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Thread: Wine, Cheese and a Bit of Botox

  1. #1
    Senior Member Max's Avatar
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    Wine, Cheese and a Bit of Botox

    Wine, Cheese and a Bit of Botox
    Sat Jul 27,11:49 PM ET
    By Jennifer Thomas
    HealthScoutNews Reporter

    SATURDAY, July 27 (HealthScoutNews) -- Remember when Tupperware was all the rage for themed get-togethers at home?



    Oh, how times have changed.

    Hip hostesses today are inviting their closest friends over for Botox injections.

    Ever since the U.S. Food and Drug Administration ( news - web sites) approved the toxin's use for certain cosmetic procedures this spring, Botox parties have become a big hit in many parts of the nation. Doctors offer their services in homes for groups of mainly women, who make the occasion festive with hors d'oeuvres and chardonnay.

    However, the trend is causing some physicians to furrow their own brows with worry. They warn the procedure should be taken more seriously. Not only can there be unwanted side effects from poorly done Botox injections, doctors are walking a fine line of medical ethics, critics contend.

    "It heralds a real degeneration of ethics in medicine," says Dr. Lisa Donofrio, an assistant clinical professor of dermatology at Yale University School of Medicine. "What's next? At-home liposuction? If we don't draw the line, this could become more and more pervasive until patients are really being put at risk."

    Botox is no mere anti-wrinkle cream. Botulinum Toxin Type A -- popularly known as Botox -- is derived from the bacterium that causes the illness botulism. For the cosmetic procedure, small doses of Botox are injected into a facial muscle, blocking the nerve impulses that cause the muscle to contract.

    By essentially paralyzing the muscle, Botox can decrease the appearance of wrinkles around the eyes and forehead. The American Society of Plastic Surgeons estimates 1.6 million Botox procedures were done last year, making it the No. 1 non-surgical cosmetic procedure performed in the United States.

    To solicit clients, some physicians are sending out invitations advertising the Botox party concept. A Botox treatment on one area of the face typically involves four to 15 injections and costs from $300 to $600, although some doctors offer group rates for women at parties. The effect lasts about three months.

    While Botox injections at home are becoming more common, many plastic surgeons and dermatologists refuse to do them anywhere than their medical office.

    "When you take something out of the office setting, you're setting yourself up to be more casual and less safe," says Dr. Melanie Grossman, a clinical assistant professor of dermatology at Columbia University in New York City. "And I would never mix alcohol with any medical procedure."

    In rare cases, people can faint at the sight of a needle or have a dangerous allergic reaction to the procedure, she says.

    Only a physician can legally buy Botox. However, Donofrio says she knows of cases in which physicians buy it, and then permit nurse practitioners and even medical assistants to do the injections.

    "They're using their office as a money-making factory," Donofrio says.

    For example, she says, spas often have a medical director. However, the doctor may rarely be there and, instead, medical assistants do the injections.

    Improperly done, Botox injections can cause partial facial paralysis and drooping eyelids.

    Some plastic surgeons have different reasons for objecting to the Botox-and-brie trend.

    Botox is being over-hyped as a cure for facial wrinkles, says Dr. Gustavo Colon, chief of the division of plastic surgery at Ochsner Clinic Foundation in New Orleans.

    "Botox is not the end all be all," Colon says. "It's just one more arrow in the quiver of rejuvenation. The ultimate thing to remove facial lines and wrinkles is surgical procedures such as face-lifts. It's the only thing that will correct sagging skin and take away lines."

    "For facial wrinkles around the mouth, Botox won't work," Colon adds. "It only works in certain areas of the face, and is only good for some people. A woman who comes in with a lot of wrinkles and a lot of sagging skin, she may not be a good candidate for Botox."

    Donofrio says patients should carefully check the credentials of the physician doing the injections, and receive an individual evaluation before the procedure. People with certain neurological disorders should not receive Botox injections, she adds.

    What To Do

    To read more about Botox and to see before-and-after pictures, visit Dermnet. Or read this American Academy of Dermatology Patient Alert that includes questions to ask before you have the procedure.

    http://story.news.yahoo.com/news?tmp...a_bit_of_botox

  2. #2
    In May, Newsweek did a front cover story on BOTOX. The drug has gotten an incredible amount of press lately and cartoons and jokes are turning up by the bucketloads. My problem with all this press is that it trivializes the use of the drug. BOTOX has many wonderful applications in the treatment of muscle spasticity in neurologic conditions. We first started using BOTOX in 1994 primarily for kids with cerebral palsy. Since then, we have treated hundreds of patients with many muscle spasticity related conditions resulting in pain and functional dysfunction. It has been a godsend to many. These kinds of applications are rarely, if ever, mentioned in the articles about the cosmetic uses for BOTOX. I am concerned about the effect of this media attention as it relates to the availability and cost of the drug for those who really need it. Hopefully, Allergan has planned ahead and will have an ample supply to meet the needs of everyone. I shall step down from my soapbox now. Thanks for listening. (EMK)

  3. #3
    Super Moderator Sue Pendleton's Avatar
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    How about if I go back on up EMK? I permenantly had loss of strength in my right wrist pronator from botox injections. I was getting them for a hand contracture. I knew all the risks that were known at the time too. It is great stuff when needed. I'd probably go back and do those sessions again even with this because I was able to lossen my palm tendons up some. But for overall muscle looseness, I found 4-AP works better for me. I also read an article once on a search of Medline where there has been some findings of botox a long way from where it was injected. So use it for wrinkles? Not me, I'll pay for surgery.

  4. #4
    In my opinion, one of these days we will look back on Botox and wonder why it was used. It is botulinum toxin. Some thoughts...

    1. When injected into muscle, it is picked up by the nerve terminals that innervate the muscle. In lower doses, it depletes the terminals of acetylcholine. In higher concentrations, it destroys those terminals and the axons must sprout out again.

    2. If botox is used for treating contractures, it should be accompanied by physical therapy that ensures that the contracted muscle be stretched out. Otherwise, what you get is weakness and atrophy of the muscle without really reversing the contracture.

    3. It is not useful for general spasticity and is best used for only for cases where individual muscles are spastic. Before Botox, surgeons did tendon lengthening of spastic muscles.

    4. In the hands of people who don't know how to use it, it can be dangerous. For example, it does evoke an immune response with repeated use. If too much is injected, it will cause irreversible weakening of the muscle. It is likely that we will see an increasing incidence botox complications in the coming months. http://depts.washington.edu/otoweb/b...xComplications
    http://www.ph.ucla.edu/epi/bioter/co...ionsbotox.html

    Wise.

  5. #5
    Senior Member Max's Avatar
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    Safe Administration of Botulinum Toxin is the Key Ingredient to Younger, Smoother Skin

    Safe Administration of Botulinum Toxin is the Key Ingredient to Younger, Smoother Skin
    Library: MED
    Keywords: BOTULINUM TOXIN DERMATOLOGY BEAUTY SKIN SAFETY DERMATOLOGISTS
    Description: The Food and Drug Administrations (FDA) recent approval of botulinum toxin type A for the treatment of fine lines and wrinkles has created a new demand for this treatment that can easily reduce the signs of aging. But what exactly is botulinum toxin, how does it work, and most importantly, who should be administering this procedure? (ACADEMY 2002)



    Karen Klickmann
    (847) 240-1735
    kklickmann@aad.org

    Jennifer Gale
    (847) 240-1730
    jgale@aad.org

    Julie Bremer
    (847) 240-1743
    jbremer@aad.org
    EMBARGOED UNTIL AUGUST 3, 2002

    SAFE ADMINISTRATION OF BOTULINUM TOXIN IS THE KEY INGREDIENT TO YOUNGER, SMOOTHER SKIN

    NEW YORK (August 3, 2002) --The Food and Drug Administration's (FDA) recent approval of botulinum toxin type A for the treatment of fine lines and wrinkles has created a new demand for this treatment that can easily reduce the signs of aging. Spas, shopping malls and walk-in clinics are all advertising the availability of this new "fountain of youth." But what exactly is botulinum toxin, how does it work, and most importantly, who should be administering this procedure?

    Speaking today at ACADEMY 2002, the American Academy of Dermatology's summer scientific meeting in New York, dermatologist James M. Spencer, MD, Associate Professor and Vice Chairman, Department of Dermatology, Mount Sinai School of Medicine, New York, discussed the advancements in botulinum toxin and cautioned consumers to select a qualified physician, such as a dermatologist, to administer this procedure.

    "Today, botulinum toxin can successfully treat a variety of cosmetic and medical concerns," said Dr. Spencer. "In fact, as dermatologists continue to research the medical benefits of botulinum toxin, future uses and opportunities will develop."

    Botulinum toxin is a purified form of one of the most potent toxins in the world. It is produced by a bacteria, clostridium botulinum, and infection with this bacteria is the cause of botulinum. However, when the bacteria free toxin is carefully injected by dermatologists in very low doses, botulinum toxin is a modern tool that can reduce the signs of aging.

    Botulinum toxin blocks nerve signals transmitted from the brain to the muscle, causing paralysis of the injected muscle. It works locally by inhibiting the release of acetylcholine, a neurotransmitter, from the nerve. After injection, the muscle relaxes, creating a smooth, yet temporary surface. Within a week after a patient is injected with botulinum toxin, the affected wrinkles and creases soften from the disuse of the muscle. Since botulinum toxin decreases the patient's ability to frown or squint, it also safely and effectively prevents the progressive worsening of these lines over time.

    Dermatologists are now able to sculpt the face non-surgically by the selective use of botulinum toxin in key areas. Wider applications on the face have been developed and extended to improve the appearance of the neck and upper chest.

    "Aside from treating fine line and wrinkles, botulinum toxin has other medical applications," said Dr. Spencer. "The ability to selectively weaken overactive muscles has had a tremendous application not only in dermatology but in the medical fields of ophthalmology and neurology as well," said Dr. Spencer.

    Recently approved to treat aging skin, botulinum toxin type A is just one of a variety of strains of botulinum toxin that is being used medically around the world. This assortment of strains, labeled botulinum toxin A through G, produces seven related, yet distinct toxins.

    Until recently, botulinum toxin type A toxin was the only strain of botulinum toxin administered in the United States, however, botulinum toxin type B is also now available. Although the action is similar to type A, botulinum toxin type B is an entirely different composition with its own advantages and disadvantages. While botulinum toxins A and B are different sizes and effect different targets inside cells, they produce the same effect: muscle paralysis.

    "Different variants and strains of botulinum toxin are a great benefit to the patient and their dermatologist," said Dr. Spencer. "The greater choice and flexibility enables the dermatologist to pick the right medication for the right patient, which enhances the results."

    The popularity of botulinum toxin has led to non-medical personnel not only administering the toxin but also conducting the procedure at casual social gatherings.

    "Because this is a quick, safe and effective method to treat wrinkles with no downtime when performed by qualified physicians, many patients are compromising their safety by having this medical procedure performed in an inappropriate setting, often by untrained, as well as non-medical professionals," said Dr. Spencer.

    "As with any medical procedure, the possibility of adverse effects occurring from a botulinum injection is always a possibility and the Academy strongly believes that patient safety comes first and should not be taken lightly under any circumstances. Botulinum injections are best performed in a medical setting for maximum patient safety."

    To assist patients in choosing a qualified physician, the AAD recommends that before undergoing any cosmetic procedure, patients should ask the following questions and consult with their dermatologist to determine which treatment is best for them:

    * What are the doctor's credentials? Is he/she a board-certified dermatologist or other appropriately trained surgeon? Ask to see their credentials.
    * How many of these cosmetic surgery procedures has the physician performed?
    * What results can be expected?
    * How long is the recuperation period? Ask to see before and after photos of the physician's previous patients.
    * What are the risks?
    * Where is the cosmetic surgery usually performed?
    * What is the cost?

    "Patients should always consult with their dermatologist prior to any medical procedure," said Dr. Spencer. "A well-informed patient and a skilled dermatologist are always the best prescription for a successful outcome."

    The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of over 14,000 dermatologists worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care for a lifetime of healthier skin. For more information, contact the AAD at 1-888-462-DERM or http://www.aad.org.

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