COSMETIC        Botox

Botox® (manufactured by Allergan, Inc) is neither new nor a cure-all against time and gravity; yet Botox® can be highly effective against preventing wrinkles and preserving the beauty of the face. What is not ‘botoxed’ today will most certainly have to undergo surgery tomorrow as aging progresses. Botox injections are the commonest cosmetic procedure in the US and in India and continue to grow in popularity.

Botox injections are the most common cosmetic procedures performed in the world and continue to grow in popularity. The Esthetic Clinic is amongst the number one users of Botox in Asia. Dr. Debraj  Shome has been an innovator in the use of Botox and has taught many other area physicians injection technique via the Botox National Education Faculty program. All Botox injections at The Esthetic Clinic for Facial Appearances are given by Dr. Shome.

Botox is a purified protein that relaxes muscles and thereby reduces wrinkles. Tiny doses are injected under the skin to eliminate wrinkles and expression lines. Areas treated with Botox include the forehead, frown lines, crow's feet, lips, chin, and neck bands. Many patients get Botox injections over the lunch hour and return to work with no sign of having been treated. The combination of topical anesthetic and a tiny needle makes Botox injections a painless experience that requires no recovery. It takes Botox about 3 days to relax the wrinkles and the effect last 3-6 months.

Botox is also used at The Esthetic Clinic  to treat patients with spasms of the eyelids, face, and neck. In addition, it has proven very useful in treating excess sweating of the hands, feet and armpits as well as an excellent treatment for Migraine and Stress headaches. Many insurance companies are even beginning to participate in payment for Botox to treat headaches that are resistant to conventional therapy.


Frequently asked questions about Botox:

Background information

1) Is Botox popular?
For the last several years Botox has been the most popular physician-administered cosmetic procedure in the world. More than 3 million treatments with Botox are administered per year.

2) Why is Botox so popular?
A number of factors account for the popularity of Botox. First of all Botox causes a consistent beneficial improvement in appearance that is noticeable, yet subtle, and natural. Botox has the highest satisfaction rating of any cosmetic procedure performed. Botox has been used in millions of patients and found to be safe. Finally, Botox does not require time off of work or out of the public eye to recover.

3) What is Botox?
Botox is a pure protein that is isolated from a microorganism. Many of the most important drugs we use today such as antibiotics were first isolated from microorganisms.

4) Is Botox new?
Botox has been used in humans for more than 35 years but did not gain approval from the FDA for cosmetic indications until 2002. Botox was purified in the 1940’s. The FDA approved testing it on human subjects in the 1970’s. In 1989 it was approved for clinical use in patients with spasm of the eyelid face or neck muscles, as wells as treatment for some forms of double vision. In 2002 the FDA approved Botox for use in wrinkles between the eyebrows. Botox is also approved for treatment of excess sweating termed hyperhidrosis.

5) Is Botox a type of filler?
Unlike fillers, Botox does not fill in facial lines. Botox relaxes the muscles underneath the skin that cause undesirable wrinkles in the forehead and the area around the eyes.

6) How does Botox work?
In order for a muscle to contract it requires a nerve signal. Botox blocks this signal at the junction between a nerve and a muscle.

7) Does Botox work on all wrinkles?
No. Botox works only on wrinkles that are made worse or change with contraction of muscles of facial expression. Classical examples are the wrinkles between the eyebrows that become deeper with frowning. Other areas where Botox is commonly used to reduce wrinkles include the forehead, and the crow’s feet. Examples of wrinkles that do not respond to Botox include wrinkles caused by sagging skin in the upper eyelids or neck. Your facial plastic surgeon is the best judge of which lines and facial wrinkles will benefit from Botox.

8) Who should not use Botox?
Botox should not be used in the presence of an infection at the injection site and in individuals known to be allergic to Botox. Botox should be used with caution in patients with a few rare neurological conditions including: amyotrophic lateral sclerosis, myasthenia gravis, and Lambert-Eaton syndrome.

9) Is Botox treatment only for rich and famous?
According to a recent survey working women between the ages of 30-55 who want to look less stressed are the most common users of Botox. Those with annual income of less than Rs.10, 00,000 per year account for 2/3rds of Botox users in India. Botox is one of the least expensive facial plastic procedures.

10) Who gives Botox injections at The Esthetic Clinic?
All injections are given by Dr. Debraj Shome, our internationally trained facial plastic surgeon. A Facial Plastic Surgeon administering Botox ensures that consumers have the best possible results. Besides, if Botox is not suitable for a particular condition or line, being a plastic surgeon, Dr. Shome has other tools in his armamentarium to deal with those.

Technical aspects of Botox injections

1) What does a patient need to do to prepare for a Botox injection?
In most cases nothing. Some over the counter medications such as aspirin, Motrin, vitamin E, Ginkgo and glucosamine increase the chance that you will get a bruise at the injection site. If you are taking these medications because your doctor has recommended you do so then continue to take the medication. If it is safe for you to stop for two weeks prior to injection this will reduce your chance of bruising.

2) Do Botox injections hurt?
Most of the patients report little or no pain. We use the smallest needle possible. Some of our patients also request numbing cream be used. We have the cream available at the center and can even prescribe it for you if you prefer to put it on before coming for your appointment.

3) What recovery is involved after Botox injections?
One of the great things about Botox injections is that it requires little or no recovery. Immediately after getting injections you will have some small bumps where the injections were given. These bumps are typically gone in an hour. Rarely a patient will get a small bruise. When it occurs, a bruise takes about two weeks to resolve.

4) How long does it take before I notice the effects of Botox?
About 3 days before you notice anything and the result becomes stronger for about two weeks.

5) How long does Botox last?
The first time you get injections they last about 4-6 months. If you get them on a regular basis the frequency at which you need to get injections actually decreases. In our experience patient typically require injections 2-3 times the first year, 2 times the second year, and twice yearly thereafter.

6) How much Botox is required to treat wrinkles?
For cosmetic purposes this varies between about 25 and 100 units depending on the number of areas treated and the size of your facial muscles. For instance, treating the wrinkle between your brows requires about 30 units of Botox. If the crows feet, and forehead are also treated it will require 2-3 times more units of Botox. Men often have larger facial muscles and require slightly higher doses.

Safety questions about Botox

Botox for headaches

1) Can Botox help patients that suffer from headaches?
Yes. We have found that patients with both tension headaches and migraine headaches can benefit from Botox injections. We have even had success treating patients that have been resistant to other medications.

2) Does the Esthetic Clinic treat headaches with Botox?
Yes.

3) How can Botox reduce headache symptoms?
In tension headaches it probably works by relaxing muscles. In migraine headaches it probably works by preventing the facial muscles from triggering headaches.

4) Will my insurance company pay for Botox injections for headaches?
Some insurance companies have begun to pay for this form of treatment. Many still do not. If you live in Utah or the surrounding area you may call the center and our insurance authorization person can provide you with more information.

5) How often are injections repeated for headaches?
Once every 3-4 months.

Botox for excess sweating (hyperhidrosis)

1) Can Botox help with excess sweating?
The Esthetic Clinic performs injections for sweaty armpits, hands, and feet and have found it to be very effective in most patients.

2) If Botox relaxes muscles why does it also reduce sweating
Botox blocks the nerve impulse to the sweat gland so that the nerve cannot stimulate sweating. The sweat duct and the nerve lie more superficial than the muscle so the injections for sweating are performed in a more superficial location.

3) How often do the injections need to be repeated for sweating?
The injections are typically repeated two times yearly.