Botox and Injectables

Botulinum toxin type A (Botox) is a medication that has been used since the 1980's to address eye conditions such as blepharospasm, hemifacial spasm and strabismus. It has recently been approved for use as a therapeutic agent for migraine headaches.

Botox is the most popular agent for cosmetic procedures in this country, and is used for a multitude of FDA approved (glabellar folds, aka forehead wrinkles between the brows) and off-use ("crow's feet") locations.

Botox treats wrinkles in animation. As we age, our untreated wrinkles eventually become fixed. Those wrinkles that are already deep set, as is typically for those in their later years of life who have not worked towards their prevention, are unlikely to gain as much from Botox as those who are addressing wrinkles which have not yet formed. Botox can prevent wrinkles from setting in if a consistent regimen is maintained starting before they have become fixed.

Botox is applied using tiny injections. Different patients will need different doses of the agent to get full effect. Full effect of Botox can take up to two weeks following the treatment. Some patients will benefit from repeat treatments every three months to maintain the effect. Others will be able to go for a longer interval.

Before your Botox treatment, avoiding aspirin, motrin and other agents that can encourage bleeding is recommended if possible. Please discuss your use of these agents prior to receiving your injections.

After your Botox treatment, please avoid intense activity such as aerobic exercise, as one would get from running and Contra dancing. Do not lie down flat. This advise is for four hours following your treatment.

Other purified protein derivatives are more recently available in the marketplace and include Dysport.

INJECTABLES is the general term used to cover intradermal and subdermal cosmetic fillers. They are used to address unwanted facial lines and and the body's loss of fat tissue.

Juviderm, Hylaform and Restylane are brand name products derived from hyaluronic acid. This product is a natural sugar that is found in the body. These products draw fluid to them, and take approximately two weeks to take full effect. The effect can last for up to one year. They can be used at the nasolabial folds (FDA approved), and additionally for lip augmentation and angles of the mouth. These injections are potentially reversible.

Collagen fillers give immediate results. They are usually used in conjunction with Botox. Zyderm and Zyplast are bovine derived, and require multiple skin tests to attempt to identify those who might have an allergic reaction. CosmoDerm and CosmoPlast are derived from human tissue that has been grown in a lab. These do not require pre-treatment skin tests. The results with CosmoDerm and CosmoPlast last up to six months. They are used to address lip borders and the nasolabial folds.

PRETREATMENT recommendations: Because inflammation and bleeding might accompany injections, certain drugs and agents should be avoided unless contraindicated (ask your doctor), for at least ten days prior to treatment: Alcohol, Coumadin, NSAIDS (aspirin, motrin, ibuprofen), Fish oil, Flax Seed oil, ginger, ginkgo, green tea, vitamin E and St. Johns Wart.

A good skin care routine, including sunscreen used daily is also recommended to aid in the prevention of wrinkles, for those wishing prevention.

This is an overview of these products, and if you have further interest a full consultation covering your needs, expectations and medical issues for any known likely associated risks is recommended.