Yep- I’m on a roll with my “things you might not know.” But since this blog is a chance for me to share all the things about Plastic Surgery that I find fascinating, it’s a pretty convenient title. Today I’m going to talk about a topic that is near and dear to Plastic Surgery- Botox.
Botox has been FDA-approved for over 20 years, and it’s first use was actually to treat muscle spasms around the eye. It is derived from botulinum toxin- yep, the bacteria that grows in canned food gone bad. Botulinum toxin prevents nerve cells from communicating, which makes it widely useful in medical terms. It has been used to treat everything from heavy sweating to muscle spasm to wrinkles.
Botox is only one of several botulinum toxins available on the market. Just like Xerox becoming synonymous with making copies, Botox has become synonymous with treating wrinkles. But there are actually a couple different brands of botulinum toxin A on the market, including Xeomin (Merz), and Dysport (Medicis). Doctors will offer these injectables at different prices, depending on what kind of special the manufacturer is offering them. But there is actually not a lot of data out there giving comparisons between different formulations, especially regarding dosages. So ask your doctor how long he or she has been using the formulation offered to you. That way you can be sure they’re comfortable with the dosage of that particular medication.
The only FDA-approval Botox has for cosmetic use is for glabellar lines (those little wrinkles you get between your eyebrows). Does this mean it should not be used for other wrinkles? Not necessarily. Seeking FDA approval is a long and complicated process. Many drugs are used for “off-label” uses, meaning the use is outside the use for which the company sought FDA approval. An example would be statins, the category of drugs that lower cholesterol. Most of these drugs are FDA approved to lower cholesterol, NOT to prevent heart attacks. We know that lowering cholesterol does prevent heart attacks. But unless a company actually follows its patients to prove that they have a lower incidence of heart attacks, they cannot have their drug FDA-approved for this use. It’s much easier to prove that your drug lowers cholesterol, as it would take many more patients and many more years to prove that your drug reduces the risk of heart attacks. So just because Botox is only FDA-approved for the lines between your eyebrows does not mean that it can’t be safely and effectively used for other areas.
Botox lasts longer the longer you use it. Well… technically the Botox lasts the same amount of time. But the more regularly you use it, the weaker the muscles you’re treating get. This means that the muscles which make those little wrinkles you hate get weak and wither away (just like your biceps would, if you quit going to the gym!). The upside is that if you’re consistent about getting Botox as it wears off, you can save money later on by spacing out your treatments.
Botox is easy to inject, but hard to inject correctly. Think about that- any medical professional who is handy with a syringe and needle can order Botox and inject it. From dentists to gynecologists, many different types of medical professionals are trying to cash in on the lucrative market that Botox, and other botulinum toxin derivatives, provide. But unless your doctor is trained in cosmetic surgery, he or she is unlikely to be intimately familiar with the underlying structure of facial muscles that Botox targets. This means less effective treatments for you, and possibly a higher risk of complications.
Do you have any experience with Botox that you would like to share?