an iron, so any line that is present at rest or etched into the skin is not going to completely disappear with Botox. Therefore, it’s best to start Botox treatment in the early stages of wrinkle formation. After using Botox continuously for years, your muscles also become trained not to make wrinkle-forming expressions as aggressively, which is another reason why it's beneficial to start treatment earlier.

Does it hurt? I’m terrified of needles but super intrigued.

MJ: I hate needles too. Brooke applied numbing cream to the areas that she was treating, and didn’t hurt at all. I got my flu shot a few months ago and wanted to cry because of how badly it hurt. While the forehead was nothing, the lips were more sensitive. I only got 4 units of botox on my upper lip, and I definitely felt a little pinch but it didn’t last more than 5 seconds.

BA: This is such a common question! We use super small needles to inject. In my practice, I use insulin needles, and so it shouldn’t feel like anything more than a little pin prick. There is no stinging or burning sensation when the solution is injected, so other than the actual injection itself, the procedure is relatively painless. Like Morgan said, there are definitely some areas that are more sensitive than others, such as the lips, and around the eyes, but we can apply a topical anesthetic before that can help to diminish any discomfort. We want the experience to be as comfortable and enjoyable for you as possible, so be open with your injector about your concerns and fears so that they can implement methods to help!

How long does Botox last?

BA: The effects from Botox on average last between 3-6 months, but this varies from patient to patient. There are certainly factors that can affect the duration of the effects, such as how much botox is injected, what area is being treated, quality of your skin, and age. There are also steps you can take to ensure your Botox results last longer. It’s super important to find an injector who is experienced at administering Botox and can tailor the treatment to meet your individual skin concerns!

What’s the difference between Botox and fillers?

BA: Great question! Simply put, Botox treats lines of expression, while fillers treat lines at rest. Botox and fillers are commonly used together, but they work differently and are used on different lines. Botox relaxes muscles to smooth fine lines and wrinkles, while fillers add volume to tissues and help fill in deeper lines. They also vary in cost, potential side effects and overall duration of effects. It is best to discuss your aesthetic concerns with an experienced injector who can provide a personalized assessment of your skin and help you select the best treatment options for you!

Is there any recovery time from Botox? Would I be able to do things after or will it be noticeable?

BA: There is very little down time. Typically, we recommend that immediately after your injections, you should keep your head level and not lie face down or bend your head forward for 4 hours. We also tell you to avoid getting too hot 48 hours after treatment, which includes heavy exercise, excessive heat and drinking alcohol. This is because heat causes increased blood flow through the muscles, which might cause the Botox to be dispersed. The results will not be immediate. You'll start to see an effect after 3-5 days, but it may take up to two weeks for the full effect to kick in.

It took about a full week for all of the Botox to activate and for me to see it - the lips showed quicker than the lines in my forehead - and I couldn’t be happier with the results. While it’s not something that you notice on someone at first sight, I feel so much more confident with expression lines on my face that bothered me before. And as someone who once got lip filler and honestly loved it, I am so happy with how my Lip Flip turned out - so subtle but achieves exactly the result I wanted: a 50/50 ratio of my bottom to top lip.

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Book your appointment with Brooke by emailing her at brooke.atherton@rejuvumed.com or by DMing her on Instagram at @bea.naturalinjectables.