What I Learned From Getting Preventative Botox


The furrows or vertical “eleven lines” between my eyebrows have become more noticeable in recent years. I have a tendency to hold tension and stress, like most people between my eyebrows. Unconsciously I furrow while straining at the computer screen or squint when outdoors in bright sunshine (which is everyday living in southern California). While I’ve thought about getting botox to prevent them from deepening, the idea of actually doing it always felt a little extreme. I mean, I’m twenty-nine years old. Though my thirtieth birthday is only a few months away, do I really need botox already? My forehead says, maybe…

I reached out to a few girlfriends of similar age or a few years older to see what their thoughts were on the subject; and nonchalantly broached the topic at a baby shower, friend’s birthday and over Sunday brunch. Unsurprisingly, my probing questions were met with shifty eyes, shrugs and avoidance. (After all we still live in a hypocritical world where youth is worshiped, but enlisting the help of anti-aging treatments is judged. Sigh). But a few ladies vocalized a similar curiosity in the preventative treatment and one bold friend (bless her heart!) revealed she had actually had it done.

After discussing with her what it was like, while staring at her smooth, wrinkle-less, but still moveable forehead, I decided to seriously consider getting preventative Botox and reached out to Beverly Hills, CA board certified plastic surgeon, Dr. Sarmela Sunder, for tips on how to not look frozen, associated risks and expected outcomes. (If you haven’t already, you can read the full piece here – “Your Guide To Getting Preventative Botox.”)

Over the course of the next few hours I started to feel a slight relaxing between my brows. If I concentrated on furrowing and frowning, I could, but the movement felt forced, unnatural.

In the most simplistic terms, Botox paralyzes facial muscles it’s injected into, but it’s the manipulation of these muscles that can create various desired results. The muscle groupings of the face are intertwined. Imagine interlacing your fingers together. Keeping them connected, pull your left hand up while your right hand pulls down. This is a general sense of how facial muscles work. One side pulls up while the other side pulls down. Botox is used to manipulate this exchange or freeze both interlaced sides completely.

For example, by injecting botox and paralyzing the muscle below the eyebrow, whose function is to pull the brow downward, the opposing muscle above the eyebrow is able to more strongly pull upward. This can create the look of a lifted brow and more open eyelid.

If you were to inject the entire forehead muscle, whose function is to raise the brows and subsequently creates horizontal forehead lines from repeated creasing, the muscle will relax ceasing to crease the skin and making the lines disappear; while giving a relaxed look to the brows since they are no longer being strongly pulled upward. (Dr. Sunder says this is why botoxing the forehead to remove horizontal lines and creating a brow lift with botox cannot be done simultaneously, as each requires manipulating opposing muscles.)

With a pretty good understanding of how botox works, I headed into Dr. Alan Szeftel’s Santa Monica, CA based practice, Ocean Cosmetic Medicine, to get, for the first time, preventative botox. My main concern: Will botoxing the area between my brows lead to a relaxed brow look? (I prefer the awake, wide eyed look.) He assured me this would not happen.

“There are three muscles responsible for creating a furrow between your brows,” explained Dr. Szeftel, “The muscle above the beginning of your left brow and beginning of you right brow pull downward, while the third muscle centered above your nose bridge also pulls down. When you inject these sites with Botox they relax and the upward pulling muscles they are intertwined with actually pull your brows slightly up giving a little brow lift.”

Oh, phew.

Dr. Szeftel continued to explain that preventative botox is characterized by using lower dosages allowing for more movement, since the aim is to minimize the intensity of facial movements, not completely paralyze them. For someone with deep eleven lines the recommended dose would be 30 units (5 units in each location) between the brows, but for prevention 15 units (3 units in each location) is recommended; and two treatments per year are all that’s needed. (Units range from $8-15 per unit depending on the injector.)

He also suggested injecting 3 units below the tail of each eyebrow. Because the center area of my brows would be slightly lifted it’s important to also slightly lift the brow ends. This would make sure the beginning and ending of my brows were lined up giving a natural effect. See the image below for where the botox was injected.


After cleansing the injection sites, Dr. Szeftel injected each location with botox. The actual injecting process took no more than 5 minutes. And I was instructed to not lie down, touch my forehead, exercise or sit at a 45 degree angle for a few hours post treatment to avoid moving the botox. My forehead was a little red where the needles punctured my skin, but I left the office looking pretty normal and was able to go grocery shopping right after.

Over the course of the next few hours I started to feel a slight relaxing between my brows. If I concentrated on furrowing and frowning, I could, but the movement felt forced, unnatural.

Now just a few days later, my brows feel relaxed. I can still move them slightly, but it’s a faint furrow rather than an intense one. Let’s just say I’m very happy with the results.

-by Amy Chang
Image source:
Nagi Sakai for Vogue Mexico, 2012

Want more on anti-aging? Read “What I learned from getting lip fillers” or “How to repair smoking damage” for tips on rejuvenating your look. Just because you sun bathed or smoked doesn’t mean you can’t repair the damage.