Botox...The Next Best Thing To A Facelift?

It’s hard to believe that people would actually pay to have their faces injected with a bacterium that causes paralysis of the face muscles. But that is of course what millions of Americans do every year and the number continues to increase. Since the procedure received FDA approval in April of 2002, my phone continues to ring off the hook from patients with questions regarding the pros and cons of Botox injections. As a matter of fact the American Society for Aesthetic Plastic Surgery (ASAPS) says nearly 1.6 million Botox treatments took place in the year 2001, a 46% increase since 2000 and a whopping 2,356% increase since 1997. It is estimated that 2.8 million individuals in the U.S. underwent Botox treatment in 2008. Although women usually outnumber men in their desire to look more youthful, men are finding they too are happy with their appearance after a visit to their skin specialist for a quick Botox enhancement. Most people associate Botox with the “next best thing” to a facelift for getting rid of frown lines and forehead furrows. Not to mention that it costs a whole lot less and recovery time is minimal. Botox is fast and convenient to the extent that the treatment has been aptly named “the lunch hour procedure”. rnWhat many people don’t know is that Botox was used in the past to treat a variety of medical conditions before it became widespread for cosmetic purposes. It was administered effectively to treat crossed eyes, uncontrollable blinking, skin conditions, as well as glandular and neurological disorders. When the FDA finally approved it, a press release stated that Botox should be used temporarily for improving “the appearance of moderate to severe frown lines between the eyebrows”. In a random study, placebo-controlled, researchers found that frown lines vastly improved or disappeared in people within a month of being injected with Botox. Why the Controversy? First of all, Botox comes directly from a deadly bacterial toxin, Botulinum Toxin Type A, a protein complex produced by Clostridium botulinum, a bacterium known to cause severe food poisoning and even death. A shot of poison into your face doesn’t sound like a very smart thing to do, but here is how it works. When injected into the face, Botox blocks acetylcholine receptors and halts the pathway leading to the contraction of muscles controlling the ability to frown. When used properly by a qualified doctor, the results are surprisingly beneficial. It only takes about a fraction of a teaspoon of Botox to make a dramatic difference in the disappearance of frown lines. Typically, Botox treatment is done in a doctor’s office. The patient is asked to sit upright and flex his or her facial muscles while the Botox is injected. The patient is advised not to lie down for the next four or five hours to give the treated facial muscles a chance to fall into the natural positions they would hold during the day. Results last for four to six months for most people but every patient responds differently to the drug. Pros and Cons of Botox I’ve touched on some of the pros of Botox treatment earlier in this article. It is quick, less costly than surgical procedures, minimally invasive, and you see results within a few days. The cosmetic industry refers to it as the ideal procedure and it has become a multi-million dollar market to say the least. Let’s talk about the downside of using Botox cosmetically. Any time you take a foreign substance into your body, especially a drug, there is the risk of side effects. These may include flu-like symptoms, nausea, respiratory problems, and facial pain like stinging, burning, or allergic reactions. Botox also weakens the facial muscles that have been affected by the injection. There may also be complications with medications that you might presently be taking or if pregnant, it could affect your unborn fetus. However, the evidence of such potential side effects is at this time inconclusive. rnOne of the biggest concerns is that the person injecting the substance may not be qualified to do so. If Botox is not administered properly, it can cause the patient to have droopy eyelids for a week or longer. The FDA insists that a trained certified physician who specializes in facial cosmetics, in a sterile environment, give Botox injections. Is Collagen a Botox Competitor? Collagen is another popular cosmetic treatment that is often used alone or in conjunction with Botox. It is used to fill in creases, wrinkles and depressions in the face with results lasting anywhere from 3 to 6 months. Collagen is derived from purified bovine (cow) but can also be made synthetically for those who have a positive reaction to a preliminary collagen skin test. The injections may be more painful than Botox and can become very expensive to keep up. The procedure is usually done as an outpatient in a similar fashion to that of how Botox is administered. If you think Botox or collagen injections are for you, make sure to check the qualifications of your doctor and ask a lot of questions. Talk to your doctor about your concerns, identify your expectations and be specific on the results you are looking to achieve. Weigh the pros and cons, consider the risks, and proceed only when you are completely comfortable with your doctor. The good news is the results are usually temporary, and the treatment is much less invasive than laser and surgical procedures. At the end of the day the choice is up to you! Jay Brachfeld, M.D.