Botox: What’s it about?

Sat. February 3, 2007 12:00 AM
by Omeed Memar, M.D.

There sure is a lot of buzz in the news about anti-aging products, plastic surgery, wrinkles and the like. Let's face it, today we are aging very differently than our parents. Gone are the days of the 60-year-old blue haired ladies. Today's 60 is Chrissy from Three's Company, Sir Elton John and Diane Sawyer. Merely by aging so beautifully we have caused a new trend in skin care known as "facial rejuvenation." Botox® is credited with having paved the way for this medical specialty, after being approved for cosmetic use in 2002. Today, there are some 3 million procedures performed annually using Botox®. In 2007, you are going to hear a lot about additional injectable products coming to market for the treatment of wrinkles and fine lines. As we kick off 2007 and the advent of this new medical speciality, I thought we'd spend some time looking at where it began, Botox. ®

Botox: What's it about?

Botox® (Botulinum Toxic A) is a purified protein made from the botulism bacteria. In minute quantities, it is used to treat painful muscle spasms and for cosmetic purposes. It is used to improve the appearance of wrinkles, frown lines and even to treat excessive underarm sweating. By selectively interfering with the underlying muscles' ability to contract, existing wrinkles and frown lines are smoothed out and nearly invisible in a week.

What's involved? Botox® is a non-surgical process. Each treatment takes about 10 minutes. Just a few tiny injections and within days there can be a noticeable improvement in the moderate to severe frown lines between the brows. Results vary and there's really no recovery time.

"I've been using Botox since it was first approved a few years ago," said David H. "I have this very prominent crease in the middle of my forehead and Botox is the most effective way to smooth it out, helping me look a few years younger," he says.

Can anyone have Botox®? You should not use Botox® if you have an infection in or around the area to be treated. And if your skin is hypersensitive it should be avoided. Patients with neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome may be at increased risk for side effects.

When will I need further treatment? The effects of Botox® can last up to four months, after this time the lines will start to reappear. David, for example, has a standing appointment every 14 weeks. It has been his experience that this is when he's ready for a new treatment.

Things to look out for/side effects. Bruising at the site of injection is a side effect, not of the toxin, but how it was administered. You want to avoid alcohol and remain upright for several hours following the procedure. The FDA recommends that Botox® be injected no more frequently than once every three months and that the lowest effective dose should be used.

Does it hurt? This is the question most often asked. The discomfort is usually minimal and brief. As the treatment is carried out with a needle, you're going to feel the prick of the needle, but its not any more than a pin-prick feeling.

Cost? Each set of injections cost about $250 and typically last up to 4 months.

How Long Does a Botox Injection Last? The effects from Botox will last four to six months. As muscle action gradually returns, the lines and wrinkles begin to re-appear and wrinkles need to be re-treated. The lines and wrinkles often appear less severe with time because the muscles are being trained to relax.

What Are the Side Effects of Botox? Temporary bruising is the most common side effect. Headaches, which resolve in 24-48 hours, can occur, but this is rare. A small percentage of patients may develop eyelid drooping. This usually resolves in three weeks. This development is usually caused by migration of the Botox and for this reason, you shouldn't rub the treated area for 12 hours after injection or lay down for three to four hours.

Who Should Not Receive Botox Injection? Patients who are pregnant, breastfeeding or have a neurological disease should not use Botox. Since Botox doesn't work for all wrinkles, a consultation with a doctor is recommended.

Will My Insurance Pay For It? Insurance coverage varies for Botox injections, depending largely on the medical necessity of your condition. Botox is not generally covered by insurance when used for cosmetic purposes. Check with your insurance carrier for coverage details.

For more information, visit Next month: Lipo.