Here's a little information about a procedure we offer at our practice.
Botulinum Toxin, or Botox is one of the fastest growing procedures in Cosmetic Medicine. Derived from the bacteria, Clostridium botulinum, Botox is a highly refined neuromuscular paralyzing agent. There are seven distinct neurotoxins produced by this bacteria, types A,B,C,D,E,F, and G. Botox is purified Toxin Type A. Another product on the market consisting of the same neurotoxin Type A is called Dysport. These products are essentially the same, but are manufactured by different pharmaceutical companies. Dysport does tend to migrate a little more from the injection site, which can be good and bad, depending on which region of the face is being injected. The forehead can be more diffuse, but you don't want to migrate too much around the eyes or you can have a drooping eyelid. The effects of the purified neurotoxin is not permanent, but does last about 3 months.
It is used as a cosmetic procedure to temporarily paralyze an injected muscle in order to provide wrinkle reduction and/or to sculp the face by preventing muscular contraction. It's medical applications include treatment of strabismus, blepharospasm, dystonias, and severe intractable tension headaches. The FDA has only approved botulinum toxin A for Glabella wrinkle reduction and axillary hyperhydrosis, due to an odd side effect of inhibiting normal function of apocrine sweat glands. It's use is cosmetic medical practice has been extended to include other facial muscles similar to the procerus and corrugators of the glabellar region which include, but are not limited to the horizontal forehead lines, crow's feet, bunny lines, verticle lip lines, brow lifting, mental crease, dimply chin, horizontal neck lines, platysma bands, nasal flare, bummy smile, and nasolabial folds. Not all injectors will know these applications, but most injectors will know how to treat the brow, glabella, crows feet, and bunny nose areas, which seem to be most popular.
Why choose a cosmetic procedure that only lasts 3 months? Why paint your nails? Facelifts are permanent and much more costly and involve more risk and involve more down time for healing than the average cosmetic patient would like to invest in. Botulinum toxin A treatment is relatively painless, numbing creams can be applied pre-treatment for patients who do not have contraindications. The patient can return to work immediately after having it done and there is no downtime. The effects of the toxin take several days to reach maximum effectiveness, so don't expect to look any different for a few days. The cost of Botox and Dysport are very similar to each other, usually about $8-$12 per unit per treatment depending on location. Usually a place that injects more regions of the face will discount the units as they go along or bundle the costs with other sales in the office. The actual procedure takes about 15-20 minutes. When combined with fillers, Botox/Dysport treatments can be subtle, but stunning. It's a nice treat before a wedding, class reunion or holiday occasion. The effects are more effective when combined with other aesthetics procedures like microdermabrasion or chemical peels and, of course good skin care. The wrinkles fade after 2-3 weeks as old skin exfoliates and new, unfolded skin, forms.
There are certain myths that come up repeatedly, so let me address one of them. "It results in a frozen look," or "I will lose all expression." This is only the case when a client chooses to have too many areas in their face done all at once or staggers the treatements with multiple clinics or when the physician/nurse injector uses way too much toxin in too many areas. Most of the time I try to talk patient-clients out of doing too much. I like to treat 1-2 areas and bring them back to see if they are happy with the results. I also like to maximize the effects of Botox inections by combining them with gel peels and/or microdermabration to give their skin a clean glow and tighten their pores and fine wrinkles. You can always add more, but you can't take it back too easily once you've injected it.
Does a doctor have to do the injections? Not necessarily. Doctors, both MD and DO can perform the procedure as well as Dentists, Oral Surgeons, Nurse Injectors of all sorts. Most importantly, they should have received adequate training in the procedure and have a certificate of that training posted in the office. Every doctor, dentist and nurse is trained to give injections, but additional training in Botox/Dysport technique is important to avoid unnecessary bruising, discomfort, and maximize theraputic efficacy. We have a trained and licensed esthetist in our office, but I'm the only person who does the Botox injections. I'm kind of a control freak and enjoy the peace of mind knowing that I do my own injections. How do you find a certified injector in your area? You should be able to go to Dysport or Botox product web site and see who is ordering their products and dyspensing in your area. Those offices should have a web site to look at what they offer and may or may not list pricing. Then, just call and make a consultative appointment to see the office, meet the people performing the procedures and get some pricing.
Botulinum toxin is a fast, easy, safe and cost effective way to take the wrinkles and creases out of your skin and look years younger. I hope you found this article insightful and enjoyable, now go out there and get fit and beatiful!
Dr. Arthrur J. Ronan is a Board Certified, D.O. Family Physician who is also a certified physician injector of Botox and Dysport forms of botulinum toxin A.
