Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Cosmetic Botox Turns 10 September 3, 2012

 

In April, 2012 Botox turned 10 years old.  That is it has been 10 years since the FDA gave Allergan approval to sell Botox Cosmetic as a solution for moderate to severe frown lines between the eyebrows and not just for medical purposes (As many readers may know Botox has numerous medical applications as well).  Now that Botox is so widely used (and even abused some would say) this is a good opportunity to look back over the last decade to see what people had to say about Botox then and the reality of its use today.

Take for instance Dr. Richard Friedman’s piece Cases: A Peril of the Veil of Botox in The New York Times from August, 2002 just after Botox was approved for cosmetic use:

Unlike a face-lift, where the skin is stretched taut like a drum but facial expression is unaffected, Botox paralyzes the underlying muscles that control facial movement and produce wrinkles. Botox, or botulinum toxin, is the neurotoxin derived from the bacteria Clostridia botulinum, the cause of botulism.

Botulinum toxin is the most poisonous substance known and is a potentially potent bioweapon. A single gram of the purified toxin, widely dispersed and inhaled, could kill a million people.

Ingested systemically, botulinum toxin kills by paralyzing the diaphragm, the muscle used in breathing. The toxin prevents neurons from releasing acetylcholine, the neurotransmitter that causes muscle contraction. But injected locally, it paralyzes just a small area of skeletal muscle. The effect is temporary, lasting three to four months.

Little is known about the long-term cosmetic effects of Botox. But there is evidence that prolonged use can cause some people to produce neutralizing antibodies against Botox, which diminish or block its effect over time.

Botox had wiped the wrinkles from the woman’s brow but had also robbed her face of some human expressiveness. It made her appear not so much youthful as lifelike — a frozen imitation of youth.

Unlike this woman, many Botox users receive extensive injections above the nose, around the eyes and across the forehead, which deeply alter their expressions.

It made me wonder: Should we become a Botox nation? What are the implications for human relationships? I’m not too worried about the adults; they can figure out that their friends and loved ones are poker faced not because of lovelessness but thanks to Botox. But what about infants and children?

Now some of the above concerns have come true.  There are people who have developed a tolerance for Botox rendering it less effective or completely ineffective for them.  Additionally some people have gone overboard with their Botox injections causing their foreheads to become motionless and their expressions frozen, but keep in mind if Botox is used judiciously this should not happen.  Certainly the popularity of Botox among Hollywood celebrities has greatly contributed to its use amongst the general popular.  While celebrities are at the forefront of the use of new cosmetic products and procedures they can also clearly show the pitfalls of these procedures as well.  (For a good illustration of how this pertains to Botox see Shape magazine’s article Botox: Hollywood’s Most Frozen Faces)

The key to a positive Botox experience and a great result?  Finding an injector, either a doctor or a nurse (In the US any doctor, not just a dermatologist or a plastic surgeon can inject Botox, and any registered nurse can inject Botox.  I would love to know from my readers in other parts of the world about how popular Botox is in their country and who can inject it), who knows their stuff.  If you place yourself in the hands of a skilled injector your face looks refreshed, not overdone.  Your forehead will still move while you look alert and your wrinkles are smoothed.  There has been a great improvement in how Botox is injected since it was approved for cosmetic use in 2002 so the concerns from then as mentioned above, while not to be taken lightly, are not as much of a problem today.

Just how did the FDA approval of Botox for cosmetic use change the anti-aging game?  The impact of Botox should not be underestimated.  According to a Skin Inc. article about the 10th anniversary of Botox being approved for cosmetic use:

“When approved by the FDA in 2002, Botox Cosmetic changed the way that physicians could treat patients who were interested in improving the appearance of their vertical frown lines between the brows,” says David E.I. Pyott, chairman of the board, president and CEO, Allergan, Inc. “Botox Cosmetic has become the No. 1 neuromodulator in the United States and the number of patients considering talking to their doctor about treatment has more than quadrupled to 5.8 million since 2002.”

Botox secured its first FDA approval more than 22 years ago as a treatment for two rare eye muscle disorders, making it the first product of its kind approved in the world. In 2002, the same formulation with dosing specific to frown lines was approved under the name Botox Cosmetic.

“The FDA approval of Botox Cosmetic enhanced the practice of plastic surgery by providing plastic surgeons with a new treatment option for patients seeking to reduce the appearance of vertical frown lines between the eyebrows,” says Malcolm Z. Roth, MD, president of the American Society of Plastic Surgeons.

In the decade since Botox Cosmetic was approved, aesthetic specialty physicians–which include dermatologists, oculoplastic surgeons and facial plastic surgeons–have developed extensive experience in the art and science of administering Botox Cosmetic to yield predictable results for their patients. These physicians have performed approximately 11 million treatment sessions since 2002 and have also contributed to the extensive clinical database demonstrating the safety and efficacy of the drug.

“The approval of Botox Cosmetic in 2002 dramatically changed our ability to treat our patients by giving them an effective option to treat the appearance of moderate to severe vertical frown lines with a minimally invasive procedure,” says Susan Weinkle, MD, president of the American Society for Dermatologic Surgery. “Botox Cosmetic has become more accepted by the public, and this treatment has brought more patients into aesthetic practices to learn about other treatments available.”

Though I have yet to try Botox (or Dysport or Xeomin which do the same thing as Botox yet are newer to the market) I am certainly not opposed to trying it in the future.

Have you tried Botox?  Are you open to trying it?  Share your thoughts below.

Further Reading:

There is, of course, endless amounts of information available about Botox online.  Here are some good sources for more information about this product.

Image from allure.com

 

Going Overboard January 27, 2012

Filed under: beauty — askanesthetician @ 6:05 am
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W magazine had a fun feature in their December, 2011 issue that poked fun at people who over do beauty and cosmetic treatments.   (The illustrations Melanie Teppich are playful and definitely worth a look.)

For example:

Eyeagra Latissima

(eye-AG-ra  la-TEES-ee-muh)
Fixation on making eyelashes appear thick and  erect at all times.
Symptoms: Addiction to prescription Latisse  or other eyelash“conditioners”; frequent reapplication of mascara. Often  diagnosed in tandem with Red Carpet Face—a perma-squint resulting from lids  being weighed down with copious amounts of lash.

Or

Botoxia

(bow-TOX-ee-ah)
Obsessive need for  frequent injections of botulinum toxin into one’s face in an attempt to be as  smooth and wrinkle-free as a fiberglass statue.
Symptom:  Confusing actual skin with that depicted in magazines.

Check out all the different beauty disorders here.

Image from W magazine

 

Just Say No to Botox Parties November 14, 2011

Filed under: beauty,Plastic Surgery — askanesthetician @ 7:00 am
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Sometimes I get the impression that people take medical cosmetic procedures too lightly.  Instead of understanding that any operation has its risks and recovery time people feel that if the procedure is meant for cosmetic reasons rather then life saving ones there shouldn’t be any side effects.  One case in point – Botox and fillers.  In certain circles it is quite popular for girlfriends to get together for Botox and filler parties which are done in someone’s home – not a medical setting.  If you are invited to such a party I would strongly advise against getting anything done.

New Beauty did a great job of breaking down all the reasons you want to avoid Botox and filler parties and instead get these procedures done in a medical setting:

 “I would be wary of any type of ‘pumping’ or injection party,” says La Jolla, CA, plastic surgeon Robert Singer, MD. “It violates so many safety standards and puts patients at risk unnecessarily.”

Fillers or injectables may not have the same risks as more extensive treatments, but they are still medical procedures that have potential complication. It’s a bad decision to treat a cosmetic procedure as a party favor, and, according to Dr. Singer, here’s why:

1. You often don’t know the full background or expertise of the individual performing the procedure—he or she may not even be a physician. You should have fillers performed only by appropriately trained plastic surgeons or dermatologists in a medical office.
2. There is no customization of treatment. “Without thorough evaluations and patient charts, how can the individual doing the injections be sure of how to appropriately treat a patient?” Dr. Singer says.
3. You can’t be certain what materials are being used. “We’ve seen everything from silicone and paraffin to oils (which aren’t safe) being used as injection materials,” Dr. Singer says. These materials are also frequently injected in a nonsterile manner, which has led to infection, he adds.
4. A party isn’t the right atmosphere for medical procedures. “Oftentimes, there is alcohol involved and that dramatically increases chances for serious problems and negates any informed consent about the treatment, which is rarely given in those settings,” Dr. Singer says. If you are undergoing a procedure, you want the undivided attention of the medical provider without the potential distractions of a party.
5. There is no protocol in place to handle emergencies. “What will happen if someone has an allergic reaction that requires immediate medical care?” Dr. Singer asks. If you have the misfortune to have an adverse reaction or complication from a “pumping” party injectable, your injector may not be qualified or experienced in the treatment of your problem.
6. If it sounds like a bargain and “too good to be true,” it usually is.

So if you are thinking of getting fillers and Botox be sure to go to a medical office to have them done.  It is always better to be safe than sorry when it comes to these procedures.

 

Botox Explained January 27, 2011

 

Since Botox’s approval by the FDA for cosmetic use it almost seems like its uses, potential side effects, and safety are taken for granted.  But do you really know how Botox works, how to store it, and how it is injected?

Skin Inc. just published a very comprehensive article that really explains everything you need to know about Botox.  Entitled Chemodenervation From Physiology of the Skin, Third Edition the article succinctly goes into detail about the history of the use of Botox, how it is injected, how injecting Botox affects facial wrinkles and also other body conditions like excessive sweating, and the potential side effects from Botox injections.

If you have ever had any questions about Botox be sure to check this article out.  Reading it will only take a few moments and leave you much better informed in the long run.

 

Discounting Dysport – Is It Ethical? March 13, 2010

Filed under: Aging,beauty — askanesthetician @ 7:59 am
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The New York Times  published an article about Dysport’s new advertising claim that offers rebates to consumers if they try the product or even a rebate on Botox if the consumer is unhappy with Dysport.  Both Botox and Dysport are purified forms of botulinum toxin that when injected into the skin result in the temporary freezing of muscles so that skin, particularly on the forehead, appears smooth and wrinkle free.  Both injectables have other applications that result in a more youthful and relaxed appearance.

Dysport was only introduced last year so until then Botox enjoyed a monopoly in the injectable toxins market in the United States.  This rebate deal is a way for Medicis, which markets Dysport, to try to attract new consumers away from Botox.  The ethical dilemma that might come into play with the discount is the fear that both doctors and consumers will make decisions about the use of the injectable based on finances (and even greed) and not safety.  Promoting a drug in the same way as one would a mattress or a cell phone (or any other number of products) strikes some as a problem since consumers come to view these procedures as run of the mill and forget the risks involved.  Basically such campaigns run the risk of turning medicines into mattresses while the medicine’s unique medical issues and risks are forgotten.

Read the article and decide for yourself:

To Take on Botox, Rival Tries Rebate  The New York Times March 11, 2010

 

 
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