Gentle Suggestions

This is not an advice column

Should I get botox? I feel like every women I know my age (33) is getting it, and I am not blind nor above vanity. I like my wiry grey hairs, until I don't and I get my hair colored. I use benzoyl peroxide and clindamycin on my face twice a day to prevent acne. I know my face has visibly aged, and I can't help envy the smooth foreheads surrounding me. I fear that five/ten years from now, I will look way older than people my age who did get botox.

However, as someone who has survived major depressive episodes and (CW) suicidal ideation, part of me wears these wrinkles and furors as a badge of pride. Like, I made it through a global pandemic and the first Trump presidency and damn it if I don't make it through the second. Aging, especially with family and friends and loved ones around me, is such a gift, one I do not take for granted. Also, for what it’s worth botox is the same stuff that causes botulism, and putting that into my body feels questionable.

Or...is it just not that deep, and I am way overthinking a cosmetic enhancement?

Crème de la Crème really tries to stay in her lane and will readily admit when she doesn’t understand something.

I do not understand being in your early 30s and being afraid of looking old. You are young! Something about this preoccupation feels very caucasian and that is not my lane.

However, depression and suicidal ideation are absolutely my lane.

I am in the middle of a medium to severe depressive episode. Nowadays I like to think of these episodes like they’re a bad cold. I do what I can to make myself comfortable and ease the symptoms but I know that you cannot really cure a cold. Colds need to run their course and they generally resolve within 7-10 days. Reminder: I am not a doctor and this is not sound medical advice. Just the musings of a woman who when her brain is sick sometimes daydreams about walking into traffic or jumping out of a window. I don’t love that for any of us.

Don’t worry. I really am taking care of myself. I’m going on walks, I’m touching grass, I’m not isolating, I’m trying but definitely failing to eat or sleep well. None of this has been pleasant and doing pretty much everything has been a tough slog especially thinking clearly. I really hate it when I cannot think clearly because when I can’t think, I can’t write.

But I know this depressive episode is resolving because today I had a very clear thought about you and this Botox business. Invoking Trump to justify or not injecting cosmetic neurotoxins in your face? This is too much. You’re doing too much.

Where to even start?

According to the American Society of Plastic Surgeons, north of 7 million people in the United States received Botox injections in 2022. This makes Botox the most popular non-surgical cosmetic procedure in the country. It’s cheaper than plastic surgery and makes total sense in the little treat economy.

Botox is also just a brand name like Wite-Out or Kleenex. It’s now become the colloquial term for all botulinum toxin type A injections but there are actually 4 brands of these injections. They all contain the same active ingredient and in 2002 they were FDA approved for the temporary improvement of the frown lines between the eyebrows. They’ve since been cleared to treat forehead lines and crow’s feet, too in addition to all "off label" uses like for sweating or TMJ. I know this because I asked my dermatologist about it and he kindly humored me as I painstakingly took notes. I highly recommend going to the dermatologist in the middle of a depressive episode. It’s very enlightening. Anyway, my dermatologist, he feels very strongly that anyone interested in wrinkle smoothing neurotoxins should discuss it with a board certified dermatologist or plastic surgeon. I know a lot of the girlies do not do this and go to all kinds of clinics and spas instead. I get really stressed whenever a woman I love mentions her “injector” but we listen and we do not judge at Crème de la Crème.

You mentioned something about how it might be “questionable” to put something related to botulism in your body and I did laugh a little because it came so late into your question that we both know that is not really the real concern you have. Like I said, talk a board certified dermatologist about this.

I also said earlier that the framing of your question and your fear really felt very caucasian. I am sorry for saying it so flippantly. I do that sometimes. My sweet friend Curtis Sittenfeld reminded me that I once told her that only white women are afraid of getting old. It left such an impression on her that she included it in her delightful short story collection. I don’t remember telling her this but it sounds like something I would say. Not because it’s profound or true. Quite the opposite. It’s the kind of half baked thought that rattles through my brain in between depressive episodes. In fact, I was in the middle of a milder depressive episode when I read Curtis’ story for the first time way back when. Then the depression left my body and I forgot to reconsider my dumb observation for a more thoughtful one.