If you’ve ever been told you are “unapproachable” or “intimidating,” or if you are constantly being asked, “What’s wrong?” you may be suffering from what is commonly referred to as “Resting Bitch Face,” or RBF for short. While the name may be funny, RBF is a real thing characterized by the downward turn of the mouth or the vertical furrows between the eyebrows that can occur as you age. Not only do these changes affect your appearance, but they can also change the way people perceive and interact with you, and the best way to alleviate the problem is to get rid of frown lines.
“I have patients who say they feel like RBF affects their relationships or their ability to accurately convey their emotions,” says Acute Care Nurse Practitioner Tamara Wong. “They report to me that others ask them why they are always sad or angry, when in fact they feel happy and content.”
While you can’t stop time, you can take action against RBF and return your face to a more cheerful, less pensive appearance. In expert hands, the correct fillers and neurotoxins can be injected in a way that results in a natural appearance and a face that looks fresh, not frozen.
Forehead Frowns: Botox and Beyond
According to Wong, Botox is still the most widely used brand of neurotoxin in the U.S., and with good reason.
“It has the longest history of FDA approval for clinical and cosmetic use,” she explains.
Widely acknowledged as the most effective way to treat “dynamic wrinkles,” which are the ones the occur when muscles contract, Botox is typically the go-to for those pesky Glabellar “eleven” lines that can make you look angry. It works by limiting muscle movement, creating a smoother, wrinkle-free appearance, and is often thought to be the best filler for wrinkles around the mouth.
However, other FDA-approved options have hit the market to give Botox a little competition over the past few years. Products like Dysport and Jeuveau offer similar smoothing results and with a lower price tag. Before deciding which one is right for you, there are a few things to consider. First, while the results may be similar, the consistency may not be. Dysport, for example, is made up of smaller molecules than Botox, giving it greater “spreadability.” According to Wong, that makes is a good choice for crow’s feet where spreading could be beneficial, but maybe not for the forehead or “eleven” lines where spreading could cause the dreaded “droop” or other undesired effects.
“I would say that Botox’s spread is ideal,” she says, adding that she has used all of the brands with “lovely results.” “I can manipulate it to modulate the amount of spread I can achieve.”
Then there is cost. Budget is a significant factor for many women when it comes to injectables, but don’t be swayed only by the price tag. Some of the newer offerings may cost less per unit ($5-$10) than Botox ($10-$15), but it might take more units to achieve the same effect, resulting in less of a “deal” than you initially thought. A skilled practitioner can help you choose the product that is right for you and your budget.
Don’t Let Laugh Lines Drag You Down—Filler Up!
One of the most tell-tale signs of RBF is the “perma-frown,” the drooping that occurs in the lower half of the face. The loss of elasticity, bone density, and fat as you age can cause the skin to sag, making you look tired and sad. Then there are the deep nasolabial folds, or “parenthesis” lines, that run from the corners of the nose to the mouth, as well as the “marionette” lines that run from the corners of the mouth to the chin. These are the two most common areas that Wong addresses through the use of fillers.
There are many types of fillers on the market, and, like neurotoxins, some work better in specific areas due to their composition. Wong recommends soft fillers like Vollure or Juvederm for directly treating the lines. These hyaluronic acid fillers are smooth and malleable, with results lasting approximately one year. It typically takes at least one syringe of filler to correct marionette or nasolabial folds, with costs averaging around $650 per syringe.
Injecting fillers directly into these areas will definitely improve the appearance of the lines and folds that can drag you down, but sometimes that isn’t enough. In fact, just treating the lower face alone can cause an overall imbalance.
“The lines or folds are caused by loss of support in the mid and upper face,” explains Wong, who turns to a stronger filler like Voluma, injecting it into some upper parts of the face to lift the folds and improve facial balance. “I would consider one syringe of Voluma per side to achieve the desired effect,” she says, adding that each syringe costs approximately $800, with results lasting up to two years.
Keep It Up
Nothing lasts forever, including your injectables. But there are some things you can do to extend their life and keep your skin looking its best. First, and most important, Wong says to shun the sun. SPF is your best friend in the fight against not only aging but also skin cancer so slather it on 365 days a year. She also recommends eating well, staying hydrated, and exercising. There are plenty of topical products on the market that, although they don’t offer the same immediate or dramatic effects as injectables, can temporarily improve your appearance and, over time, create improvement in texture and elasticity. Finally, once you decide to go under the needle, take a “less is more” approach and do your homework when it comes to whose hands you place your face in.
“More isn’t always better,” cautions Wong. “Good injection technique and artistry results in naturally attractive proportions and believable results.