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Is Botox the New Teeth Cleaning?

By a show of hands, how many of you reading this right now have colored your hair?

Yeah. I thought so.

If you think back a couple of decades, hair coloring was a deep dark secret and women would rather die than admit that underneath it all lies what my hair guy calls "mature colored" roots.

Flash forward to 2010 and Botox has taken over as the new hair color, in some parts of the country becoming as common as a teeth cleaning. Has she? Hasn't she? It's tough to know for sure and she's certainly not fessin' up.

But is our vanity putting us in danger?

If the image of a continuously surprised or frozen face with no movement is etched in your head (think Joan Rivers, people), Dr. Craig Ingber, a board certified facial plastic surgeon who practices in the cosmetic-procedure Mecca of the world – Southern California – says you can rest assured.

"Some think they're going to have a totally paralyzed face and they're going to look like a puppet -- you can achieve that if you want. But in most cases it's very natural." Dr. Ingber adds, "Patients who do Botox are 99 percent pleased. It's probably the most common starting point for patients."

Are Botox injections for everyone or just Hollywood starlets and wealthy suburban housewives or could it even be for this budgeting writer? Dr. Ingber says his clients are "amazingly diverse," ranging from the upper middle class to some you'd never imagine. "We see a lot of people who don't seem to be interested in makeup and fashion, yet they're very interested in Botox."

For those he treats, Dr. Ingber says Botox is rarely a gateway to plastic surgery, creating an endless cycle of addicted never-satisfied women. Dr. Ingber says that while Botox is often an entry-level procedure with some patients moving on to try some dermal fillers or laser treatments, most patients who come in for these procedures are trying to avoid surgery, not progress to it.

Of course there are some warnings. Aside from the 200-500 bucks you'll be draining from your wallet, possible side effects include bruises that can appear with any injection or headaches. Some patients have reported a droopy eyelid that can last between one to three months, but Dr. Ingber says that's never actually occurred in his practice.

A couple of other things to consider:

• As with any medical procedure, it is important for women to have a competent practitioner fully explain all of the risks and benefits of the procedure. Not any doctor will do Any physician can legally do Botox but it's best done a doctor who is well-versed in the facial musculature like a plastic surgeon or dermatologist. (Know a dentist who injects Botox? Probably not the best idea.)

• Know your med spa Some offices who do Botox are actually staffed by registered nurses who have the use of a doctor's name but don't actually have a physician overseeing the process. Dr. Ingber says it's important for a doctor – or at the very least, a nurse practitioner – to examine the patient and determine the course of action.

• Botox is not advised in pregnancy as there is no data on the safety.

In Dr. Ingber's experience, most doctors know what they're doing. "Complications I've seen coming from other offices that have injected Botox are ones where the physician isn't present. I never see someone come out of another doctor's office with a big problem."

And, like many procedures, Dr. Ingber advises that Botox is not for people who are taking certain medications and those with certain neuromuscular disorders. It's always recommended that patients share medical history with their doctor.

This article was reviewed by Dr. Steven Johnson, MD
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