Sharpening your image

Alicia Robinson

A little vanity may not hurt anyone; it’s the things people do to

satisfy their vanity that are painful.

Actually, in the jungle of torturous-sounding treatments like acid

peels and laser dermabrasion, Botox injections are probably among the

less frightening, although they do require needles in the face.

The idea unnerved Deborah Fonseca a bit. Working as an

aesthetician in a Newport Beach salon, Fonseca met a doctor who

offered Botox and she saw people he had treated -- and noticed how

good they looked.

“It took me a year before I would walk into his business,” she

said. “I was still afraid of it.”

But after she saw Botox erase the angry line between a friend’s

eyebrows, she was convinced. Her first Botox shot was more than a

year ago.

Botox injections have become increasingly popular since the late

1980s, partly because they are one of the fastest and least invasive

cosmetic procedures.

People also like it because they look a bit younger but it’s

subtle and less dramatic than a face-lift, said Steve Yoelin, a

Newport Beach ophthalmologist who began offering Botox about three

years ago.

Yoelin is the doctor Fonseca went to see the first time, and she’s

not the only one who’s returned for more Botox.

“This is my third time back and I’m loving it,” said Roxann Katz,

a grandmother of two and one of Yoelin’s patients. “[It’s] the best

I’ve ever felt in my life.”

The approach of her 50th birthday this summer made her decide to

spruce up her appearance, she said. Katz has also tried collagen and

another “filler” called Restylane, she’s had her eyelids done, and

she’s on her second set of braces to straighten her teeth.

“I just felt that I wanted to look good turning 50,” she said.

At first she didn’t tell her family about the Botox, but they

wondered why she looked better.

When she did spill the secret, their reactions weren’t negative,

she said. Katz said Botox is perfect for her because it’s quick and

won’t cause the kind of allergic reaction she had during her eyelid

surgery.

“It’s a pretty invasive surgery, and this, I can go back to work

from here,” she said.

A PARALYZING TREATMENT

Botox is a trademarked name for a product made by Irvine-based

Allergan, but it’s commonly used to refer to the cosmetic treatment

for which the product can be used. It contains botulinum toxin, which

can be harmful or fatal in large amounts, and it was originally used

by ophthalmologists to treat strabismus, or crossed eyes.

When a solution containing the toxin is injected into a muscle, it

temporarily paralyzes the muscle, an effect that has a variety of

medical uses. Botox is used to decrease sweating, stop excessive

blinking and ease migraines, and in large doses, it treats muscle

stiffness associated with cerebral palsy.

For cosmetic purposes, a Botox treatment consists of a number of

small injections with a syringe, most often into the scowl lines

between the eyebrows, the horizontal creases in the forehead or near

the “crow’s-feet” next to the eyes. A topical anesthetic can be used,

but most patients said it only stings a little or doesn’t hurt at

all. The actual procedure takes minutes and reaches its maximum

effect after about four days. Results usually last three to four

months and in some cases six months or longer.

Just about everyone seems to offer Botox today. After adding Botox

injections as a sideline to his ophthalmology practice, Yoelin now

devotes a full day each week to cosmetic treatments.

As well as the usual plastic surgeons, aestheticians at spas and

salons are even giving Botox now, Yoelin said.

NO LOSS OF YEARS

Newport Beach plastic surgeon Boris Ackerman has been giving Botox

injections since the early 1990s, offering it “off-label” before the

Food and Drug Administration approved it for cosmetic use. He said

it’s been popular all this time.

His patients run the gamut, from people in their 20s to those in

their 80s, he said. Most are women, but Yoelin said about 5% of his

patients are men.

For a patient to be happy with Botox treatments, Ackerman said,

they must have realistic expectations of the outcome.

“It’s really not an alternative to surgery,” he said. “You cannot

create the same look with Botox that you would with facial

rejuvenation surgery, but for someone that does not want surgery or

is not a candidate for surgery, it’s a nice adjunct.”

In other words, if you’re 50 but you want to look 40, Botox won’t

do the job. But when it’s done right, the doctors said, people are

generally quite pleased with the results. That’s one of the things

Yoelin said he likes about offering the treatment -- the patients are

so upbeat and they enjoy what he’s done.

As much as people like how they look after Botox, they don’t

always want to talk about it. Indeed, part of what they like is that

they look well rested and healthy but no one can put their finger on

what’s different. Several of Yoelin’s patients sang the praises of

Botox and said about half of their friends had gotten it too, but

they didn’t want their names used in this story.

“Some of my patients say, ‘You do a great job, but you’re not

going to get referrals from me because I’m not going to tell my

friends,’” Yoelin said.

Fonseca isn’t shy about her Botox treatments or her reason for

getting them.

“I did it for vanity first, not for my career [or] to project to

my clients,” she said.

She doesn’t mind using Botox for a little maintenance now that

she’s about to turn 40, but she doesn’t think she’ll go further and

have surgery on her face.

“I like how I look,” she said. “This just enhances me.”

When she was younger, Katz might not have expected she’d one day

be using Botox and other cosmetic procedures, but she didn’t know

then how she would look and feel at this age, she said.

For now she’s happy with the results and expects to keep pursuing

elusive youth for a bit longer.

“I’m going to give it up at 60,” Katz said. “You can only stay

young so long, and life goes on.”

* ALICIA ROBINSON covers business, politics and the environment.

She may be reached at (949) 764-4330 or by e-mail at

alicia.robinson@latimes.com.