Smile--You're On Botox!

By RICHARD CORLISS

Let's hear it for wrinkles--for those fabulous frown lines and high-kicking crow's-feet. What crucial moods they so subtly express! With a slight tightening of the skin between the eyebrows, bosses can communicate killer exasperation. Moms, salesclerks and 30-ish women at singles bars can signal displeasure without raising their voices. And consider the alpha male: why, Clint Eastwood with an unlined face would just be... Dick Clark. Wrinkles were surely what George Orwell had in mind when he wrote that at 50 everyone has the face he deserves.

That Orwell--he was so 1984. Today, when Youth is a secular religion and a huge industry, you can choose your favorite age and, with the help of wonder drugs, stay there. So let's join the 21st century and hear it for Botox, which may soon guarantee that at 50 everyone will have the face she, or he, can afford.

Botox: short for botulinum toxin. The name won't make you smile, but the injection can keep you from frowning. A decade ago, the toxin that causes botulism (a form of food poisoning) was a treatment only for spasmodic eye muscles. Then doctors saw that it also smoothed skin. Now it is the most popular cosmetic procedure, with more than a million injections in 2000 (according to the American Society for Aesthetic Plastic Surgery), 89% of them to women. Botox is just the thing to erase worry and anger lines, to take years and cares off the most fretful visage. And all for $300-$1,000 a shot, compared with a $15,000 face-lift. "Advertisers can present this as a face-lift in a bottle," says Norman Shorr, a Beverly Hills plastic surgeon. "This is a true miracle drug. It really works."

The Food and Drug Administration may shortly agree. Botox, made by the Irvine, Calif., pharmaceutical firm Allergan, is expected to win FDA approval--but only for removing frown lines, not for the full facial makeover. According to a source close to Allergan, if the company had applied for multiple places to use Botox, it would have been required to conduct more expensive clinical testing. Either way, doctors will still inject you all over.

Any miracle has skeptics, and Botox has earned its share. Dr. Robert Butler, president of the International Longevity Center, worries that "no one will look as if they have facial expressions" and that repeated use of the drug, which requires an injection every few months, could "create a psychological dependence." Down-market clinics could flourish, offering the drug for $100 by diluting it, thus causing creepy side effects. Dr. Debra Jaliman, a dermatologist who teaches a Botox course at Manhattan's Mount Sinai, is a proponent of the drug but has corrected nasty complications from other doctors' misapplied injections: "Eyelid droop; slurred speech, as if they've had a stroke; dropped mouth; asymmetrical forehead; eyes that don't shut."

Warnings won't scare off the folks in Hollywood. "I live in a town completely devoted to vanity," says writer-actress Carrie Fisher, 45, who has been Botoxing for five years. "It irons out the wrinkles. You'd never know I was manic-depressive." Danny Bonaduce, 42, a child actor (The Partridge Family) turned co-host of The Other Half, was accompanying his wife to a Botox session when her doctor asked him if he wanted some. "Three days after I did it, Dick Clark said to me, 'You look 10 years younger!' With Botox, people can't really tell what you've done, just that you look better." (Pssst, Danny: now they know.)

But the trend has spread beyond the beauty-fanatic media world. Patty Reimerdes, 50, a divorced mother of two from Queens, N.Y., had her first Botox procedure last week and pronounces herself pleased. Reimerdes says she doesn't mind being 50: "I just don't want to look 50." And so what if your face freezes up a little? As Fisher notes, "It's good for poker."

Of course, if everyone gets Botoxed, the minority now using the drug will lose its competitive edge; no one will look younger or more serene than anyone else. But then, who cares if you're unhappy, as long as you're incapable of showing it?

--Reported by Leslie Berestein/Los Angeles, Wendy Cole/Chicago and Charla Krupp and Heather Won Tesoriero/New York

With reporting by Leslie Berestein/Los Angeles, Wendy Cole/Chicago and Charla Krupp and Heather Won Tesoriero/New York