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America, The Botox Nation? - 2002-06-28

It is a well-known fact that America is a culture that celebrates youth or, if you aren't really young, at least acting and looking that way. Millions of dollars a year are spent on weight loss schemes, health foods and even plastic surgery, all in pursuit of turning back the clock. Now, a new craze has taken hold of the American cosmetic industry.

Botox, a form of poison, is a drug that, when injected, temporarily removes frown lines and other wrinkles from the face. Since its approval by the Food and Drug Administration in April, the demand for Botox has grown so large, so fast, that some people have even referred to the U.S. as "The Botox Nation."

When Botulinum toxin was first introduced by the U.S. army in the mid-20th century, it was as a bioterror weapon - one drop of the deadly poison in a water supply could conceivably kill 10,000 people. Years later, Botox, a sterile, purified form of the toxin, was used to treat a variety of medical conditions, mostly involving muscular spasms and twitches, by temporarily paralyzing the facial muscles. What doctors found was that their patients were more than pleased with the results - not only did they get rid of their facial tics, but the injections also left them looking remarkably refreshed...even younger than their years. The rest, as they say, is history.

"I mean, people are just happier if they feel good about themselves, and I think that's what it's all about, feeling good about yourself," said Marie, 48, a police officer in the U.S. Army. She was one of about 20 women who gathered at a salon in Virginia to take learn more about or receive Botox injections from a registered nurse. These informal gatherings are called Botox parties. Complete with food and wine, they are often held in spas or beauty salons or even private homes - and they taking place in increasing numbers in cities throughout the United States.

At the Bella Donna Salon, owner Lisa Brown introduces some of her new products, and brings nurse and an esthetics specialist Lisa Brewer to the front of the room. Ms. Brewer has come to administer Botox injections for some of the women there.

"With the approval of the FDA for the use of Botox for cosmetic purposes, we have seen an incredible explosion of interest in Botox," she said. "I've been injecting it for patients for almost four years, not only for cosmetic purposes which would be for the furrowed brow or what we call the 'smoker's lines' which are the little vertical lines in the upper lip, but also for migraine sufferers. It's very beneficial."

Lisa Brewer injects Botox into the forehead and corners of the eyes of Judy, a 51-year-old homemaker.

"I'm going to ask you to smile please...little pinch...relax, little sting," she said. "How's that? Not too bad? Now we're going up above, one centimeter, go ahead and smile for me...little pinch, relax, beautiful. Now we'll do the other side."

The procedure, which takes about five minutes, costs approximately $300-$500 and is not permanent - most people return for subsequent injections every three or four months. Still, Judy, who just finished her procedure, couldn't be more pleased.

Robin: "Judy, you just had the Botox treatment, how do you feel?"

Judy: "I feel fine, it feels great. There was no pain, no discomfort. Very quick."

Robin: "What made you decide to do this?"

Judy: "I don't know, I'll be 51 tomorrow and I looked at my eyes and thought, 'Boy, it would be nice to get rid of the 'crows feet' and so, it [the procedure] was on sale - this was a 'special' so I couldn't pass it up."

According to aesthetic specialist Lisa Brewer, Botox injections are safe and there have been no reports of any patients developing botulism or any other severe side effects. However, there is a growing concern that paralyzing one's facial muscles, particularly the area between the eyes, risks a person's ability to change expression naturally - giving them a strange, mask-like appearance.

"I think it's kind of a creepy trade-off, to be honest," said Ellen Goodman, a columnist with The Boston Globe newspaper.

"You trade the ability, literally to express your emotions." You can't crinkle your eyes, you can't furrow your brow, and you trade that for a flawless appearance. I think it's asking you to hide what you feel in order to get approval from others."

Ellen Goodman recently published an article entitled, "Angry at Botox, and Able to Show It."

"I don't think it's the worst thing in the history of the world," she said. "But I think there's something pretty bizarre about going to Botox parties, the way they used to go to Tupperware parties where you're preserving yourself instead of the food! One of the complicated things for me, speaking as a someone of a 'certain age' is that if you keep changing what 50 looks like, you've changed the standard of what that is. And when you have so many women who no longer 'look their age,' you change the whole idea of what age is. And you make it harder for every other non-Botoxed, non-'lifted,' non-collagened woman to look their age."

At the Bella Donna Salon, Sue Reynolds has other, more basic concerns. "I want to be able to frown," she said, "I really do. Because I have to frown at my kids!"

Ideally, people should not be judged on their appearance alone. But nurse Lisa Brewer says most of her clients who request Botox injections are professionals, whose want to look young and healthy in a competitive marketplace.

"Unfortunately, in this country, we do have a problem with age discrimination," she said. "Age is not revered in this country, unfortunately, like some other cultures. And again, you have professionals competing with younger professionals and they want to stay looking youthful for that reason."

At this time, the United States is the sole distributor of Botox, which is manufactured by Allergan, Inc. in Irvine, California. But as Boston Globe columnist Ellen Goodman noted, this will "probably not remain an American phenomenon." As for herself, Ms. Goodman adds, she will continue to "wear her emotions on her sleeve as well as her face."