Bella, that's someone trying to make money. I don't think it's a physician's place to SUGGEST something entirely cosmetic when you haven't expressed any interest in it.

I'm 30 and have some sun damage and wrinkles. That stuff is normal, and no one even notices it except you and your money-grubbing doctor. That said, I would have been very upset as you were.

Sorry you had such a bad day!

Bella, you're not the only one!!!

I saw the dermatologist a couple of years ago with my mum and sister at the one time (easier, cheaper) and he brazenly (and I felt that it was so rude) told my mum exactly where she needed botox!

They get a commission from it, they don't care what it does to your face long term. It says a lot about their 'credibility'!

I'm sure you're beautiful, don't you think on it

Your dermatologist is an insensitive prick. His/Her job was to do his job and be a professional. Not tell you that you need "help" and seriously its not his place to suggest Botox at all. Also how long can a person keep doing Botox? They're just putting off the inevitable.

Look at Helen Mirren and then look at Joan Rivers...who would you rather be? I respect Helen Mirren so much more than I do Joan Rivers because she's embracing getting older and she's still living her life, she's keeping her mind sharp, and she's still acting.

Anyway, to answer your question I would ignore the person. I don't think its anyones place to tell me or you or anyone else that they need Botox. We're smart, we have brains, we can make our own decisions, we know when we need Botox and when we don't. We all know that option is out there. If you want it then you know how to get it.

Maybe you don't want to do Botox now or ever. And that's perfectly fine too.

So yea don't feel bad at all. Also if you look 10 years younger then I'd take that as a sign that you don't really need the Botox as much as your doctor would like you to believe. So yea like seriously don't feel bad at all. Just ignore this suggestion from your doctor. Its not his/her place to tell you that.

He/She was trying to make a buck. That's all. It's really not that different than your waiter suggesting another cocktail or dessert, or the salesperson helping you with a dress bringing out shoes. It should be different, because this is a medical professional we're talking about, but sadly, with elective/cosmetic treatments, a lot of salesmanship is involved.

I wouldn't feel that it reflected on your appearance at all, to be honest. If a 20 year old went there and asked for Botox, they'd probably do it.

I'd hate to think of a medical professional suggesting treatment for personal gain... but Dermatology is a business.

Also, it may not have been a reflection of how you look. I know several of my friends who have expressed plans (or even started) botoxing late 20s to early 30s to prevent rather than correct...

Anything a doctor suggests is only because they will make money off of it. It is not because they are concerned about your health!

Here's a subtle example) Veterinarians get paid to recommend certain dog/cat foods even though vets admit they would never feed that to their own animals. I would never ever trust the recommendation of a doctor in that context.

Now if you're talking about a friend or a co-worker, as the title of this article actually suggests, then that person is just a b*tch. But a doctor? Just laugh in their face and tell them that they have enough of your money.

That's completely unprofessional. But like the others have said, they're just trying to make money off of you. Cosmestic procedures mean ca$h for them, especially if you get hooked and keep coming back for more.

Dermatologists look at so-called imperfections all day long, pretty much to the point where EVERYTHING is an imperfection. So basically, when someone walks into their office, they start dissecting a patient from head to toe.

Bella, I think your doctor was definitely out of line considering you did not ask for his/her opinion on getting botox. However, I wouldn't take it to heart. Like others have said, Dermatology is a business, and they want to make money. Plus, I feel like those doctors can look at anyone (regardless of age) and point out a so-called imperfection that an average person wouldn't notice with a magnifying glass.

He wanted to make money off of you. Ignore it. He probably would have told a 13 year old that she needed botox.

However, if a close friend or family member told me I might think about getting botox, I would be like "You know, maybe you're right." Sometimes, it's good to hear the brutal truth instead of always getting false compliments.

Tidal, I wouldn't go so far as to say that anything a doctor suggests is solely to make money! That's ridiculous. My mother's doctor recently suggested an mri and they found out she has been suffering from ms for years and she is finally getting the treatment she needs; I don't think the doctor suggested it only to make money. And, I've seen my vet at the pet store, with a cart full of the same food she recommended for my dog (which was the food we were already using anyway). I'm not denying that doctors suggest things, particularly cosmetic procedures, to make money, but I can't believe you're seriously suggesting that that is always the sole motivation.

And, I don't think the title implies that it's necessarily a friend or family member suggesting you need Botox. I think the title is intentionally vague.

About the topic at hand, as others have said, I'm sure the doctor was trying to make money. What this says about society at large, that women are expected to get Botox at some point, bugs me.

Well said, lilkimbo.

Sorry that your feelings got hurt, Bella. I know I'd be feeling the same way if my doctor told me that.

I agree with posters above, your dermatologist was out of line suggesting it, if you went in asking about Botox that would be another thing. I have to see a derma soon (for the first time) for some moles and now I'm worried that he is going to suggest Botox or something along those lines. I'm getting older but proud of it.

I know how you feel bella. One time at the mall during a pretty bad breakout this Chinese Dr. walked up to me and handed me an acupuncture card and said, "I can help you with your acne" I don't have acne. And just the point that someone noticed it and said something. I cried right there too. It's embarrassing.

I´d be seriously angry. Nobody "needs Botox". Sure, it may improve your appearance at some point, but why is it mandatory to do so just because you happen to be a women and thirty-ish? I know we live in an image obsessed society, but if your skin is healthy isn´t that what is important?
Shame on your doctor Bella.

I would tell so-so where they could shove the Botox needle. (Maybe it would rid them of a few underside wrinkles. )

I prefer the idea of using natural anti-aging products and to start from the inside-out (where it all begins.) And proper SPF. I will do my best in aging "gracefully". Injecting toxins? No thank you. As for that doctor, they were just trying to make a buck. Do not take the botox claim seriously.

Ouch! That sucks! It would bother me, especially since I would never consider botox in the first place. I think I would switch doctors. Even a dermatologist should have some sort of notes on your concerns. For example if you have expressed a concern about looking older, then I could see a botox recommendation, otherwise out of line.

Ugh. Botox is tested on animals to determine how much it takes to damage you. Sad and not worth it, in my opinion, no matter how magically stiff and shiny it makes you.
My mom is in her mid 50s, never wore sunscreen, and still looks great. If I look half as good as her when I'm middle aged, I certainly won't be considering injecting poison in my face, even if there are cruelty free options.

Your dermatologist skipped the People Skills 101 class. It would be one thing if you asked her to let you know when she thought Botox or fillers were appropriate; it's an entirely different matter for her to suggest them without any prompting. Ugh.

On another note, it's been my observation that bouncers (bartenders, waiters, etc.)are supposed to tell you you look younger that you do.

The derm was pretty nice about it — it's not like I was told that I was a huge hag or anything like that. And to be fair, I was asking about acne and then jokingly said, "And there's nothing that can be done about these smile lines." That's when she said that it would be good to start thinking about the 'tox. I had talked about the smile lines in a joking, jovial way, and then, bam, flood of tears.

It's interesting to read all of your responses. My best friend was really sweet and sent a long note about how I'm ok, and my therapist was also really helpful. Mr. Bella didn't get what the big deal was. He as well as an ex I'm close to both said, "That's ridiculous" and went on their merry little way. I think we women may be more sensitive to this sort of comment.

I would've gone off on him/her, and I'm not a particularly confrontational person in the first place. However, it's the principle of the thing. A dermatologist is a doctor. Not an athestician, not your hairdresser, not a makeup artist, not some person on the street. Doctors take an oath to do no harm, and Botox is unnecessary poison injected into your face to paralyze the muscles. The long-term effects are still unknown. A dermatologist's job is to make sure that your skin is healthy and address any underlying issues that may be causing breakouts, dryness, changes in moles, etc, in conjunction with your regular doc. If you also have aesthetic concerns that you bring up, derms are supposed to help, suggest products, etc. But pushing you into Botox? If the doc is affiliated with a hospital, I'd file a complaint with the ombudsman and find myself a new derm ASAP. It's not like you went to a plastic surgeon who specializes only in cosmetic procedures; in a place like that, maybe such a suggestion wouldn't be so out of line; this scenario is totally different.

Bravo to you, Bella, for going in the first place, getting your annual mole check, and keeping the Botox craze in perspective. You just to find need a dermatologist with the same attitude.

Even if you jokingly mentioned the smile lines that would still irk me if it was me. But it's true that someone like a dermatologist or plastic surgeon are use to looking for perceived imperfections even though it bothers me when a doctor or anyone else makes someone feel insecure over very little things that people wouldn't even notice or really think someone actually needs injections or surgery for.
To answer the question, I would think anyone who suggests it is an idiot. I don't even think botox is something I would ever consider. I don't really care to have something that is a mild form of a poison injected into my face just because society expects me to freak out over getting older. After turning a year older recently I even decided I don't want anyone joking to me about us getting older because I don't want anyone making me feel like being older has to be a bad thing. I take care of my skin so it'll be in good shape when I'm older, but what I really want is to be healthy throughout my life.
-Smile lines don't have to be a bad thing, Better to have plenty of reasons to smile than plenty to frown.

I completely agree with all the other posters. Despite your derm was nice about it, I guess she saw the opportunity in making some extra money when you joked about the lines. As someone said above, docs shouldn't suggest something you don't need. And if you haven't thought about it before don't star now just because of what she said. Sometime men are quite wiser by just not giving a second thought about things, do the same!

I think it's time to start thinking about a new dermatologist. Unless he's a cosmetic surgeon primarily, a medical professional shouldn't be pushing unnecessary cosmetic procedures on patients like that.

Lines add character to a face. I'd rather have a few laugh lines that show I've enjoyed life than inject a toxin into my face that might paralyze the underlying muscles or make my eyelids droop.

I feel for you Bella. Something similar happened to me the other day. I recently had surgery, and since then I have noticed my hair has been shedding increasingly bad. First I thought I was imagining it, but then my derm diagnosed it as telegen effluvium...a disruption of your hair cycle. Ok, well I can live with that..as long as it comes back, which she reassured me it will. Well I have always had very nice thick hair, so it is not that noticeable (at least I didn't think so, nor anyone close to me) so I went to a salon to pick up some good quality shampoo that is suppose to help. Well the nosy hair stylist came over, without any soliciation and told me that I should purchase the Nioxin kit for "noticeably" thinning hair. I walked out, and starting crying hysterically once I got in my car. Why do some people take it upon themselves to give unsolicited advice is beyond me...

I was about to say that it was unethical until I read your comment. You introduced the subject of your wrinkles, she suggested a treatment. Most derms consider it one of the best ways to deal with wrinkles so I don't see a problem. Would you have been upset if she suggested retin a when talking about acne?

I'm kind of sorry you wrote this entry leaving out the details, but glad you cleared it up a little with your comment.

We do Botox and Restylane in the office I work in. We never try to sell it. We have pamphlets and things sitting around and we wait for patients to ask about it.

It always feels good when someone ID's you. I love that! I picked up a pack of smokes for a friend the other day and the cashier asked me if I was old enough to buy them. I laughed and told her I'm 29!

I don't think doctors mean to hurt feelings, they just make suggestions and sometimes say things without subtlety about body issues we may already feel self-conscious about. I was 9 months pregnant, was within the normal range of weight gain, hadn't gained a pound for weeks...then all of a sudden, I gained 5 lbs in 1 week. When the doctor came in, she said "wow...5 lbs..that's not all baby weight, you know." My hubby spoke up and said I was wearing heavier clothes than the last time and the doc said "oh...look, he's trying to protect you..." I am a very self-conscious person when it comes to weight and was extremely hormonal. I seriously had to choke back tears in the office. When we got to the car, I started bawling. I'm sure the doctor didn't think twice about it and probably thought she was helping me keep my weight in check when really she just hurt my feelings! (I went home and chowed down on a big bowl of ice cream!) I'm sure Bella's derm. didn't mean anything by it especially if she had joked about the lines first. I'm just surprised - Botox seems so controversial to me. I'm surprised a dermatologist would suggest it!

Nobody "needs" botox. Ever. It is solely a choice certain people make at a certain point in their lives, often too soon and too much of it unfortunately.
Sometimes people feel pressure to do this kind of thing, others feel like they can push its use on someone else, which is immoral I think. After all injecting toxins in your face is not a thing you do lightheartedly or at least you shouldn't.
Shame on your doctor.
Personally I can't ever imagine doing this (and I'm 36), but never say never.

Time for a new dermatologist! I could never imagine my dermatologist saying anything that rude. I would seriously consider switching.

dermatologist is a doctor. Not an athestician, not your hairdresser, not a makeup artist, not some person on the street. Doctors take an oath to do no harm, and Botox is unnecessary poison injected into your face to paralyze the muscles SO WELL PUT.

Bella, do yourself a favor and get a new derm. NOW.

My God, what is with this culture that makes us all want to look the same- like some manufactured porcelain dolls?!
What that woman told you was very rude, and inappropriate. What is so terrible in wrinkles?! Even if one gets botoxed you are still the same age, you didn't turn the clock! You are just pretending, just hiding. And why hide the years- you were there when they were being made, they are a part of you.
I don't know, my mom is well in her 50's and yes she has wrinkles (even more now after her illness) and I know she would never consider that. Why, why torture yourself just someone else, some stranger, could tell you that you look younger. Talking about vanity...It's like being ashamed of oneself.

Sorry, this just makes me really angry...

$$$$$ that all I see. Time to get a new doc. I'd be totally pissed! And I'm even madder that it wasn't a stranger on the street or some weirdo, c'mon doc lose the money grabbing charm.

That's just sick. The only place where I can imagine a dermatologist saying such a thing would be L.A. and maybe NYC. Change your derm stat!
It's amazing to me that people like that don't realize that most people in the world DON'T subject themselves to botox. For some reason, in Hollywood, the Stanford Wives look is seen as beautiful. Ugh.

Bella, it's time to get a new dermatologist.

I have to agree that I would recommend getting a new doctor. Regardless of whether or not it was said in a light-hearted way, I don't think her comments were appropriate. I remember my mother took pride in her laugh lines saying she worked hard by laughing a lot her entire life to earn those and no one was going to take those away. I feel the same way. It shows that I've done my fair share of smiling and that's not a bad thing.

Not that this is even remotely similar, but my aunt recently switched docs after he tried to put her on blood sugar meds because she had early stage diabetes. She left because at no point did the doctor ever say "You need to eat better and exercise more, it's affecting your health". The second she heard him just try to prescribe her a cocktail of pills she realized she needed to do this for herself. She's since lost 45 lbs and her blood sugar is under control.

Again, totally different, but I do think that docs have become a little too free wheeling with prescriptions and medical quick fixes.

Tact is a gift and not everyone has it. There was a better way to name-drop Botox than suggesting you "needed" it. Anyway, don't rule out talking with the Derm and expressing your feelings over how he acted, some people honestly don't realize they are being rude. Unfortunately I question the ethics of any doctor that insists you need to inject a toxin into your face rather than continue to use sunscreen and, say, retin-A.

Poor Bella! I know just how you must have felt. I haven't been recommended Botox, but I've been recommended breast implants, so there you go.

Your dermatologist should have picked up on YOUR joking tone, and responded in kind. Something like "Well, you certainly don't NEED to do anything about them, but if they really really start bugging you, I have options" or something like that. I'm in my late 20s, and I'm noticing lines already -- I joke constantly about what I call my Harrison Ford wrinkle from my cocky smile. But if someone immediately responded with "Time for Botox!" I would be very upset as well.

If the bouncer thought you were younger, than that's all the sign you need for going Botoxless. That's a judgmental crowd!!

Yup, he has dollar signs in his eyes. Think about it - prick someone with a few needles and collect $500. Easy cash.

Not that I'm against it - I've had it myself - but I wouldn't take kindly to someone pushing it on me. Thankfully my plastic surgeon just tells me about different options and prices and leaves it at that - no pressure at all.

I'd switch derms quickly.

I would have been mad enough to inject him with Botulism! Seriously, though, that's unprofessional because it's not what you came in for and it's just plain rude. I might give him another chance, but I'd try to get recommendations for dermatologists from friends or my physician. (I've been to a doctor with no tact, but she's so good at her job that I've been trying to overlook it. However, I think if she were a derm and making me feel bad about myself, I might not be so keen on staying.)

This culture is so afraid of wrinkles. I love laugh lines. They add character and a certain air of sophistication in my opinion.

how old are you? if more than 30 you can think about it, but do it 10 years later what's the big deal? dermatologists are not gods and we shouldn't take everything they say so seriously. trust yourself, not someone who gets paid more to put you down.

Allytta -- if more than THIRTY?! thirty isn't old, my dear

What kind of doctor would say that to a woman?? That is beyond rude and completely unnecessary. Most women know exactly what Botox is and would more than likely ask for it or something similar IF they deem it appropriate. To mention it casually to a patient as if it's a necessity is shallow and also a blatant attempt at getting into your wallet in the future. An experience like that with a doctor like the one you had would leave me with a bad taste in my mouth. In fact, I'd see someone else. That's just me.