Thursday, April 21, 2011

A "new" fad - Defensive Aging

This fad,which is in the spotlight now, was apparently sparked by Kim Kardashian who in 2010 decided to get some prophylactic Botox for her potential "crow's feet" . Unfortunately she bruised (although a normal sequelae to some injection sites) .The injector must have been horrified "why me?"
Defensive ageing - an attempt to intervene in your late 20s to avoid even a smidgeon of a fine line from appearing or at least keeping them at bay a little longer. Aging isn't this one dimensional and lifestyle factors such as sun exposure and smoking play a role in the condition of your skin. Also as we age our muscles change, we lose fat in our face, gravity does have some influence.


"The time to start Botox is before you need it.  As your muscles continually contract and 'wrinkle' your skin over many years, the lines only seen when the muscles are contracting become lines present at rest.  Thus, if you treat (paralyze) selected muscles before these lines appear (it is normal to have them when your muscles contract), you can slow the 'aging' process, at least as it relates to fine lines on your skin." - Dr. Vincent P. Marin, San Diego Plastic Surgeon
"It is best to start Botox before the wrinkles develop...If you start Botox early, then you are decreasing the stress on the skin and, thus, helping to prevent wrinkles."  -- Dr. David Shafer, New York Plastic Surgeon
"I definitely think Botox is excellent for prevention of static lines in the brow and crow's feet." -- Dr. Matthew Bridges, Richmond Facial Plastic Surgeon
"Botox works best in younger patients because it reverses the trend to frown unnecessarily. Over time, you can actually re-train those over-active muscles and prevent wrinkles." -- Dr. Mary Lupo, New Orleans Dermatologist

"If you have no wrinkles, leave yourself alone! They will come soon enough, and I don't think you can prevent them." -- Dr. George J. Beraka, Manhattan Plastic Surgeon
"I don't believe you should do Botox preventively.  Your crow’s feet are supposed to crease when you smile...Botox works very well once you have [wrinkles] and I don't believe you gain much ground by doing it prior to actually needing it." -- Dr. Lisa Benest, Burbank Dermatologist
"The downside of starting injections early is that if you like the results you will need to repeat treatments every 3-4 months to maintain your appearance." -- Dr. Kelly Gallego, Iowa Plastic Surgeon
"Botox should not be used to prevent wrinkles but to address them." -- Dr. David A. Robinson, Indiana Plastic Surgeon

There's not much clinical evidence to support this trend , but a study done in Canada called the Botox Twin Study to demonstrate the long-term effects of prophylactic Botox /BontA .The Botox Twin Study shows twin sisters in a 13-year period where one received injections 2 to 3 times a year for the duration of the study and the other only twice; once in year 3 and again in year 7.

Long-Term Effects of Botulinum Toxin Type A (Botox) on Facial Lines

A Comparison in Identical Twins

  1. William J. Binder, MD
  1. Author Affiliation: Department of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, Calif.
  1. Correspondence: William J. Binder, MD, 120 S Spalding Dr, Suite 340, Beverly Hills, CA 90212-1800 (


Objective  To evaluate the presence of imprinted facial lines in identical twin sisters, one of whom had received botulinum toxin type A (Botox) treatment in the forehead and glabellar region regularly for 13 years and one of whom had not. Crow's feet were also compared.
Methods  One twin received Botox in the forehead and glabellar region (approximately 2 to 3 times each year over the past 13 years) and in the crow's feet (twice in past 2 years). Her twin received Botox only twice (in the forehead and glabellar region, 3 and 7 years ago).
Results  Imprinted forehead and glabellar lines were not evident in the regularly treated twin but were evident in the minimally treated twin. Crow's feet were less noticeable when the regularly treated twin smiled (even at 7 months after treatment) than when the minimally treated twin smiled. Untreated facial areas (eg, nasolabial folds) showed comparable aging in both twins. Neither twin experienced adverse effects.
Conclusions  Long-term treatment with Botox can prevent the development of imprinted facial lines that are visible at rest. Botox treatment can also reduce crow's feet. Treatment is well tolerated, with no adverse events reported during 13 years of regular treatment in this study
The Twin on the right is the regularly treated twin. Amazing difference hey?
Wow, quite a difference.

Is it just me or does it appear that they're not really that identical in this picture?

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