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While the stigma around plastic surgery and, more specifically, injectables, has faded significantly over recent years, few celebrities talk as openly about their experiences with it as Jenny Mollen.

The mother of two, actress, and the New York Times bestselling author of I Like You Just the Way I Am has cultivated huge followings on Twitter and Instagram—The Huffington Post has recognized her as one of the funniest women on both platforms—simply by being herself. And a notable part of that is her love of injectables, particularly Botox.

“Whenever I need it, I just gotta go in and replenish. I don’t ever plan it. I just think of it as an ongoing situation,” Jenny Mollen said of the frequency with which she gets Botox injections in a recent interview with Allure magazine. “I like to think of my Botox situation as I’m in school year-round.”

The 40-year-old Mollen often shares those occasions on her Instagram Story. Even in this age of increasing candidness and acceptance, Mollen’s transparency is striking. But for her, it’s the only way she’s ever known. Her parents, she said, were always fans of cosmetic enhancements, so she was never exposed to the stigmas against fillers.

“When I saved my placenta, my mom was like, ‘Can I have it to inject into my face?’” Mollen said. “I’m like, ‘I’m pretty sure that doesn’t happen, but where are you going to get that done?’”

Mollen tried Botox for the first time at age 29 and immediately understood the difference it could make in her appearance. “That was the first time I started to think, OK, wait, this could look softer, or I could get rid of this line. Or, maybe if I did a little bit up here, these lines wouldn’t be so intense when I was raising my brows and just emoting,” she said.

She insisted, however, that it wasn’t insecurities about her appearance that led her to that moment. “No, I was just like, Wait, this could be better,” Mollen said. “Always in life, I’m like, Oh, is there something that would make this look a little bit more to my liking? It wasn’t really, Oh, I hate this about myself. It was, Let me see what I can do.

“I think you just kind of have to accept and embrace what’s happening to you naturally,” she said. “And, if there’s something that you can maybe lessen, cool. But you sort of have to just ride the wave. That’s the exciting part about living in this age—solutions are popping up all the time.”

“This is what I tell friends and doctors, facialists and nutritionists, make-up counter employees, concerned Instagram commenters, nosy strangers on the street. No, I am not tired. No, I am not sad. I am not hungover or hungry. I don’t have celiac disease, and there is no black mold in my apartment. You might not know it from looking at me, but I like my life.”

Alice Gregory is plagued by dark circles under her eyes. She wrote about her plight recently for Allure magazine. On bad days, she writes, they’re the same color as “fresh bruises.” She’s spent hundreds of dollars on concealers and untold hours applying them. “Some,” she says, “are better than others, but all produce, to various degrees, a creepy, crepe-y grayness that looks worse, in my opinion, than my bare, discolored skin.”

So she set out to find a more effective remedy.

While under-eye circles are partly genetic, a number of external factors, including diet, lifestyle, and allergies can make them worse. As can aging. As we get older, the fat pads all across our face get smaller and move down. It’s particularly noticeable under the eyes because the skin around the eyes is the thinnest on the body.

Which is to say that under-eye circles are one of the earliest signs of aging.

At only 31, Alice had already noticed that her under-eye circles had worsened over the last few years. The effect, she was told by a dermatologist, was being heightened because brownish splotches, AKA hyperpigmentation, had also formed around her eyes, caused in part by eczema.

Alice was presented with a few different options that could potentially improve her circles. Platelet-rich plasma injections—blood is extracted from the patient, spun in a centrifuge to increase its platelet concentration, then injected into the targeted part of the body—and microneedling would boost collagen production, which would thicken the skin under her eyes enough that fewer blue blood vessels could show through.

The most effective approach would be blepharoplasty, or eyelid surgery. For those who have protruding fat pads under their eyes, like Alice, the fat can be redistributed in the lower eyelids to eliminate puffiness or bulges. In the process, the surgeon may also make adjustments to correct special issues, like muscle laxity.

Alice opted for a less-invasive approach: a hyaluronic acid filler, like Restylane-L or Juvéderm Vollure, “robust enough to lift but soft enough to be used in a delicate area,” as her doctor describes them. The results would last about a year.

“My three most attentive female friends confirmed I looked a lot better, but only after I reported what I had done to myself; my husband didn’t notice anything at all, which, when I think about it, is exactly the reaction I had wanted but not articulated,” Alice writes. “The dark circles are still there—let’s not kid ourselves. But they’re less the result of ever-worsening facial cavities and due more to hyperpigmentation, which is slowly improving. I now look a little tired rather than agonized.”

As straightforward as injectables may sound, it’s still a good idea to do your homework before booking a consultation with a board-certified plastic surgeon. To help with that endeavor, I noted a couple of points to home in on in my last blog post: your budget, the injector, and the product that will be used. We’ll finish the discussion here with a couple more considerations.

Preparation and recovery

All injectables tend to be lumped together because they’re minimally invasive and can be done in minutes, but there are some important differentiations to be aware of. Botulinum toxin type A (Botox, Jeuveau), for example, require no preparation, and the only restrictions afterward are not exercising or putting your head down for about four hours.

Fillers, on the other hand, can cause slight bruising and swelling, particularly in sensitive areas like the lips. So it’s a good idea to schedule appointments at least 48 hours before a major event. You should also stop taking any ibuprofen and fish-oil supplements two weeks prior to getting a hyaluronic acid filler because they’re blood thinners that can increase the likelihood of bruising and swelling.

How long the results will last

The most common question that comes up during a consultation for an injectable is: How long will the results last? That’s influenced by several factors, including the product that’s used, how much was injected, and where it was injected. Generally, botulinum toxin type A lasts around four to six months, while hyaluronic acid fillers last anywhere from six to 18 months.

On the flipside of that response, if you don’t like the results, hyaluronic acid fillers are reversible. An enzyme can be injected that will dissolve the filler within 24 hours. Botulinum toxin type A is not, however, which is why it’s a common practice for plastic surgeons to have their first-time clients come back a couple weeks after their injection to reassess the results and touch up with more if needed.

Setting your expectations

Perhaps most important to this entire process is managing your expectations. If your goal is Angelina’s lips, or Kim’s cheekbones, or a 20-years-younger version of yourself, you’re bound to be disappointed in the end. While it never hurts to have a source of inspiration, the aim of most plastic surgeons, particularly where injectables are concerned, is to enhance your natural features.

Your focus may be solely on Kim’s cheekbones, but your surgeon is considering how they’ll fit within your own anatomy and modifying them accordingly. We see your face in a three-dimensional way that can be very different from how you register it. So, be willing to listen to their recommendations, even if they’re not something you initially thought of.

According to the American Society of Plastic Surgeons, there were nearly 7.5 million injections of botulinum toxin type A (Botox, Jeuveau, Dysport, and Xeomin) in 2018, the most recent year for which data’s available, and well over 2.6 million filler injections, making them the two most popular minimally-invasive cosmetic procedures performed in the United States by a pretty wide margin.

In other words, if you’re considering going under the needle, you’re in good company. But, as straightforward as an injection may sound—relatively quick procedures, little to no downtime—it’s still a good idea to do your homework before booking an appointment. To help with that, I’ll review a few things in this post and the next one that you should be considering.

Budget

You may already have noticed that there’s a lot of variation in pricing for a cosmetic injection. Much of that depends on the product and where you live. That said, you get what you pay for when it comes to injectables. If a price seems especially low, like a Groupon for $50 Botox, that’s a red flag.

As interest in injectables grows by leaps and bounds, so, too, does the fake-filler market. It’s become all too common of a practice to dilute the product, which enables the injector to offer it well below the average price, but it also makes the product less effective—and potentially harmful, depending on what it’s diluted with. And illegally-purchased black-market knockoffs from China have given rise to a growing population of self-taught injectors.

Excited as you may be over the chance to save some money, you’ll likely end up spending more in the end when you factor in the inevitable corrective treatment. For the best results, wait until you can pay for an injection provided by a board-certified plastic surgeon.

Injector

Narrowing your search to only board-certified plastic surgeons is a good start, but then you’ll want to filter it further by digging a little deeper and seeking out those who have experience in the specific procedure you’re interested in. So much of the success of these kinds of cosmetic treatments depends on who is doing them. The remainder is dependent on the product—more on that in a moment—which makes the injector’s expertise even more critical.

Schedule consultations with more than one plastic surgeon, and don’t be shy about asking how long they’ve been doing this particular procedure and how they were trained. It should also be helpful to see before-and-after photos of their patients, not just those from a brochure for the product.

Product

The range of available cosmetic injectables is likely much larger than you’re thinking, so it’s important to learn as much as you can about your options before sitting down with a plastic surgeon. Botulinum toxin type A is a good example. It’s often referred to as Botox, which is the oldest and most widely-used brand, but it isn’t the only neurotoxin out there. It’s like calling all tissues Kleenex. Once you know the true extent of your options, you’ll be better positioned to ask your injector which one they plan on using and why.

The demand for preventative, minimally-invasive procedures—particularly among millennials—has never been higher, according to the recently released annual survey from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).

The survey looked at both surgical and minimally-invasive procedures, both of which experienced a significant increase compared to 2018. According to the results, the total number of facial plastic surgery procedures increased by 6% between 2018 and 2019. The year’s most widely performed procedures included rhinoplasty, facelifts, and blepharoplasty (surgery to correct drooping eyelids).

The upward trend was even more prominent among nonsurgical procedures, which increased by 13% over 2018. In fact, minimally-invasive procedures represented 85% of all the procedures performed by those surveyed.

The three most popular minimally-invasive procedures, in order from most to least, were neurotoxins (Botox, Jeuveau), fillers, and skin treatments (lasers and facials). While Botox has been the most popular procedure among patients ages 35 to 55 since 2013, skin treatments experienced the largest growth, with a 39% increase over 2018.

Our fascination with celebrities deepens

It’s been widely reported that our selfie obsession is having a direct and noticeable impact on cosmetic surgery trends, and the AAFPRS survey continued to reinforce that idea. Among those surveyed, 72% reported seeing patients who sought cosmetic procedures in order to “look better for selfies.”

Though, celebrities proved to be an even greater influence, with 84% of those surveyed agreeing that celebrities have a “moderate-to-great” influence on facial plastic surgery trends, a 6% increase over 2018. Cited as the most influential of them all: Kylie Jenner, Kim Kardashian West, Brad Pitt, and Bradley Cooper.

It wasn’t included in the survey, but there’s also something to be said about the cross-section between social media and celebrities. “Social media gives us intimate access to people that we otherwise would not have any contact with,” Mary Lynn Moran, MD, president of the AAFPRS, told Allure magazine. “Increasingly, people are willing to share what procedures they have done to look the way they do, which destigmatizes the subject. As we study what subtle and more dramatic changes can do to improve someone’s appearance, we become more educated about what we are drawn to and are more likely to elect to make changes in our own appearance.”

‘Prejuvenation’ is the future

When asked to predict future trends, survey respondents overwhelmingly (73%) cited preventative treatments among millennials, or “prejuvenation,” as they’ve been dubbed. The idea behind the concept is that having minimally-invasive treatments at a younger age will help stave off the need for surgical interventions later in life.

How conscious are you of your jawline? Probably far more than you’d like to be. Whether you choose to stick your chin out or press your tongue against the roof of your mouth in photos and, as often as you can, in person, you’re constantly accommodating. And you’re not alone. Just about all of us do it, to varying degrees.

Our skin begins to thin in our 20s. Around age 50, we start losing bone, fat, and muscle in our jaws, which can have the effect of making the jowls look looser and much more prominent. For a long time, the only procedure that could do anything about them was a facelift. But now there are a number of noninvasive ways to get the capital-V jawline we covet.

Filler

Believe it or not, a stiff filler—yes, fillers have different consistencies—like Radiesse or Restylane, can compensate for a shrinking jawbone. Injections in the jaw under the chin and ears can add structure where the mandible bone has shrunk. If further support is needed, injections can be placed all along the jawline, which should be sufficient to lift and smooth the entire jaw for someone with mild to moderate sagging.

Kybella

Sun damage and genetics are two of the main causes of aging skin. On top of that, gravity is constantly working against your jaw (and breasts). A pocket of fat under your chin, AKA a double chin, only compounds matters. We can’t undo gravity, but there’s a simple solution for the double chin. Kybella is an injectable, synthetic form of a fat dissolver that exists naturally in your body called deoxycholic acid.

Essentially, Kybella breaks down fat cells so they can be flushed out of the body by your circulatory and lymphatic systems. It’ll not only get rid of your double chin, it’ll also tighten tissue around the injection site, which could help stave off sagging over the long term.

Radiofrequency

Different kinds of noninvasive radiofrequency treatments, like Thermage, heat up deep layers of the skin, which causes controlled damage that stimulates new collagen and ultimately firms the skin. Many who use it for tightening aging tissue along the jaw do so in combination with fillers to achieve a capital-v jawline.

Botulinum toxin type A

If you’re more concerned about a square jaw than sagging jowls, injecting a botulinum toxin type A, like Botox or Jeuveau, into the muscles at the edge of your jaw will relax the muscle, narrow the lower half of your face by a couple millimeters, and smooth the jaw. It’s proven to be an especially effective treatment for teeth grinders, whose jaw muscles can bulk up over time. As a secondary benefit in that instance, relaxing the muscles also usually relieves the chronic headaches caused by grinding.

Botulinum toxin type A—better known by its brand names, Botox, Jeuveau, Dysport, and Xeomin—is the most popular cosmetic treatment in the United States. But, as much as it continues to find new audiences (the number of procedures performed grew 845% between 2000 and 2018, according to the American Society of Plastic Surgeons) and new uses, including the treatment of migraines and hyperhidrosis, there remains some trepidation (and a little confusion) among those still wondering, “Is it right for me?” So, here, I’ll answer the questions about Botox that are difficult to Google—and sometimes even harder to ask in person.

Will Botox make my face look frozen?

It’s a concern that comes up more often than you may think. Botox is designed to soften or temporarily erase horizontal forehead lines, vertical frown lines, and crow’s feet—essentially, the creases that form from squinting, frowning, and smiling as the skin begins to lose its natural elasticity.

Yes, it does paralyze the muscles responsible for those expressions, but it will not affect the nerves that cause sensation. So, you shouldn’t feel any numbness. Nor should your face look like it’s frozen. I know there’s no shortage of images online of women and men who obviously look frozen following treatment, but that’s the result of poor technique, not the Botox itself. Which is why it’s important to be treated by a board-certified plastic surgeon who can accurately gauge the size of your muscles and how much Botox you’ll need.

Does it hurt?

Like most injections, you’ll likely feel a short-lived pinch, especially between the eyebrows. Some doctors apply numbing cream 10 minutes before the procedure or ice the area to numb it. Either is usually enough to minimize any sensation during the injection.

What can I expect the day after my procedure?

Generally, not much of anything. Everyone’s a little different, but, for the most part, you should experience little to no discomfort, and there’s no downtime. Results will usually begin to show within four to five days after the procedure. After that point, they’ll continue to develop gradually over the course of the next two weeks. If you’re planning to get Botox before a big event, schedule your procedure about two weeks ahead of time.

Will my friends and coworkers know I got Botox?

Possibly. Once you see the full effects of your results, you’re going to look undeniably fresher and perhaps younger. As long as you’re happy with the results, you’re probably going to find that it won’t matter to you as much as you think it will if your friends, family, and coworkers can tell. Much of the stigma that once surrounded Botox has fallen away, which is one of the biggest reasons for its surge in popularity. Every day, men and women are turning back the hands of time, and they don’t care who knows it.

With warmer weather on the horizon, many of us are weighing the same concern: Where exactly do you draw the line between normal and excessive sweating? And, is it safe to get sweat-halting Botox injections before a big occasion, like your wedding? As it turns out, excessive sweating, or hyperhidrosis, is more common than you think.

Unpacking hyperhidrosis

There are two types of hyperhidrosis: primary and secondary. Primary is the more common of the two. It’s a result of overactive signaling from the sweat glands to secrete sweat. In other words, your body starts sweating without any clear reason. Primary hyperhidrosis can occur at any time and during any point in the year. You don’t necessarily need to feel warm. You can even be asleep when it happens.

Most commonly, it’s seen in the underarms, palms, and soles of the feet, though it can happen pretty much anywhere on the body, including the face.

Secondary hyperhidrosis, by contrast, is excessive sweating that’s brought on by an external factor, like medication or a physical condition, such as diabetes or a thyroid issue. With both types, there are also different degrees of hyperhidrosis: mild, moderate, and severe. Sweating through your shirt without doing much of anything on a temperate day would usually be classified as moderate hyperhidrosis. Severe is something along the lines of pouring sweat from your hands and feet when you’re at rest without any triggers.

When to be concerned

Now that we have a clear idea of how excessive sweating is defined, let’s get back to our original question: When is it time to start worrying about your sweat levels?

There’s an aspect of hyperhidrosis I neglected to mention before: It’s a relative disorder. Basically, how you perceive your sweating is very personal. What might be excessive to you is normal to somebody else. So, hyperhidrosis is harder to define than it first appears.

Generally, though, if it’s something you’re thinking about and it’s caused you some level of embarrassment, it’s worth mentioning it to your doctor. There’s no such thing as an overreaction here.

Does Botox really help?

Botox—yes, the same injectable that could help fend off wrinkles between your brow—is the longest-lasting nonsurgical treatment for hyperhidrosis. It’s most effective in the underarm area, where it can work for up to 14 months.

Botox works by paralyzing the nerves responsible for activating your sweat glands, but only in the specific area where it’s injected. You’ll receive several injections with a fine needle that’ll form a sort of grid pattern around the area of concern. It’s a relatively simple procedure that can be done during an office visit. And you’ll be able to resume your day as soon as it’s done.

While sweating does help eliminate waste from the body, it’s safe to get Botox in your underarms (or elsewhere) before a big event, or even to continue the treatment indefinitely. It’s important, though, to consult a board-certified plastic surgeon who can rule out any underlying medical causes.