How to iron out the wrinkles in your poker game



This column first appeared in Ante Up Magazine in December 2009.

Peter Eastgate, the 2008 World Series of Poker Main Event champion, has a tell I can fix. I didn’t notice it during last year’s November Nine broadcast, but ESPN edits those shows so much that facial expressions might not even occur in the same hour as the hand you’re watching. Instead, it was a few months later on High Stakes Poker when I first noticed it.

Internet whiz Tom “Durrrr” Dwan had rags, but that didn’t stop him from betting enough chips to buy a Mercedes-Benz. Don’t you just hate the way he does that? I know I do. Anyway, Eastgate had trips but he began to agonize that maybe, just maybe, this time Dwan held a monster. That’s when it happened.

Usually Eastgate’s 22-year-old forehead is as smooth as butter, but as he struggled with the idea of giving up this juicy pot, his brow furrowed. His eyebrows moved downward and closer together and two deep vertical creases appeared between them in the area called the glabella. He clearly was very uncomfortable. He had a good hand, a very good hand, but you could see he had lost confidence. Dwan saw it, too. Even if Eastgate called, Dwan knew he could take it away on the next street. Eastgate eventually laid it down, but the hand was lost with the furrow, not the fold.

I saw him do it again twice at this year’s WSOP. Similar situations: good hand for Peter, big bet from an opponent, loss of confidence, furrow, fold. Normally I’d keep this kind of valuable poker strategy information to myself but I doubt Eastgate is going to be furrowing his brow at my home game any time soon. The key is this tell can be fixed with a little chemistry.

Some of you may know that, like Superman, I have two identities. At night, I don my super-powered E.R. white jacket and stamp out disease in one of our nation’s healthcare safety-nets. If you get drunk and beat up, I can hold your hand and say, “There, there.” If your dog ate your Vicodin, I can call a vet. (Sorry, sir, no refills.) And if you get swine flu, I’ll tell you to heat up some soup.

But during the day, I assume my secret identity. I become a mild-mannered medical spa doctor who makes beautiful women just a tiny bit more beautiful. My alter ego purchases Botox by the truckload just to keep up with demand. I know Botox well and I know it can help Eastgate’s forehead.

Botox is an interesting molecule. It’s made when bacteria grow in improperly canned foods. It blocks the part of muscle fibers that recognize messages coming from nerves. If the message is blocked, the muscle doesn’t contract. Wrinkles disappear; furrows go away; Eastgate looks relaxed; Dwan backs down; Eastgate wins a car. His furrows are pretty deep so he’ll probably need a lot of Botox, maybe 35 or 40 units which, by the way, costs less than what he would have tipped the dealer if he had won that pot.

The late John Bonetti, a three-time bracelet winner, also had a tell that Botox could have fixed. Watch reruns of the WSOP and you’ll see his bushy eyebrows shoot up to the ceiling whenever he had great hole cards. Forty or 50 units in the forehead and those eyebrows would have stayed put.

Now I’m not suggesting Botox is the answer for poker tells, far from it. Behavioral experts will tell you hands and feet and shoulders broadcast many more tells than foreheads. But you should be aware that Botox certainly can be used to hide furrowing, wrinkling, crinkling and even frowning.

Be especially wary of those sly ladies who secretly use Botox to look a little younger but nevertheless enjoy the benefits of hiding some facial expressions at the tables. I won’t name any names, but take a real close look at any of the lovely female poker pros who are older than 40. Do they have clear, smooth foreheads, classically arched eyebrows, curiously absent crow’s feet? Some of them just don’t seem to age much from year to year. They look well-rested, even perky. Could it be good genes? Or is it skillful use of chemistry? I know which side of that bet my money is on. My “secret-identity self” can sniff out Botox from across the poker table.

That’s not to say all enhanced foreheads look good at the table. To see a really bad Botox job, check out the shockingly dreadful 2003 poker movie Shade. Skip all the painful pot-splashing and string bets and fast-forward to the showdown when Sly Stallone and Melanie Griffith appear. Sly’s glabella never moves. That’s okay, but check out his “Spock” brows, a result of too much Botox in the wrong place. Probably done by the same doc who did Melanie’s lips.

So, if you want to look a little younger, a little more refreshed or if you would just like to soften your pensive frown, erase your crow’s feet or smooth your forehead, Botox works pretty well. Seek out a doc who’s a real Botox pro. But if you really want to hide your excitement over flopping the nuts, pay close attention to what your hands, feet and torso are doing.

And, Peter, if you really can’t control that furrow, I can fix it. Give me a call.

— An avid poker player, Frank Toscano, M.D. is a board-certified emergency physician with more than 28 years of front-line experience. He’s medical director for Red Bamboo Medi Spa in Clearwater. Email your poker-health questions to

Ante Up Magazine

Ante Up Magazine