By Ellen Creager
Knight Ridder Newspapers
BLOOMFIELD HILLS, Mich. - Drink Chardonnay, nibble hors d'oeuvres, get needles poked in your face.
This lovely evening is brought to you by Dr. Gregory Roche, a Bloomfield Hills, Mich., facial cosmetic surgeon who is trying hard to popularize in the sensible Midwest the fad of Botox parties.
If you haven't heard, a Botox party is where people who hate their wrinkles can get injected with muscle-paralyzing botulism toxin in the forehead, crow's feet or eye furrows in a festive atmosphere.
"It's the hot new thing, like a Tupperware party," says Barbara DiMaria, 55, of Bloomfield Hills, standing in Roche's enormous kitchen along with 12 others intrigued by the nosh and needles. "None of us needs Tupperware. A lot of us need this."
Even Roche's wife, Bonnie, is involved. She made the guacamole, salsa and beef tenderloin. She got the flowers and made the family dogs, cats, parrot and pet raccoons behave.
A few months ago, her husband experimented on her, injecting her lip with a tiny dose of Botox to see what would happen. She couldn't whistle or sip through a straw for three months until it wore off.
Last week, she had three doses of Botox to smooth out eye lines.
Tonight, only three people want to be Botoxed: DiMaria, her friend Nina Brooks and Debbie Murphy, a surgical assistant in Roche's office.
Murphy, 37, has a forehead as taut as a new calfskin wallet. She can't move it or wrinkle her brow anymore, but her face is line-free. The worry furrows between her eyes are gone, too. This is her fourth Botoxing.
"People before told me I looked tired and unhappy," says Murphy, who wanted the drug after she saw patients' results. "Now, I like it. It's great."
Nina Brooks, 54, is here to get her furrows filled, too. "I've had this guy for 30 years," she says, pointing to a vertical crease between her eyes.
She and her crease will have to part ways without family support. "My husband wouldn't even come to watch," says Brooks. "He asked, 'Are they going to be poking someone?' He wouldn't have anything to do with it."
Brooks' husband's attitude is what Roche aims to change. Botox, he says, might be a fad, but he does not want to miss the opportunity. "I think it's an entry-level drug. It gets people in the door," says the silver-haired surgeon, who has Botoxed many Detroit-area celebrities, although he won't reveal who.
But he has never Botoxed himself.
On his Web site -http://www.drroche.com/- Roche advertises that if you get 10 friends together for a Botox party, the host or hostess gets a discount, paying $350 per area instead of the normal $425 to $750. It's a way to drum up interest in a fad popular on the west and east coasts. Everyone else at the party pays full price.
"The Midwest is always slow to catch on," says Roche, who sees Botox as a loss leader for his office. He estimates half his Botox patients will eventually opt for one of seven face lifts, laser resurfacing or other procedures he offers.
Insurance won't pay for Botox or any cosmetic procedure. A vial of Botox costs the manufacturer $40. The markup to doctors is 1,000 percent, to $400. Doctors mark it up about 700 percent, to about $2,800, and can treat three or four patients per vial.
DiMaria and Brooks don't know how much their Botox treatments will cost tonight. "Their office will send a bill," Brooks says, not appearing to worry.
Roche sees nothing wrong with doing a medical procedure in his kitchen. Heck, he once stitched up an Isiah Thomas injury right here after a Pistons game. A Botox treatment involves three things: the toxin, saline solution and a short needle the diameter of a hair - smaller than a tattoo needle. Patients don't even need to wash their faces before treatment.
The party revs up, with everyone standing around the black marble island, nibbling and sipping and chatting. Someone cuts into the white chocolate cake, putting slices on festive red and orange plates.
Over in the corner, Roche, still in purple scrubs from the office, injects Murphy near the eyes and nose. Then he seats DiMaria in a chair hand-decorated with glued-on pencils. Bruce the Shih-Tzu, one of four Roche dogs, wags his little shaggy body and bobs his little head with the bow on top. DiMaria picks up the wriggly dog and plops him in her lap.
"See how easy this is? You can even hold a dog," she says, looking serene.
Bruce wriggles around, watching as Roche, in sterile gloves, draws 25 units of Botox into the tiny needle. DiMaria sits still. Roche pokes the needle into the center of her forehead and injects some of the clear liquid.
She lets Bruce slide to the floor.
Then Roche makes her scrunch her eyes. On the top of her crow's feet he injects two tiny bits more. Then he puts two more injections near the furrows between her eyes. She gasps ever so slightly. A drop of blood oozes from one injection, but it's quickly patted down. Each spot is slightly swollen with toxin, but that will disappear within an hour. In two days the Botox will kick in, paralyze the tiny muscles and relax the skin above to make the creases vanish.
Moments after her injections, DiMaria is back chatting with the group.
Then it's Brooks' turn. Roche injects her in nearly the same spots. Nobody else really pays attention, their conversation turning to the Red Wings and Formula One racing. But Brooks is so fair-skinned that when she rejoins the group, the outer corner of her left eye is beginning to bruise.
Somebody gets a Ziploc bag of ice. She holds it to her eye.
"Don't tell anyone you got Botox," Roche kids.
"I won't," she says with a grin. "I'll tell them you hit me."
Although it is made of the poison that causes the food poisoning botulism, Botox is safe, Roche says, because it is so diluted. The drug has been used for more than a decade to treat excessive sweating, migraines and other medical problems. A single injection for cosmetic reasons uses five units. A unit is about a drop. One reason Botox parties are cost-effective for doctors is that once a vial is open, it must be used within four hours.
In Europe, Roche says, even beauty salon operators are allowed to inject Botox. In this country, only doctors, nurses and physician's assistants can.
Any of them can hang out a Botox shingle or hold a Botox party. Given how lucrative it can be, it is likely. Medical trends like LASIK eye surgery have a way of getting price-competitive and sloppy.
That could be a problem.
Because it paralyzes muscles, Botox has to be used only on specific spots. Used it around the mouth, it can cause drooling or trouble talking, Roche says. It is not good on frown lines around the mouth, because then only the smile muscles work, "And sometimes you end up looking like the Joker," Roche says.
Too much Botox in your face, and you can get an expressionless look.
Too much Botox too close to the eyebrow, and you can get a droopy eyelid.
Botox given on the wrong forehead muscles can cause the eyebrows to rise in a constantly surprised look.
"You need to find a doctor familiar with the muscles of facial animation," Roche says. Of course, Botox wears off in three to five months, so nothing, even mistakes, is permanent.
Tonight, the needles now are only a memory. The party coasts along, brief pain forgotten. Nobody has had to sign a consent form, pay a bill, change into a sterile gown. The party is a hit.
"I'm real private, but this doesn't have the same stigma as other medical procedures," DiMaria says. "It's not a big deal. Besides," she adds, smiling, "if you get all your friends to do it, there is security in numbers, then nobody can talk!"
© 2002, Detroit Free Press.
Distributed by Knight Ridder/Tribune Information Services.