My boys and I recently watched a DVD called "Christmas With the Kranks." It stars Tim Allen and Jamie Lee Curtis as Luther and Nora Krank, a suburban couple going through empty nest syndrome and, in the case of Luther Krank, a simultaneous mid-life crisis. About half way through the movie there is a scene that had me in tears and floored with laughter. Luther had apparently just received botox prior to meeting Nora for lunch to discuss their plan to boycott Christmas. Tim Allen does a very amusing, albeit exaggerated, take on someone post botox treatment. He can’t move his face, chew or swallow so food is falling out of his mouth and his drink is dribbling all over his spiffy new outfit. I can only imagine what it would’ve been like to be Jamie Lee Curtis or the cameraman filming that scene and trying not to laugh out loud at every take…

This reminded me of a request made by patients in my practice. It’s not uncommon for them to come in requesting botox "all over" so they can look more youthful. Although botox for cosmetic purposes is primarily used to soften the forehead lines, the lines between the brows and the crow’s feet, there are cases where I will use botox in other parts of the face and neck. If done skillfully, botox can

- improve the appearance of conditions such as a "gummy smile" or high lip line;

- soften marionette or "puppet lines" lines;

- improve the "pebble" appearance of the chin;

- lessen the appearance of the upper lip or "smoker’s lines;"

- diminish the appearance of hyperactive neck lines or "platysmal bands," especially in athletic people and

- correct a facial deformity/distortion due to injury or trauma.

Botox for such purposes is done on a case by case basis and usually in conjunction with other cosmetic procedures such as facial fillers. Of course injecting these lower facial muscles with botox can be risky and should be done by averyexperienced cosmetic doctor. Otherwise you may end up looking like Tim Allen in "Christmas with the Kranks!"

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