Botox

Botox® has become the most commonly performed cosmetic procedure. By 2002, when officially approved by the Food and Drug Administration for the treatment of facial wrinkles, it was approaching a billion dollar industry. Many still wonder what Botox is and how it can help improve faces.

Botox is actually botulinum toxin, the most powerful poison ever discovered. The reason why it works safely is that only very tiny amounts are used. The original batch of the toxin "cooked up" to make Botox was only about a teaspoon. This small amount was then divided into many tens of thousands of doses, which lasted the manufacturer many years. These miniscule doses are bottled for individual use, and mixed with salt water by doctors, who inject it into muscles to produce local paralysis, improving facial wrinkling.

In 2003, Botox cost doctors a bit over $5 per unit wholesale. It takes about 20 units to treat frown lines between the eyes, or crow's feet. To treat the whole forehead, crow's feet, and frown lines, sometimes 35-50 units are needed. We double the wholesale cost to cover our office expenses, bringing the patient expense to $350 minimum for treatment of the whole upper face. Some offices triple the wholesale cost.

Botox doesn't work very well on the lower face below the eyes, although some innovative physicians are trying to use it there. When the treatment paralyzes these muscles, which is how it works, it can sometimes cause problems with facial expression. Fortunately, these are temporary because the treatment generally works for only three to four months before needing a repeat.

The only likely side effect with Botox is paralysis of muscles that are accidentally treated. Most commonly, an upper eyelid droop might occur. This may happen in a few percent of patients at most, and is usually gone after a few weeks. It certainly couldn't last longer than the treatment lasts on the rest of the face, which is only a few months.

Botox is very safe, and patients love the effects. The only trouble is the expense and hassle of repeat treatments. When done skillfully, it usually involves very little pain or bruising. You can resume your normal activities almost immediately.

Combination Facial Treatment

We are currently using facial mesotherapy in conjunction with both the Syneron Aurora-RF and the Syneron Polaris-RF. The three treatments — mesotherapy, light, and radiofrequency — together along with our rejuvenation creams can produce dramatic improvements of fine lines, color, texture, and overall quality of the skin. Of course, Botox and filler injections are also helpful, depending on the patient.