I tried botox to reduce my facial tics

Why I did it

Like many people with Tourette's, I have quite a few facial tics that can make it harder to function. There were two tics in particular I was hoping to decrease with Botox.

The first is an eye tic which involves moving my forehead in such a way that it rubs my eyelashes against my eyes. Along with the fact that this looks very unattractive, when it is bad it can cause headaches, trouble focusing, eye pain, and impaired eyesight. The second is a tic which involves making an 'E' shape with my mouth. This tic often happens in conversation, leading to a lot of awkward pauses.

For the past year, I had been thinking about trying Botox for my tics after reading studies which showed its effectiveness at treating certain facial tics. I finally decided to go for it because I was going to present my paper at CVPR, and I was worried that my tics would inhibit my ability to give a good talk.

So why might botox help? My tics are proceeded by an urge to tic until it feels ‘right’ . For my snorting tic, it’s when my airway feels clear, for my eye tic, it’s when my eyelashes rub against my eyes. If I can weaken the muscles which are used in a tic, then it could make it impossible to do the tic ‘right’, then the urge to tic goes down.

The process of getting it

Full disclosure, I've had Botox before for cosmetic purposes, so I already had a clinic that I was comfortable going to. I could write a whole other essay on my internal struggles with deciding to try cosmetic procedures, but I will stick to what I think are the most salient points.

In my experience, clinics which specialize in these minimally invasive cosmetic procedures feel much more like a Sephora than a doctor's office. While the nurses are great, it's hard to fully trust they are not trying to upsell you, so I would recommend doing research on exactly what procedures you think you would be interested in before hand. Another useful thing to know for people who don't have experience with these types of procedures is that after your consultation, nurses will often offer to give you Botox at that same appointment.

When going in for Botox for my tics specifically, I was nervous that I would be turned away because Botox isn't FDA approved for tics, but it was much easier than expected. Turns out if you are willing to pay for a lot of botox, your nurse is very willing to help you out. After I showed her my tics and explained that any reduction in movement would help, she explained the different places we could inject to reduce movement in my forehead and lower face, and I picked the places which lined up with what I had researched. In the end I got botox in my forehead, frown lines, eyebrows, crow’s feet, chin, and marionette lines.

It’s a lot of botox. My thought process was to throw everything at the wall and see what sticks (not saying that I recommend this tactic). 

How much was it

In total it cost just under $1000. Some insurance providers may cover parts of this, but mine does not.

Results

1-3 days after the procedure I didn’t see any decrease in my tics nor did I feel any real restriction of movement in my face. 

After 3 days, I noticed my chin didn't dimple, it was harder to make an 'E' face, I could barely move my forehead up and down, my crow's feet were gone, and I could not push my eyebrows together to make a frowny face. My eye tic did decrease, but my lower face tic got worse because I was trying even harder to make that 'E' face.

Surprisingly, I found the inability to move my eyebrows together incredibly annoying. Probably not the most relatable analogy, but it felt very similar to if you had glue or one of those peel-off face masks on your eyebrows. I'm a very expressive person, so I was frustrated that I couldn't express certain emotions like confusion with my face. My annoyance was at around a 5/10 for a week; since then, it's been sitting at maybe a 2/10.

So the big question: how are my tics now? I am pleased to say that my eye tic is nearly gone and my mouth tic has decreased around 30%, although I am unsure if the decrease in my mouth tic is from the Botox. As a bonus, some of my other facial tics look much less noticeable now, and I did give a great talk at CVPR :)

A concern that I had before getting Botox was that my other tics would increase or that I would develop new tics. While I haven't noticed an increase in my previous tics, I have developed a new tic which is, hilariously, trying to move my eyebrows together. On the spectrum of how disruptive my tics are, this one ranks near the bottom, and it's barely noticeable because, you know, I can't actually move my eyebrows together.

Will I do it again

I would definitely do it again if there was a tic that was particularly bad and getting Botox might help reduce its frequency, but I wouldn’t say this is a miracle cure. My advice for anyone considering Botox for facial tics is to research if your tics use one of the muscle groups that Botox can be injected into. I have quite a few tics like snorting, eye rolling, etc., which Botox wouldn't help with, and it's an expensive process to have no results. I have recently been trying CBIT (comprehensive behavioral intervention for tics) to help reduce all of my tics and would recommend trying it out before exploring more invasive procedures. 

Lastly, if you’re reading this and you’re my mom, this was all a joke.