Thursday, June 06, 2002
Here's your E-Newsletter ~ For Friends & Patients of Russell W. H. Kridel, MD, FACS & Facial Plastic Surgery Associates 6655 Travis, Suite 900, Houston, TX
BOTOX® Cosmetic : THE WAVE OF THE FUTURE! The purpose of this email is to inform you of this exciting procedure- already one of the top anti-aging treatments, and how it can dramatically rejuvenate your upper facial appearance without surgery. You've been reading all about it in the newspaper or on the Internet or hearing about it on TV; now we'll give you the medical information you need to help you make the decision if BOTOX® is right for you.
HEADLINES:
- Ask Dr. Kridel- What is BOTOX® (Botulinum Toxin) and how does it work?
- BOTOX® Leads Boom in Nonsurgical Cosmetic Procedures
- BOTOX® and Lasers May Reduce Demand for Facelifts
- FDA Approves BOTOX® to Treat Frown Lines
- What is BOTOX® and how does it work?
BOTOX® (Botulinum Toxin) injection is a simple, in-office approach to treat facial wrinkles and works by weakening the muscles of facial expression that insert on the undersurface of the facial skin. The most common areas of usage are the deep frown lines between the eyes, the creases on the sides of the eyelids (crow's feet), and some forehead lines. Once the resting tone of these muscles is weakened, the pull of the muscles relaxes and the skin flattens out. This is an exciting and different approach from traditional methods for treating the aging face. Collagen and autologous fat injections work by filling in a wrinkle. These fillers are not as effective as BOTOX® in removing wrinkles in the upper third of the face. By physiologically weakening the muscles, BOTOX® flattens the wrinkles naturally.
The BOTOX® takes up to three days to take effect and lasts for between three and six months. It is most effective for wrinkles in the upper third of the face: the forehead lines, crow's feet (smile lines around the eyes) and especially between the eyes frown lines (glabella area) above the nose. (It is generally not wise to use it for wrinkles in the middle and lower portion of the face because it would also distort your smile and facial expression.) Because the BOTOX® weakens the muscles it is best not to let the muscle get strong again. Therefore, repeat injections should take place as soon as there is a hint of the return of the frown line or wrinkle.
BOTOX® needs to be prepared fresh, as it has a shelf life of only one day. It comes freeze-dried, and we reconstitute it just before use. Most doctors treat 4 or 5 patients with the contents of one bottle. We only treat 3 patients per bottle, which means more Botox per patient and generally better results for you.
Side effects can be caused when the BOTOX® migrates from the injection site. For this reason, we ask you not to rub or massage the area for twelve hours after the injection. You will feel a small amount of discomfort when the needle enters the skin and when BOTOX® is injected. This will last for approximately five seconds. Putting ice on the area ahead of time reduces discomfort. Because there are many small blood vessels in the skin around the crow's feet, you get a small bruise from the injection, which can be covered with makeup. On rare occasions, the needle may puncture a blood vessel and you may have a black and blue area that lasts for up to seven days.
There are no serious side effects associated with the use of the Botox with the dosages that we employ. We have seen no allergies, shock or whole body side effects associated with our use of BOTOX®. BOTOX® has been used in a safe and effective manner at a much higher dosage for patients with neuro-muscular disorders for approximately 15 years. In very few patients, with repeated use an antibody can develop which may make the BOTOX® ineffective. In such cases, we then switch to Myobloc, another, but different, botulinum toxin derivative.
Minor side effects can occur. When we are injecting the forehead if the BOTOX® spreads beyond our injection, a small droop in the eyebrow and puffiness of the upper eyelid can occur. When the crow's feet are being injected and the needle is placed close to certain lower eyelid muscles or if spread occurs, you can get a small droop of the lower eyelid. There is no specific treatment for this, and you must wait for the BOTOX® to wear off. Therefore please do not rub the area after injection and hold off with strenuous exercise for a day.
BOTOX® is utilized to enhance your appearance and does not take the place of standard facial plastic surgical procedures such as face-lifting, Blepharoplasty, dermabrasion, chemical peeling, or laser resurfacing. It has the ability to improve areas that are not addressed by these operations and is an effective adjunct to these operations. When the BOTOX® starts to wear off, you will notice a return of your wrinkles. Frequently, when they return they are not as deep. At that time, you may elect to have another BOTOX® treatment. It takes two or three injections a year to maintain the appearance that you have achieved. It's best not to wait until full muscle function returns before your follow-up injections. The weaker and more atrophied the muscle is, the better the BOTOX® works. If a wrinkle is really deep, we may need to use both BOTOX® and Collagen to fill in the depression and relax the muscle.
Some wrinkles of the face are not amenable to correction with BOTOX® injection, such as the deep creases that are in the structure of the skin and are not caused by muscles pulling on the skin. This type of wrinkles tend to be in the areas that are caused by trauma, scarring, or sun exposure and damage and are frequently found in older patients. BOTOX® works best in patients aged 30 to 60 and is less effective in sun damaged skin. During your consultation, the areas that are amenable to improvement with BOTOX® will be pointed out to you. The purpose of BOTOX® Cosmetic is to help you look your best. If you have any further questions regarding this issue, please feel free to contact me in my office.
Russell W.H. Kridel, MD, FACS
RELATED ITEMS
"Pretty Poison; BOTOX® leads boom in nonsurgical cosmetic procedures", Story & interview with Dr. Kridel by Louis B. Parks: Houston Chronicle - BOTOX® now the most common medical cosmetic procedure in the United States. http://www.chron.com/cs/CDA/story.hts/features/1359595
"BOTOX® and Lasers May Reduce Demand for Facelifts", By Patricia Reaney: ABC News -"For those too squeamish to go under the knife, BOTOX® -- already one of the top anti-aging treatments -- together with lasers could give patients "optimal rejuvenation," said Dr. Nicolas Lowe, of the Cranley Clinic for Dermatology in London.
http://abcnews.go.com/wire/Living/reuters20020411_235.html
"FDA Approves BOTOX® to Treat Frown Lines", US Food and Drug Administration - "FDA today announced the approval of Botulinum Toxin Type A (BOTOX® Cosmetic) to temporarily improve the appearance of moderate to severe frown lines between the eyebrows (glabellar lines), a medical condition that is not serious. The product's manufacturer, Allergan, Inc., Irvine, California, is now allowed to market Botulinum Toxin Type A for this new indication." Consumer Inquiries: 888-INFO-FDA
http://www.fda.gov/bbs/topics/ANSWERS/2002/ANS01147.html
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