In a society that is obsessed with youth but scornful of anything artificial, wrinkle-smoothing Botox has been many a woman's not-so-well-kept secret. Hollywood celebrity Courtney Cox, 47, famous for her role as Monica Geller in the U.S. TV sitcom Friends, is one of few exceptions. Amid denials and criticism—Julia Roberts is a critic—Cox told a U.S. magazine last year that she uses Botox "sparingly."
Many have benefited, but few proclaim it. In the local entertainment scene, tabloids like to speculate on Botox users. But except for Charice Pempengco's controversial procedure, supposedly to prepare for her role in the hit U.S. TV show Glee, local celebrities have generally chosen to keep quiet about it.
Is it a poison?
Botox, the most popular brand of botulinum toxin type a, is a substance responsible for botulism, which causes food poisoning that may lead to paralysis or death.
"For cosmetic indications, one cannot overdose with [Botox], if done by a board-certified dermatologist or plastic surgeon," explains dermatologist Camille Angeles, M.D., medical affairs manager of Allergan Philippines and member of the Philippine Dermatological Society. "It is a purified toxin or protein whose action is limited to the injected muscles only," she adds.
Allergan is the company that makes Botox, which was approved in 2002 by the U.S. Food and Drug Administration (FDA) for the removal of certain types of wrinkles. Before that, Botox was medically useful in managing twitchy eyes and other muscles spasms typically experienced by patients with cerebral palsy.
Presently, facial wrinkle treatments generally require 30 to 60 units of Botox shots. Anywhere near 360 units may result in overdose, which could lead to life-threatening problems in swallowing and breathing. For safety, the toxin is not advised for pregnant and breastfeeding women.
Flat, emotionless face
At the end of the day, it's really about preferences. The natural-versus-artificial debate is as old as the invention of hair dye.
What's really giving Botox the bad name are the "frozen faces" sometimes—if not often—seen among celebrities. In one interview, Julia Roberts decried the lack of flexibility that can dilute the expression of authentic human emotion, such as happiness or anger.
Dr. Angeles says it really depends on what the patients want. "Some patients just want softening of their wrinkles; they still want to have some muscle movement. Some patients want a ‘frozen look,’ or no lines at all. So a good doctor would ask the patient what she wants," she explains.