Starlets and superstars aren't the typical users of Botox, says the American Society for Aesthetic Plastic Surgery.

Most Botox users are middle-aged working mothers in their 40s and 50s, according to a new ASAPS survey. The most frequently cited reason in the survey was "to look more relaxed, less stressed."

The Aesthetic Surgery Education & Research Foundation (ASERF), a research branch of the ASAPS, did the survey. The two-page questionnaire was mailed to more than 1,600 doctors who are members of the ASAPS; 1,048 surveys were processed.

Surprising Botox Results

"The results of this survey may come as a surprise to some people," says Leroy Young, MD, in a news release. Young is the chairman of the ASAPS' committee on nonsurgical procedures and has also led the ASERF's research committee.

"Many are under the assumption that Botox is used mostly by models, movie stars, and the extremely wealthy," he continues. "The reality is that the majority of users are working mothers who are juggling their career and family, and are just as likely to be administrative or clerical staff as managers."

Botox Basics

Botox is the brand name of botulinum toxin type A. It's made from a very small dose of the toxin. Botox is injected with a fine needle into specific muscles, blocking nerve signals to those muscles and preventing them from contracting. That makes wrinkles relax and soften.

Botox is approved for the "temporary improvement in moderate to severe frown lines between the brows in people 18 to 65 years of age," says the web site of Allergan, the company that makes Botox.

In the ASAPS' survey, just over half of respondents (51 percent) said their injections lasted four to six months. An additional 38 percent said the shots wore off after one to three months.

Survey's Participants

Virtually all survey participants were women (97 percent). Most were in their 40s and early 50s. The age breakdown was:

— 41-45 years: 19 percent

— 45-50 years: 19 percent

— 51-55 years: 18 percent

— 36-40 years: 13 percent

— 55-60 years: 13 percent

Most had two children (33 percent). Twenty-six percent did not have children. Seventeen percent had three children. Seventeen percent had one child, and 7 percent had four or more kids.

Most were married or had a life partner (67 percent), 12 percent were divorced, 12 percent were single, 7 percent were in a committed relationship, and 2 percent were widowed.

Occupations included professionals (22 percent), homemakers (12 percent), proprietor/business owners (12 percent), administrative & clerical support staff (10 percent), and managers (10 percent).

Survey's Results: Reasons, Feedback

When asked why they started using Botox, the top three reasons were:

— To look more relaxed, less stressed (30 percent)

— To look less angry or stern (17 percent)

— To look more attractive (13 percent)

Asked about their emotions after a Botox treatment, 47 percent said they felt more attractive, 33 percent said they felt more confident, and 29 percent said they felt less stressed and more relaxed.

In terms of satisfaction, 79 percent said they were "definitely" satisfied with Botox. Regarding side effects, 75 percent said they had not had any side effects or complications. Botox was considered "safe" by 74 percent of people taking the survey.

Survey's Results: Cost

Most people said they paid several hundred dollars per treatment. The majority (64 percent) said a Botox treatment cost them $250-$500. Fifteen percent reported paying $501-$750 per treatment, and 17 percent said they paid less than $250.

Allergan's web site says any authorized health care provider can administer Botox, but it suggests finding a doctor with experience in the procedure. Patients should tell their doctor about any medications they're taking, the drug company adds.

Botox Side Effects

Side effects can include headache, respiratory infection, flu-like symptoms, droopy eyelids, and nausea. A few patients (less than 3 percent) may have more severe reactions, such as facial pain, redness at the injection site, and muscle weakness. Symptoms are usually brief but could last several months.

Women should not use Botox if they are pregnant, breastfeeding, think they might be pregnant, or are planning to become pregnant, says Allergan.

Botox should not be used by patients with allergies to Botox's ingredients or infections in the targeted areas, says Allergan.

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: Aesthetic Surgery Education & Research Foundation, "2005 Botox(r) Cosmetic Survey." News release, Aesthetic Surgery Education and Research Foundation. Allergan: "Botox(r) Cosmetic." WebMD Feature Archive: "The Many Faces of Botox." WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Botox."