IAPAM Aesthetic Physician Bulletin: DIY & Illegally Imported Botox

Author: Leslie Marshall

The Recent DIY Botox Trend

Recently, there have been several reports regarding DIY "botox-like" injectables, which can be purchased through the internet. A woman in Texas, Laurie D'Alleva, offered consumers a botox-like product called "Freeze," complete with a "How-To" video, so consumers could administer the botulinum toxin themselves. "The Texas Attorney General is charging D'Alleva with several violations of state law. She could be fined up to $25,000 per violation per day of the Texas Food, Drug and Cosmetics Act, and up to $20,000 per violation of the Texas Deceptive Trade Practices act.” The red-flags regarding this internet offering range from the unrealistically low pricing, indicating the product is not FDA approved, to her complete disregard for the potential life threatening side affects that can accompany the delivery of a neurotoxin into the body by an untrained, unlicensed administrator.

Cosmetic Injectables Must Be Purchased in US

A parallel issue with the administration of botox by non-physicians is that "Botox and Dysport and all other cosmetic injectables can only be sold legally in the US .... to physicians." These products must be legally approved and labeled by the FDA. Depending on state law, which varies, only physicians, nurse practitioners, and nurses may inject these substances. Dr. Russel Kridel offers his expertise and concerns regarding the issues associated with purchasing cosmetic injectables. "The products obtained must come from the US where the FDA maintains safety levels not so strictly adhered to in other countries. Importation of cosmetic injectables can be a felony, subject to one year in prison and $100,000 in fines. Recently 5 physicians, a nurse and a practice manager in New York plead guilty to such charges. Therefore patients p[and doctors, alike] need to be cautious when injectables are offered at bargain prices, because they may have been obtained through web sites or offshore; they may be counterfeit and there’s no one to assure purity or content. Serious injury or personal harm may result when unknown substances are injected."

Dr. Melissa Babcock also generously shares her insights regarding the purchase of botulinum toxin products. "It is true that Allergan, the maker of Botox, sells its product to pharmacies outside the US for a much reduced price. I have received flyers in my office offering Botox for up to 30% off from Canadian pharmacies and other internet sources. I have know of physicians buying Botox from Canada. It certainly is enticing to receive a 30% discount on an expensive injectable. I bought Botox from a Canadian pharmacy. When the product arrived it was not Botox Cosmetic but regular Botox. The two products are identical. When Allergan applied for FDA approval of their botulinum toxin to be used for cosmetic reasons the FDA approved the drug but required Allergan to add the word "Cosmetic" to the packaging. This concerned me, but my other concern it that it took 7 days for the product to arrive. Normally when I order Botox from Allergan I receive the product in less then 24 hours and on dry ice. Botox is extremely sensitive to re-warming. Re-warming would certainly decrease the efficacy of the product.

Before using the Canadian Botox I called the Georgia Drug Association to inquire. A representative told me it was illegal to dispense or to treat patients with medications from Canada. Specifically every drug manufacturer who wishes to sell medications in the state of Georgia must have a license. The Canadian companies do not. The penalties for using medications purchased from Canadian pharmacies are hefty fines and revocation of the physician's medical license. Since that time I have only ordered Botox from Allergan and I will never order medications or even sunscreen from companies outside the US.

If you are a patient and wonder if you physician is using Botox purchased outside the US first you should ask if they are using Botox Cosmetic. The word "cosmetic" is a hologram on the bottle. Canadian Botox is usually not Botox Cosmetic. When you make your appointment, tell the staff that you want to see the bottle when you have your injection. If the office does not want to show you the bottle then go elsewhere. Additionally every bottle has a lot number. When you call for your appointment you could ask to see the lot number on the bottle. This number would identify whether the Botox was sold in the US."

Medical Malpractice Insurance Coverage Could be at Risk

Susan Preston, President of the Professional Program Insurance Brokerage firm is very clear about the implications to a practice if a physician purchases botulium toxin products from an unlicensed distributor or another country. “Many, if not most insurance carriers, including ours, only provide coverage for Botox or other injectable products bought in the United States. There have been reports of people dying when treated with an injectable product from another country. The risk is too great when buying products from other countries as no one controls drugs as well as the FDA does in the United States. Also the manufacturer might not support liability for imported products especially if they were altered in any way. Thus the person getting the injectable solution cannot be sure that it is manufactured to US specifications, backed by the manufacturer and the potential for major injury including death is much greater.”

Cosmetic Treatments Should be Performed in a Medical Facility

Dr. Kridel shares that "doctors’ offices or other medical facilities are the safest place to have injectables administered," either during botox training or during patient treatment....Not too many spas, peoples’ homes, or hotel rooms have the same standards for cleanliness and emergency care that a doctor’s office does!" The FDA agrees, and specifically states that, "botulinum toxin products should be administered in an appropriate setting using sterile instruments. Malls, private homes, [hotel rooms, and conference rooms] are not medical environments and may be unsanitary." Furthermore, Dr. Kridel reminds practitioners that, "all staff should be trained in sterile procedures so as to avoid contamination, re-use of needles, and infections. Plus, in the rare case of an allergic reaction, only qualified staff and physicians are trained in resuscitative measures and have emergency drugs available.

Comprehensive Botox Training Needed

Dr. Melissa Babcock reinforces for physicians and patients alike, the importance of having a skilled professional involved in product preparation. "If you are not a trained medical professional, botulinum toxin (Botox or Dysport) can be very dangerous to use. Medical professionals are trained to dilute the concentrated product correctly, inject it correctly into appropriate muscles and use the correct concentration for each muscle they are injecting. An untrained person injecting Botox would certainly experience side effects such as drooping eyelids, and other facial distortions resembling a person who suffered a stroke.

Dr. Thomas Sterry also champions the importance of being trained in a product's preparation and dilution. "Botox comes in 100 unit vials that need to be diluted by the physician. Some doctors are accustomed to diluting it with 10 cc’s of saline, making the concentration weak, but they inject more volume. Some make a very concentrated solution to give more pin point results. It’s a style point with no generally accepted “right” way to do it, but the more concentrated solution does tend to hurt less."

The Patient Consultation Is Central to a Successful Outcome

After training, managing patient expectations is the next most critical success factor in a good outcome with botox. Dr. Sterry offers these tips for physicians to discuss with their patients:

1. Ensure that you discuss with the patient, "what they are paying for." Some physicians will charge per area (e.g. forehead) while others will charge based on how much product is being injected.
2. Ensure the patient understands the office policy for “touch ups” before beginning the treatments. Some offices charge, while others will not. Typically, when patients pay by the unit, touch-ups are not "included."
3. Council patients that they should wait at least three months between injections to avoid the risk of developing antibodies to the botox, which will counteract the effects of injections.

Conclusion

Dr. Sterry provides these final thoughts. "People love Botox - patients and doctors - because of how accessible it is and for how minimally invasive it is, [but] the ease that people perceive it's administered with has become exaggerated. In order to administer injectables with the best results, one must know very well the layout of facial muscles and understand well the product being injected. Finally, a huge part of injectables is artistic flair - you are using these products to literally fine tune the physical appearance of the face in a manner that is semi-permanent. Whatever the result is, it'll be there for some time."

"The most important thing for both patients and physicians to keep in mind is that injecting the skin with Botox, Dysport, Juvederm or any other product is not 'easy' and even otherwise trained professionals have seen far less than stellar results. A colleague of mine let me know that even after undergoing some training with Botox injections, he was still unable to generate the results he wanted. In one case, he very unfortunately had some trouble with the muscles around the eye. Certainly after more Botox training and practice he's honed his skill but it just goes to show that these injections must not be taken lightly [just] because they are far less invasive and less expensive than other facial cosmetic procedures." by Leslie Marshall. Ms. Marshall writes for The International Association for Physicians in Aesthetic Medicine (IAPAM).

About the International Association for Physicians in Aesthetic Medicine (IAPAM)

The International Association for Physicians in Aesthetic Medicine is a voluntary association of physicians and supporters, which sets standards for the aesthetic medical profession. The goal of the association is to offer education, ethical standards, credentialing, and member benefits. IAPAM membership is open to all licensed medical doctors (MDs) and doctors of osteopathic medicine (DOs). Information about the association, or about physician certification, can be accessed through the IAPAM's website http://www.aestheticmedicinesymposium.com/botoxtraining or by contacting:

Jeff Russell, Executive-Director
International Association for Physicians in Aesthetic Medicine (IAPAM)
1-800-219-5108 x705
e-mail: info@theiapam.com
web: http://www.IAPAM.com

Botox and Juvederm is a trademark of Allergan, Inc. Dysport, Restylane, anbd Perlane is a trademark of Medicis, Inc.

Article Source: http://www.articlesbase.com/anti-aging-articles/iapam-aesthetic-physician-bulletin-diy-illegally-imported-botox-1551464.html

About the Author

Online Media and Research Specialist ~ Leslie Marshall
Leslie is responsible for crafting and managing the IAPAM’s (http://www.iapam.com) internal and external communications including: producing our member newsletter www.aestheticmedicinenews.com, creating association press releases, augmenting website content, writing industry articles, managing our online reputation, partnering on social networking strategies, and developing varied means to effectively keep members, industry professionals, and the media informed about the association and the industry. Additional responsibilities include: verifying industry facts and information and making the results available to our members.

Botox, the Temporary Quick Fix for Wrinkles

Author:

Sarah Labdar

Botox is one of the newer forms of cosmetic surgery, which is practiced in today\'s society. Cosmetic botox is relatively new compared to other facial cosmetic surgeries such as a facelift, eyelid surgery, chin surgery, nasal reconstruction and lip enhancement. Unlike these procedures, botox is minimally invasive and non surgical. Cosmetic botox is a relatively short procedure with no recovery time. More and more people are turning to botox because it has quick results, which last a decent amount of time. So what is botox and why has it become the most popular non-surgical cosmetic procedure preformed by plastic surgeons?

Botox is a protein produced by the bacteria OnabotulinumtoxinA. It is has several types and cosmetic botox is a diluted form of botulism known as type A. Originally botox was used for cervical dystonia, strabismus, blepharospasm, upper limb spasticity, controlling severe underarm sweating, and headache prevention. During the use of botox on other facial problems, it was noted that botox helped to smooth fine lines and wrinkles. In 1989, Dr. Richard Clark a plastic surgeon documented botoxes effects. By 2002, the FDA approved botox type A to temporarily improve the appearance of frown lines and wrinkles on the face. Since then cosmetic botox has become a growing market not only for the famous, but also for all.

Anti-aging is a huge market and botox has become one of the leading possibilities for men and women who are trying to look younger. Cosmetic botox treats wrinkles that are caused by age, stress, worry or environmental factors. The muscles of the face make uncontrollable movements such as tightening and contracting. These muscle movements create frown lines, crow\'s feet, forehead creases and neckbands. Botox is a neuromuscular toxin, which blocks the nerve signals thereby paralyzing or weakening the muscles from creating wrinkles. Cosmetic botox is quick and effective at smoothing frown lines on the forehead, between the eyes, and at the base of the nose. Within a few days the wrinkles disappear for a more youthful, smoother looking skin.

Cosmetic botox has been proven safe due to the highly diluted form of the toxin used. Additionally, botox injections must be prescribed and administered by a doctor, most often a plastic surgeon or dermatologist. Results last anywhere from 3-8 months and refills can be injected once effects disappear. There are some minor and temporary side effects to botox such as bruising, redness, swelling, and allergic reaction. More intense side effects include paralysis of the wrong muscle group, inappropriate facial expressions such as drooping eyelids, double vision, uneven smile, and the loss of ability to close your eyes, headaches, dysphagia, flu-like syndromes, blurred vision, dry mouth, and fatigue. These side effects are temporary and will wear off in up to six weeks. Botox is safe for adults, however women who are pregnant, people with neurological disorders, people taking certain medications or antibiotics, and children under 18 years of age are should not receive botox injections.

Remember that botox is only a temporary fix to diminish fine lines and wrinkles on the face. Although it is quick, effective and non-surgical it cannot permanently reverse the signs of aging. Always, talk to your doctor about questions or concerns you may have in regards to botox procedures.

Article Source: http://www.articlesbase.com/anti-aging-articles/botox-the-temporary-quick-fix-for-wrinkles-4185677.html

About the Author

Graduated with a BA in exercise science and have worked in the medical field since.  My focus is alternative medicine however all aspects of health interest me.  Check out my health website!

Everyday Health, Live your Life to the fullest!

http://www.universalhealthinfo.com/Botox.html

Botox® (botox® Cosmetic) Wrinkle Free Solutions

Author: Dr HariMuralidharan

BOTOX® (BOTOX® COSMETIC) Wrinkle free Solutions

Dr. Hari Muraleedharan Msc,PhD,MA

Microbiologist

It is the hottest craze. With one minute injection, within minutes your face can be youthful, devoid of any unsightly wrinkles. BOTOX® clinics are popping up all over the country, helping clients venture back a few years into their past. A hub for beauty, unblemished skin, and eternal youth. Now a day’s most of the senior film stars were using BOTOX® to keep their porcelain skin wrinkle free. Although BOTOX® has been used for other conditions in the past such as neck spasms, cranial nerve disorders and eye spasms, when the FDA finally approved BOTOX® to be used to treat wrinkles, the popularity of the toxin rose tremendously.

BOTOX® is currently the only form of botulisum toxin approved for such cosmetic purposes. It is a nonsurgical, physician-administered treatment that can temporarily reduce moderate to severe frown lines between the brows in patients 18 to 65 years of age. It is a mixture of several protoplasmic proteins that are released from cells after autolysis. BOTOX® is the brand name for a special formulation of botulinum toxin A manufactured by Allergan Inc., of Irvine, CA, U.S.A.,. BOTOX® is used to generate lines or wrinkles between the eyebrows look better. Initially, the toxin was used for eye muscle problems.

What is BOTOX® COSMETIC?

BOTOX® COSMETIC (Botulinum Toxin Type A) Purified Neurotoxin Complex is a sterile, vacuum-dried purified botulinum toxin type A, produced from fermentation of Hall strain Clostridium botulinum type A grown in a medium containing casein hydrolysate, glucose and yeast extract. It is purified from the culture solution by dialysis and a series of acid precipitations to a complex consisting of the neurotoxin, and several accessory proteins. The complex is dissolved in sterile sodium chloride solution containing albumin human and is sterile filtered (0.2 microns) prior to filling and vacuum-drying. The specific activity of BOTOX® COSMETIC is approximately 20 units/nanogram of neurotoxin protein complex. Each vial of BOTOX® COSMETIC contains 100 units (U) of Clostridium botulinum type A neurotoxin complex, 0.5 milligrams of albumin (human), and 0.9 milligrams of sodium chloride in a sterile, vacuum-dried form without a preservative.

How was this found?

United States Food and Drug Aadmistration (FDA) approved BOTOX® over 10 years ago to treat certain problems with the eye muscle. Doctors observed that some wrinkles around the eyes looked better, too. The company that makes BOTOX® tested it. They showed the FDA that BOTOX® worked and was safe for treating some kinds of wrinkles. The lines that appear between your brows actually result from muscle movement and the passage of time. Two muscles are largely responsible for frown lines between the brows. When those muscles contract, they draw the brows together. As skin becomes less elastic over time, repeated frowning can result in those moderate to severe lines between your brows. BOTOX® works by blocking nerve impulses, which reduces the movement of those muscles. With less movement, the skin surface gradually smoothes out, and the moderate to severe frown lines between your brows begin to fade. A doctor skilled in the use of BOTOX® will inject little amounts of BOTOX® into the muscle. Only the `treated muscle can’t move. BOTOX® works for about four months. As the muscle returns to normal, you will see the wrinkle again.

How is BOTOX® Tested for Potency?

The standard method for assessing the potency of BOTOX® is the LD50 Test. This test involves giving mice a single injection of the product into their abdominal cavity and seeing if they die within 3-4 days. The mice are first assigned to one of various dose groups. The aim of the test is to approximation the dose that kills 50% of the animals (hence the name “Lethal Dose 50%”). The LD value is designated as a unit (U) or a Mouse Unit (MU) of potency. The lower the LD50 value (or the U or MU), the higher the potency. Approximately 100 mice have conventionally been used to test each batch of botulinum toxins products, though Allergan has claimed that the company has significantly reduced this number. Depending on the dose injected and the potency of the batch being assessed, the test animals experience differing levels of muscular paralysis and impaired vision. The end point of the LD50 Test is death, usually by suffocation after the respiratory muscle becomes paralyzed.

Background of hazardous bacterial toxin as a biological weapon

The term “toxin” means the toxic material of plants, animals, microorganisms, viruses, fungi, or infectious substances, or a recombinant molecule, whatever its origin or method of production, including – (A) any poisonous substance or biological product that may be engineered as a result of biotechnology produced by a living organism; or (B) any poisonous isomer or biological product, homolog, or derivative of such a substance.

Over 60 years ago, botulinum toxin was first developed as a biological weapon; it can be aerosolised, or used to contaminate food, and the estimated lethal oral dose is 70 µg. Botulism is a rare paralytic disease caused by botulinum neurotoxin (BT), a protein produced by the soil anaerobic bacteria Clostridium botulinum. Eight types of Cl. botulinum have been identified (Types A, B, C1, C2, D, E, F, G) based on the immunological diversity in the toxins produced by them. The toxins are proteins with molecular weights of approximately 70,000 mgD. Botulinum toxin is the most poisonous substance known and the microorganism that manufactures it is relatively easy to isolate from nature and to culture. The only problem is making sure that oxygen is excluded from cultures. Despite its large size, the toxin molecule is stable enough to be dispersed as an aerosol. The toxin was considered for use as a major biological weapon by Britain and Japan during the 1930's and there are suggestions that it was used by the Japanese to poison streams used as water sources by the Soviets. It has also been suggested that either the microorganism or the toxin were incorporated into grenades used in the assassination of the Reinhard Gehlen, Hitler's likely successor and Reichsprotektor of Czechoslovakia.

A biological warfare attack with botulinum toxin delivered by aerosol will expected to cause symptoms similar in most respects to those observed with food-borne botulism. Commercially this organism attacked in canned food industry due to contamination. Proper sterilization will remove these organisms. In pure form, the toxin is a white crystalline substance, which is readily dissolvable in water, but decays rapidly in the open air. The lethal dose of toxin is very minute amount, for mice, its amount is 0.000,000,033 mg .The lethal dose of human being is probably 1-2 µg. It is a neurotoxin and acts gradually, taking several hours to kill.

Naturally-occurring cases of botulism arise from food spoiling in the absence of oxygen in canned foods. The commonest source historically has been spoiled meat, notably sausage (the species name derives from the Latin botulus meaning "sausage") and poultry (especially duck), and improperly sterilized canned foods. The neurotoxin produced from Clostridium tetani (tetanus toxin)another bacteria from some genus is encountered by humans as a result of wounds and remains a serious public health problem in developing countries around the world.

How long does the effect last?

BOTOX® can help by reducing the over activity of the muscles very quickly. In fact, most people begin to see results within the first two weeks. Generally, BOTOX® provides release of spasticity in the injected muscle for over three months (12-14 weeks). Then patients begin to notice a gradual fading of its effects over several weeks. At this point the doctor can give another treatment. BOTOX® treatment may be required three or four times a year. It is not given more frequently than every three months.

Side effects may include:

All prescriptions may have some side effects. With BOTOX®, side effects are usually transient and mild to moderate in nature. Side effects are usually temporary, and BOTOX® is generally well tolerated. Mild bruising or swelling may occur at the site of the injection. The treatment may also cause a brief headache. In rare cases, the injections may cause the eyebrow or upper eyelid to droop, but this condition is temporary and corrects itself without treatment within 2 to 3 weeks. The effects of BOTOX® may be increased with the use of certain antibiotics or other drugs that interfere with neuromuscular transmission. Ensure your doctor is aware of any current medications you are taking. If you have any questions regarding the use of BOTOX® treatment, please consult your doctor. Some side effects includes

• Droopy eyelids, which can last for a few weeks

• Feeling like you have the flu

• Headache and upset stomach

• Risk of botulism (a life or death illness that makes it hard for a person to move the arms and legs or to breathe) is low with BOTOX® if used the right way

Most patients experience minimal pain or discomfort following injections. Swelling and puffiness at the site of the injection usually subside within a few days. Care must be taken to keep the head upright and avoid massaging the treated area, so that the BOTOX® affects only the desired areas.

Who Markets BOTOX®?

BOTOX® is marketed by Allergan, Incorporated, which describes itself as “a global specialty pharmaceutical company that develops and commercializes innovative products for the eye care, neuromodulator, skin care and other specialty markets.” Allergan made over $1.2 billion dollars in net BOTOX® sales in 2007. 50% of that ($606 million) came from BOTOX® COSMETIC. Total yearly sales of BOTOX® increased 406% between 2000 and 2007. Net sales in 2007 for all Allergan products reached $3.88 billion, of which BOTOX® and BOTOX® COSMETIC accounted for 31%.

In order to learn more specifically about the product BOTOX® please visit the official Allergan site, where you can also find listings of private offices offering a variety of services to treat many aesthetic issues, such as wrinkle reduction. Most wrinkles may be treated with BOTOX® injections.

References:

1. Wang YC, Burr DH, Korthals GJ, Sugiyama H. Acute toxicity of aminoglycoside antibiotics as an aid in detecting botulism. Appl Environ Microbiol 1984; 48:951-955.

2. Allergan (ELN 1145) BOTOX® COSMETIC (Botulinum Toxin Type A) Purified Neurotoxin Complex(Glabellar Lines) Manufactured by: Allergan Pharmaceuticals (Ireland) Ltd. A subsidiary of: Allergan, Inc. 2525 Dupont Dr. Irvine, California 92612.

3. Bazbek Davletov, Mark Bajohrs and Thomas Binz, Beyond BOTOX: advantages and limitations of individual botulinum neurotoxins, TRENDS in Neurosciences Vol.28 No.8 August 2005.

4. Harimuraleedharan , Book: Bioterrorism (Releasing book review),Tamilnadu book house,Chapter:Biological agents/clostridium.

5. Teguh Thajeb, Yi-Min Chen, Dao-Fu Dai, Daniel Daile Thajeb, Peterus Thajeb Botulism: A Frequently Forgotten Old Malady, Review Article, International Journal of Gerontology | September 2007 | Vol 1 | No 3.

6. Lewis, C. (2002) Botox Cosmetic: A look at looking good. FDA Consumer Magazine July–August, 1–4 .

Guidelines for BOTOX® Reconstitution

1.

Using the reconstitution needle, draw up the proper amount of saline (see dilution table) in the appropriately sized sterile syringe. A 21-gauge, 1®-inch needle is recommended for reconstitution. Reconstituted BOTOX® neurotoxin should be clear, colorless, and free of particulate matter.

2.

Insert the needle at a 45º angle and slowly inject the saline into the BOTOX® vial. Vacuum is present in the vial, which demonstrates that the sterility of the vial is intact. Do not use the vial if the vacuum does not pull the saline into the vial.

3.

Release the vacuum by disconnecting the syringe from the needle and allowing air to flow into the vial. Gently mix BOTOX® neurotoxin with the saline by moving vial side-to-side or rotating the vial.

Draw the fluid into the injection syringe by placing the needle into the bottom corner of the vial for full extraction. Do not completely invert the vial.

5.

Disconnect the injection syringe from the vial and attach an appropriate needle for injection. A 25-, 27-, or 30-gauge needle may be used for superficial muscles, and a longer 22-gauge needle may be used for deeper musculature.

Note: Because the product and diluent do not contain a preservative, use within 4 hours once opened and reconstituted. During the 4 hours, BOTOX® solution should be stored in a refrigerator at 2ºC to 8ºC.

Article Source: http://www.articlesbase.com/skin-care-articles/botox-botox-cosmetic-wrinkle-free-solutions-713380.html

About the Author

R&D scientist

MIOBIO Biological Reserach Center(MBRC)

Bnaglore

info@miobio.com

www.miobio.in

Botox: Fountain of Youth or Poison in Your Face?

Author: Alex Levin

What Is Botox?

Derived from the botulinum toxin type A, Botox is a brand name for a highly purified and diluted preparation of botulinum used in numerous medical and cosmetic applications. It is also sold under the names Dysport and Myobloc. Botox is most widely known for its use in removing wrinkles.

While the botulinum toxic itself is highly poisonous and even deadly, the same toxin in smaller doses can be used to safely treat a variety of conditions. Botox is most widely known for its use in removing wrinkles, but is also has numerous medical applications.

Botox was first used in medicine to treat strabismus, a condition in which a person’s eyes do not align normally, and blepahrospasm, or uncontrolled blinking. Today, Botox is the most commonly performed cosmetic operation in America, with over four and a half million people getting the treatment in 2007.

Does Botox Work?

Botox does work to lessen the appearance of wrinkles, but this effect is temporary and has a host of risks attached, including paralysis of the wrong muscles and changes in facial expressions. So is Botox a fountain of youth or just poison injected into your face? Like so many things in life, the answer isn't black and white, and while this answer many not satisfy some readers, both are true to a certain extent.

What Is Botox Used For?

Cosmetically, Botox is only FDA approved for use in smoothing out wrinkles in the forehead between the eyebrows, reducing crow’s feet, forehead lines and frown lines. Additionally, Botox is used to treat various medical conditions, including:

• Achalasia – an esophageal disorder characterized by difficulty swallowing


• Blepharospasm – involuntary blinking


• Cervical Dystonia – a neurological disorder that causes the muscles around the neck and shoulder to contract uncontrollably


• Hyperhidrosis – abnormal underarm sweating


• Strabismus – crossed eyes

Studies of the use of Botox in treating other ailments such as migraines and prostate problems are ongoing.

How Does Botox Work?

The everyday facial expressions we all make, from happy to sad and everywhere in between, cause our skin to lose resilience. Cosmetic Botox injections work by blocking signals that are constantly firing from your nerves to your muscles. This causes a controlled weakening of the specific muscle targeted, and when the muscle doesn’t contract, wrinkles don’t show up as much. Noticeable improvements are usually seen within the first month after treatment.

How Is the Treatment Administered?

Botox is delivered to the muscle via a fine needle and causes little discomfort. The procedure only takes about ten minutes and requires no anesthesia. If you’re uncomfortable with needles, an icepack or anesthetic cream will do the trick.

Do I Need to Do Anything to Prepare for Botox?

Botox treatment methods vary from clinic to clinic. Some doctors recommend avoiding alcohol for one week prior to treatment and avoiding aspirin and anti-inflammatory medications for two weeks prior. This helps reduce the risk of bruising after injections.

Can Botox Be Used on Other Wrinkles?

No. Botox is only approved by the FDA for use between the eyebrows.

Will Botox affect my ability to make expressions?

You will still be able to make all the facial expressions you always could after Botox injections, just without the wrinkles between your brows showing. Only the muscle that has been injected with Botox is paralyzed. Problems making facial expressions arise when the wrong muscles are paralyzed, and this typically occurs when Botox is administered by someone who’s unqualified. The FDA strongly advises against attending Botox parties for this reason.

When Will I See the Effects of Botox?

Noticeable reduction of wrinkles will be seen within 2-3 days, and the full effects of Botox takes up to week to show.

How Long Does Botox Last?

The effects of a Botox injection last for approximately 4 - 6 months, and the wrinkles will return as the muscle starts to function normally again. Over time, the wrinkles will look smoother even without Botox, as the muscles are being conditioned to relax.

What Are the Side Effects of Botox?

The most common side effect of Botox is mild short-term bruising, which is caused by the mode of treatment rather than by the drug. When Botox is administered by a qualified medical professional side effects are quite rare but may include:

• Allergic Reaction


• Botulism – this illness is characterized by widespread paralysis and is rare when Botox is used correctly


• Flu-like symptoms


• Headache


• Paralysis of incorrect muscles


• Sagging eyelids


• Stomachache

How Much Does Botox Cost?

Depending on various factors such as the experience of the doctor performing the treatment and location of the clinic, Botox typically costs from $200 to $800 per treatment.

Will My Health Insurance Pay for Botox?

Most insurers will not cover Botox for cosmetic use.

Am I A Good Candidate For Botox?

Because the procedure, which requires a short series of injections over the span of a few minutes, is a fairly simple one, most people find they are good candidates for Botox. Botox is FDA approved for use on people between the ages of 18 and 65.

• Do not use Botox if you are breastfeeding.


• Do not use Botox if you are pregnant or think you may be pregnant.


• If you have a neurological or muscular disorder, tell your doctor during your consultation session.


• If you have any allergies, tell your doctor during your consultation session.

If you have any concerns about taking Botox treatments, be sure to bring them up to your doctor. Being informed about the process is the best way to feel comfortable about your decision. In addition, you may want to ask your doctor for references and look at some of his or her before-and-after pictures to get an idea of what to expect.

The information in the article is not intended to substitute for the counsel and expertise of a medical professional. We encourage you to discuss any decisions about treatment or care with your doctor.

Article Source: http://www.articlesbase.com/anti-aging-articles/botox-fountain-of-youth-or-poison-in-your-face-715854.html

About the Author

Alex Tatarinov-Levin is a web content editor for Yodle, a business directory and local online advertising company offering practical and innovative solutions for advertising in the 21st century. Find consumer guides, tips and articles at local.yodle.com/articles.

The Misconceptions about Botox

Author: Dr. Patrick Treacy

Botulinum neurotoxin, which was once called the 'most poisonous poison on the planet'has recently seen a surge in the number of medical conditions that this elegant and specific chemical can treat. In the United Kingdom and Ireland, the pharmaceutical comes in two differing forms, Botox ® and Dysport ®. Botox was the original word patented by Allergan but it has now crept into the common use amongst the public for both. Within the first few months of 2006 the application of this novel compound was extended to use in urinary incontinence, voice tremors, prostatic disease and then came news that it could be used to treat depression. Despite these increasing novel uses of the compound many people are still frustrated by the many misconceptions surrounding it. There is not a day passes but someone asks me "is it a toxin?" "Will it give me a glazed look?" "Will it leave me expressionless?"

Misconception No 1: Botox injections are highly toxic

Nearly every worthwhile drug in medicine is a diluted solution of a toxin. If you had a major cardiac event today and ended up in hospital most of the drugs that would be used to save your life, digoxin, atropine, lignocaine or adrenalin are all chemicals extracted from plants, microbes or animals that are used in a controlled fashion. Some drugs such as digoxin are extracted from the foxglove plant can actually stop your heart beating if they are used in a strong enough strength. If we dilute them they have less effect but could stop your heart from beating uncontrollably and allow it to beat normally. Other drugs such as atropine are extracted from deadly nightshade can block the nerves that slow down your heart and allow it to beat normally again. Roman girls put a diluted form of this compound into their eyes to dilate them and make their suitors feel they were chemically attracted to them. In a similar way, Botox is a mild dilution of botulinum toxin, which can cause a serious form of food poisoning. The safety of Botox is also ensured by its selective administration into a certain muscle or a group of muscles, which leaves it largely incapable of action outside the given area. Remember we give new born babies who suffer cerebral palsy or muscle spasms much higher doses every day without evidence of problems. Many physicians would agree that aspirin and antibiotics are potentially more harmful than Botox. However like any drug, anaphylaxis can occur and Botox procedures should be performed by trained physicians in proper clinics with adrenaline on standby.

Misconception No 2 Patients can develop an "addiction" to Botox injections

This misconception was based on a recent UK psychological study, which was apparently based on a survey of clients at eighty-one clinics. The study reached the conclusion that more than forty per cent of patients regularly using Botox expressed a "compulsive motive" for doing so. The research was conducted by Dr Carter Singh, a psychologist, and Martin Kelly, a plastic surgeon with London Plastic Surgery Associates. The results of the study showed that about forty percent of people who have resorted to Botox injections to reduce wrinkles were very prone to request another such treatment in the near future. Those who had received five or more injections displayed more "addictive traits" than those who had not. However, I personally feel the study was totally unscientific and as I stated in a press release at the time was "nothing but a PR exercise for the authors involved". We really have to ask some simple questions. Firstly, "how could a procedure that a patient requires only twice a year be labeled as addictive?" The authors apparently forget to mention that "if the patient has the procedure more often they build up antibodies against the pharmaceutical and it stops working". "This is something akin to an alcoholic having wine turning into water after the second drink…I don't think alcohol addiction would last very long!" As well as that the medical definition of addiction means it has to involve repeated use of a substance or behaviour despite the patient being aware that it is detrimental to their health. There is no evidence that Botox has any detrimental side effects, in fact to the contrary it has a built in mechanism to protect the patient by the use of new nerve regeneration". In essence, this type of tawdry science appears from time to time and should not get a public airing. It only serves to confuse the public and give these people some short lived glory that the rest of responsible medical doctors takes many years to diffuse.

Misconception No 3: Botox injections are a painful experience

On the contrary, an injection of Botox is usually quite painless. The needle that is used to administer Botox is tiny, in fact it is the same size used by diabetics every day to give insulin. Those who were given Botoxinjections compare their sensations to those experienced during an insect bite. Some patients do prefer applying an anaesthetic cream to the face about fifteen minutes before the procedure and this totally eliminates any possibility of pain. There is no pain after injection as Botox works as a kind of anaesthetic itself.

Misconception No 4:Botox injections cause headaches

On the contrary, although Botox can cause headaches in about 2-3% of people, it actually relieves them in the vast majority of patients treated. It has been known for some time that Botox can help prevent and treat migraine sufferers. To do this, doctors usually inject it into various trigger points that can differ from patient to patient. The duration of action of Botox in migraine prevention varies from about 10 to 13 weeks and the onset of effect may take a few weeks. Ideally, the medication should not be administered more frequently than every 3-4 months. I was interested to see a recent paper by Brazilian dermatologists Dr Bertha Miyuki Tamura and Dr Bobby Chang (Dermatol Surg 2003) who used known acupuncture points to achieve temporary relief of pain in acute migraine. They gave the treatment to 10 women who regularly suffered from severe and prolonged migraines and after 2 weeks, 90% were pain free and one had minimal pain. The results lasted between 4-6 months. This is about the same level of effect that we see in clinical practice.

Misconception No 5: Botox injections distort a facial expression

This is one of the most common misconceptionsabout Botox procedures. Many people seem to forget that the resultant expression on a patient's face is really dependent on the skill of the proceduralist and has little to do with the Botox. This means that the ability of the brow to raise or lower, the ability of the frown to move or not, the ability of the crows feet to disappear or slightly remain is usually dependent on two factors, the amount of Botox added and to the location to where it is added.

Accordingly, facial expressions can be distorted only in case of an overdose or misdirected injection of the drug. By analogy, if your house flooded after installing a new washing machine, surely you would blame the plumber and not the water company. The bottom line is those who want to look five years younger are strongly recommended to use services provided by certified experienced doctors rather than attending home-based charlatans who frequent beauty parlours and salons.

Misconception No 6: Botox injections can cure depression

The idea that Botox can cure depression came from a study in the May 2006 issue of the Journal of Dermatologic Surgery , where Dr. Eric Finzi from the Chevy Chase Cosmetic Center in Marylandclaimed to have treated clinically depressed patients with Botox. This led to further exposure on Good Morning America, where he claimed that by taking away the ability to frown, he was breaking a neurological feedback mechanism to the brain and thereby taking away the ability of his patients to feel depressed. I must say that I was initially heartened to see the study of the treatment of depression with Botox as many doctors will reveal a similar picture from their patient's own experience. I examined Finzi's paper in the Journal of Dermatologic Surgery and was concerned that this doctor used a very small number of patients, lacked a control group, had no psychiatrist assessing the patients and even allowed the patients to assess themselves. I noted in an accompanying commentary, the editor Alastair Carruthers, cited a series of flaws with the study and concluded that its finding must be considered anecdotal. It is of more than passing interest that this doctor has now filed a patent concerning this treatment. If Botox does relieve depression then this is not the paper to prove it.

Misconception No 7: Botox injections can create new wrinkles

This misconception started back in 2002 when Dr David Becker, an assistant professor of dermatology at Weill Cornell Medical College in New York, suggested people unconsciously recreate facial expressions in the area where the facial muscles have been paralysed. His work was published in Cosmetic Dermatology (2002; 12: 35-36). The doctor noted increased wrinkle prominence and the development of fine lines following botulinum toxin therapy for vertical frown lines. His feeling that paralysis of a set of muscles in one area might lead to recruitment of other nearby muscles to compensate was not shared by Allergan (the maker of Botox) who immediately repudiated the results. Other doctors around the world including Dr Robert Sinclair, from the Australasian College of Dermatologists, stated that he had also seen the effects of muscle recruitment after Botox was used in the forehead and frown area. Many other doctors disagreed and in the end Dr. Becker retracted his findings somewhat afraid he was being misquoted. My own impression after treating tens of thousands of patients is that it probably happens to a lot of patients to a very minor extent, but because you can usually easily treat the new muscular activity there is little to worry about. The doctor involved later said "Doctors can minimise the risk of new wrinkles by altering their technique to include potential accessory muscles when rectifying an abnormal expression — so you weaken all muscles, not just the ones responsible for the expression.'

Misconception No 8: Botox injections should be administered only to persons above 40

It is difficult to know where this misconception came from or in reality if it really still exists amongst young people in most developed parts of the world. The feeling possibly exists amongst an older generation who are less exposed to media and peer pressure. These people often feel it is a big event to approach a doctor who get Botox and wish to keep it a secret known only to themselves. In reality, the average age of starting Botox in the US has now dropped to 19 years and Australia is considering legislation not to allow patients below 18years to have it freely available. So, why is there such a generational difference in attitudes to Botox?. It is really simple…young people now realise that it is a lot easier to tackle a problem at its early stage and if they start early they will not develop wrinkles at all. If you start early then you probably get a better response and require less to continue into your later life.

Misconception No 9: Botox will be less effective if it is used to often

There is evidence that about 5% of patients injected continually with BOTOX® can develop neutralizing antibodies that can cause the injections to stop working. The chances of this happening depend on large doses being injected, repeat or booster injections given within four weeks of treatment. There is a new form of German Botox coming onto the market in early 2007, which has a lower potential for neutralizing antibody production because of its decreased protein load. Hopefully this will minimise the problem of non-response.

Misconception No 10: There are risky side effects from Botox injections

This is a total misconception as side effects are uncommon, generally mild, and generally transient. These side effects include nausea, fatigue, malaise, flulike symptoms, and rashes at sites distant from the injections.

 

The needle used can cause some side effects including bruising, pain, redness, headache and local numbness. The most common bothersome side effect is unwanted weakness in a muscle usually around the eye. Fortunately, this usually resolves in a few weeks and in the worst case scenario may last until the action of the toxin usually disappears in four to six months.

Misconception No 11: There is no effective treatment if a brow or an eyelid drops after Botox injections and patients have to wait until it wears off.

This is a misconception to an extent, although any person who has had to sit out four months with a lowered eyelid may think differently. Lowering of the upper brow or eyelid (ptosis) can occur after injection in the frown muscles. This may occur as late as 2 weeks after injection and is more common in older patients receiving Botox for the first time. Patients are usually instructed to avoid rubbing the area. Some doctors feel that actively contracting the muscles under treatment may increase the uptake of toxin and decrease its diffusion. Most lowered brows tend to settle after about 4 weeks. Elevated brows can easily be corrected. It is more difficult to treat eyelid drop, although many patients are responsive to a special adrenergic agonist eyedrop called apraclonidine. This medicine causes specific Müller muscles to contract but it should not be used in patients with documented sensitivity. Phenylephrine (Neo-Synephrine) 2.5% can be used when apraclonidine is not available. Neo-Synephrine is contraindicated in patients with narrow-angle glaucoma and in patients with aneurysms. Use 1-2 drops 3 times daily until the ptosis resolves. Doctors will try and minimise this happening by placing injections 1 cm above the eyebrow and not crossing the line of the pupil.

Misconception No 12: Patients are not allowed to lie down for four hours after receiving a Botox injection

This is probably a misconception although many doctors still give patients this instruction. The perceived logic comes from the fact that lowering of the eyelid (p tosis) is thought to be caused by migration of toxin through the orbital septum. Patients are thereby instructed to remain in an upright position for 3-4 hours following injection. However, if this was the only reason then patients should really stand on their heads to prevent this type of diffusion. In general I don't tend to give patients this instruction but do tell them to avoid manual manipulation of the area. Active contraction of the muscles under treatment may increase the uptake of toxin and decrease its diffusion.

Misconception No 13: Patients are not allowed to fly after receiving a Botox injection

This is also probably a misconception although many doctors still give patients this instruction. The perceived logic comes from the fact that different cabin pressures could contribute to causing migration of toxin through the orbital septum. Patients are thereby instructed not to fly following injection. However, cabin pressures are generally the same as the air pressure on the ground. It is the air pressure outside the cabin that is different. In general I treat many patients from overseas and usually don't tend to give patients this instruction but do tell them to avoid manual manipulation of the area. Active contraction of the muscles under treatment may increase the uptake of toxin and decrease its diffusion. If they are flying long haul, I tell them to wait one day.

Misconception No 14: Patients will always look better after Botox injections.

This is a misconception as weakness of the lower eyelid can occur following injection of a muscle in this area called the lateral orbicularis oculi. This weakness then allows the fat pad under the eye to bulge out causing the patient to appear more tired than they were before they had the Botox injections. This effect will eventually disappear but it will last the four to six months that the Botox has effect.

Misconception No 15: Botox injections are dangerous if given during pregnancy

This is another misconception. From evidence from millions of people all around the world, women who inadvertently were injected during pregnancy thus far have had uneventful deliveries, and to date no fetal abnormalities have been attributed to botulinum toxin. Nonetheless, it is a category C medication, and delay of injections is recommended until pregnancy is complete and breastfeeding has ended

Misconception No 16: Botox injections are good for facial lines only

This is a total misconception that is still held by a few people. In fact many of my patients are surprised to learn that young infants with muscular spasms and cerebral palsy receive higher concentrations of Botox than they do. They are also surprised to learn that it was actually doctors who were treating muscular spasms that discovered it had an anti-wrinkle effect as a beneficial side effect. In reality Botox is now used to treat sweating, migraine, incontinence, spasms, strokes, multiple sclerosis, anal fissures, writers cramp, cross eyes, cerebral palsy, prostate disease as well as chronic back and neck pain.

Misconception No 17 : Botox is not yet used to treat back pain

On the contrary, there are many UK and Irish doctors already using Botox for this clinical indication. Studies began when researchers from the Walter Reed Army Medical Center in Washington, D.C., studied 31 patients with lower back pain. (Bahman Jabbari: Neurology, 2001). All of the patients had experienced pain for at least six months, with an average of six years, and were taking standard medications, which they continued to take during the study. Patients received either Botox injections or injections of a saline solution. Three weeks after the injections, 73% of those who received Botox injections said the amount of pain they experienced had gone down by 50% or more. Two months later, 60% of those who received Botox said their pain was still decreased by 50% or more.

Misconception No 18: Botox has little effect on underarm sweating

On the contrary, Botox has nearly a 100% effect on excessive sweating that can last up to a year. The condition known as hyperhydrosis is caused by the overstimulation of sweat glands by the autonomic nerves. Other sites commonly affected include the palms, soles, back and face. Botox injections now have been cleared for this use in most western countries are extremely effective in treated the condition. Although I have been treating patients for underarm sweating since 2001, the earliest publication that I can find relating to the subject is a study at the University of California San Francisco ( Derm Surgery 2002). The study involved twelve patients who received injections of Botox® directly in the underarms. Amounts of the medicine used were similar to those used for wrinkles and frown lines. All patients reported decrease of underarm sweating within 48 hours of the treatment. Further follow-up suggested the treatment is effective for five to twelve months.

Misconception No 19: Different types of Botox last for different periods in patients

In the United Kingdom and Ireland, the pharmaceutical comes in two differing forms. One is known as Botox ® and the other Dysport ®. There is anecdotal suspicion amongst many doctors and patients that the UK variety Dysport ® lasts six months while the US based formulation Botox ® lasts four months. Various clinical studies have shown no difference between the two groups. However, my own experience would tend to favour the patients anecdotal beliefs.

Article Source: http://www.articlesbase.com/anti-aging-articles/the-misconceptions-about-botox-1110507.html

About the Author

Dr. Patrick Treacy won "Professional Journalist of the Year" in 2003 for his award winning column "The Cutting Edge" published weekly in the Irish Medical Times. His lecture series on minor surgery was published in Modern Medicine of Ireland Dr. Treacy is a cosmetic columnist with Ireland's Rejuvenate Cosmetic Surgery Magazine, Health & Living Magazine as well as the UK Aesthetic Medicine and MediSpa Destinations Magazines. Dr. Treacy is regularly invited to speak about Cosmetic Medicine on Irish breakfast television (TV3), RTE TV and Discovery Health and has been an expert panelist with the BBC World Services on many occasions.

Botox Injection Technique for Wrinkle Reduction in Virginia

Information about botox treatment
Botox Injection Technique for Wrinkle Reduction in Virginia.

Board Certified Facial Plastic Surgeon in Northern Virginia, Dr. Naderi, discusses and demonstrates his injection technique for Botox. Botox is injected to the forehead, crows feet, lower eyelid and frown lines of a young female to PREVENT formation of lines and wrinkles. A very conservative 30 units of Botox is used for all three areas (Cost $450). This can be repeated about 3 times / year.

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Smoothing Your Furrowed Brow With Botox

Author: Botox Vicks

Botox has grow to be the favored treatment for erasing the lines and wrinkles that appear as we age.
Both males and ladies make use of this easy and successful treatment when they want to appear and sense their greatest.


There is absolutely nothing wrong with hoping to seem your finest or acquiring therapies to complete this. Aging gracefully doesn't imply that you should ignore your look or put up with lines and wrinkles that you hate to appear at each and every day.
You are not denying your age when you try to enhance your look.
By searching your best, you will really feel your finest and be able to appreciate life to the fullest.

Botox operates by soothing the muscular tissues that contract and lead to frown lines and fine wrinkles.
A lifetime of laughter and concentration can result in our muscle groups around our eyes, mouth and among our eyebrows to contract even when we don't consciously frown or grow to be amused.
By injecting quite modest quantities of Botox into individuals muscle groups, they relax and the lines that marred the encounter are removed.


There are a lot of myths about Botox therapy that retain some men and women from enjoying the benefits of it. Due to the fact the formal title for the substance injected is Botulinum toxin, several individuals assume that a dangerous substance is becoming applied.


The sum of Botox employed in cosmetic treatment options is this kind of a tiny dose that it can't possibly have the unfavorable consequences of botulism. In fact, the FDA approved Botox in 2002 for cosmetic and therapeutic treatment options for a assortment of medical problems this kind of as excessive sweating, muscle discomfort, spasticity, neck soreness and uncontrolled blinking to name just a couple of.

It is not true that Botox numbs the confront.
When applied by a qualified doctor there are no such side results.
Only when a particular person tries to save money by going to an untrained amateur do they suffer ill results from the therapy.
One particular should often go to a cosmetic surgeon, a dermatologist or other licensed, skilled medical professional who has experience with the process.

Botox treatments are administered in the physician's office or in a specialty clinic and typically take just a number of minutes.
The advantages last up to four months, after which you can go for another remedy if you like. If you believe that receiving injections is painful, believe once more! The needles used for the process are so great that you'll barely sense it. Some patients report some tenderness and slight bruising but by the subsequent day even these results have disappeared.
Your physician will possibly advise you to use those facial muscle groups for a few hours in order to distribute the medicine evenly.

Before your method, be certain to tell your medical doctor if you've had facial surgery or are pregnant or planning to be.
Give him or her a total list of any medications you are getting and any physical ailments you have now or have had in the past such as asthma or bronchitis.

Good luck with your Botox Injections

Article Source: http://www.articlesbase.com/health-articles/smoothing-your-furrowed-brow-with-botox-2706447.html

About the Author

For more information on Botox and Alternatives visit http://backlinker.com/wc/botox/