Ask Dr. V

Q: How do I determine if and when to start Botox injections?

A: I get asked this question often. Botox is the number-one cosmetic procedure performed in the US. It is approved for the treatment of facial wrinkles, excessive sweating, and migraine headaches. Botox is approved for people ages 18 to 65, but only because that was the age range of the patients used in the FDA studies. I have personally treated patients from ages 12 to 88.Men and women of any age can have wrinkles and lines as a result of dynamic muscle movement in-between the brows, on the forehead, and around the eyes. This can make us look tired, mad, or sad, even when we are feeling just fine. Botox was the first of three drugs approved in the US to treat lines by temporarily relaxing the muscles underneath the skin. This “valium for the face” leaves you visibly refreshed for up to four months.

The best time to start getting treatment can be when the wrinkles you want to treat are minimally visible, thereby preventing a deep line from forming. If you start treatment after a wrinkle is fully formed, you can still decrease the age of your appearance while preventing further lines. The decision regarding when to start Botox treatment is a very personal one. Done correctly, everyone will notice how great you look, but no one will know you have had Botox injections. Consult your physician or go to

Most of us lead busy lives and want to make healthy snack choices to give our bodies the nutrients and energy we need to keep us going. Reaching for an energy bar is an attractive choice for its portability and convenience, and bars can contain fiber and protein to keep us feeling full. Some bars are so tasty they may satisfy our chocolate cravings. An energy bar may seem like a quick and wise choice, however, this may be just the kind of fix to avoid. So what is the problem? Energy bars can be full of sugar and some give us over half of the maximum daily limit of dietary sugar. This is comparable to eating a candy bar and may not be the best dietary choice. So if you are looking to find a sustainable snack to satisfy your hunger throughout the day, grab almonds and walnuts. Eating fresh is the best way to give your body the nutrients it needs for peak performance throughout the day.



Do you dream of full, luscious lips? Lip augmentation is a very effective way to give your lips the smoothness and plumpness you may have lost or always wanted. The injectable dermal fillers, made out of an all-natural sugar, are the most common method of lip augmentation. Restylane is the only FDA-approved injection for the lips, but Juvéderm is another popular option. Both products can give a beautiful, natural look to the mouth when injected in an artful way, and these fillers dramatically improve the appearance of your lips by adding the shape, structure and volume you want. Worried about ending up with “duck lips?” I think the best approach is to find a picture from a magazine or the Internet of the lips you want. Take the picture to your appointment with your physician and discuss your personal options. Results last up to one year.


Living an active lifestyle is something we all desire to achieve, but our constant activity can do damage to our toes. Running, hiking and even walking, all contribute to constant friction on our toes, which can result in toenail trauma. No one wants to sport a sandal or open-toe shoe only to reveal such an injury. Signs of trouble in the toenail include splitting, thickening, looseness, white spots, and bleeding beneath the nail bed. It takes about four months for an injured toenail to regrow, if it does at all, so prevention is key. Keep your nails trimmed short and file the edges smooth so as to prevent ingrown toenails. It is important to wear properly fitting shoes and thick cotton socks to prevent trauma to the nail bed, especially when performing activities downhill.

Finding the perfect concealer can be difficult. When you are looking for redness coverage, under eye lightener, and long-lasting wear, it may seem unrealistic to find an affordable, “all-in-one” product. Boi-ing concealer by Benefit Cosmetics is called the “world’s best concealer,” and truly does it all. This award-winning concealer comes in five easy-to-match shades, imparts a seamless, natural finish—and won’t break your bank. Available at Sephora. $20


About The Author: Dr Elizabeth VanderVeer MD