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A pretty redhead woman explains How Long Botox Last

How Long Does Botox Last?

Botox / By  Medical Community

10 Sep

Botox is an undeniably effective treatment for facial wrinkles, folds, and lines. It has been proven to significantly reduce the formation of new lines and wrinkles become with sustained injections.

In addition, Botox has several long-term effects that contribute to the overall self-satisfaction by patients who choose to undergo this treatment.

It is important to gauge how long Botox lasts to prepare for how often maintenance treatments are necessary, to preserve and extend its effects.

What is Botox?

Botox is a brand of neurotoxin injectable used to reduce signs of aging by inhibiting and suspending targeted muscles from contracting and forming lines, wrinkles, and folds. It is also known as Onobotulinum toxin A, derived from the neurotoxin Clostridium botulinum.

Despite being dubbed as the deadliest toxin in the world, this particular type of botulinum toxin has numerous medical and scientific applications. In 2002, it was approved by the Food and Drug Administration to be a safe, minimally invasive procedure to address moderate to severe frown lines in adults.

It is used to minimize the appearance of frown lines, eliminate horizontal forehead creases, relax the lines around the eyes (crow ’s feet), lift the lines at the corners of the mouth and smoothen out glabellar lines.

How Does Botox Work?

Once injected deep under the skin, the active ingredient in Botox blocks a signal from the nerves of the targeted facial muscles. The absence of this signal prevents these muscles from contracting, which results in a relaxed, softened state of the paralyzed muscles. What were once lines and creases formed from the duress of everyday expressions gradually disappear.

Botox takes several days to fully exhibit its effects because it takes time for the treatment to take over the process of nerves and muscles coordinating to contract muscles to express facial expressions. Botox silences the particular chemical messenger called acetylcholine which is responsible for signaling the muscles to move and contract according to the facial expressions expressed by the individual.

How Long Does Botox Last?

It generally takes three to five days to notice the effects of Botox injections, but it takes ten to fourteen days to see and feel the full effects of the treatment. By this time, the skin fully projects a naturally-looking, youthful appearance free of fine lines and wrinkles.

Botox lasts for an estimate of three to six months before it gets safely disposed by the body. Its actual duration on the skin depends on the size of the dosage and area targeted. The higher the dose, the longer the effects last.

After this period, muscle action may resume and lines and wrinkles can begin to reappear once more. However, the facial muscles gradually shrink and fewer wrinkles reappear with every repeat treatment. After months of muscles at a relaxed state, Botox makes the body aware of how much muscles it takes to make every movement. The body responds to this by easing into less movement in the forehead and smile lines.

Long-term use of Botox also causes the muscles to weaken from lessened muscle activity, therefore shrinking and having a less prominent appearance. This may lead to needing less Botox over time. The most important long-term effect of Botox with continued use without interruption is looking years younger naturally.

How much does Botox cost?

Botox treatments are priced per the number of units used, but some clinics may price it per target area. Depending on the healthcare provider, one unit of Botox is priced around $10 – $15. A typical forehead treatment that uses 20 units may cause around $200 – $300. Other treatments can also include brow and neck lifts, jaw slimming and many others to name a few, all with different costs.

To have a more comprehensive assessment of the onset, duration, and costs, it is best to schedule with a licensed healthcare provider for a consultation on what to expect when undertaking Botox injections.

a woman feels happy after Contouring her Jawline

Contouring the Jawline | Medica Depot

Botox, Dermal Fillers, Face, Professionals, Radiesse / By  Medical Community

30 Jul

Introduction

Patients seeking facial rejuvenation often present with prominent nasolabial folds, marionette lines, perioral lines, loss of volume to the lips, and changes along the jawline. The patient’s appearance is significantly affected by the loss of definition along the mandibular border. A contoured jawline is often seen as indicative of a more youthful appearance.

Aging is a natural phenomenon and gravitational forces, increased tissue laxity, and progressive bone resorption all play a role in the facial manifestations. Atrophy and resorption of the malar, submalar, and buccal fat pads lead to volume loss in the midface. With aging, the jawline’s shape becomes less aesthetically appealing. As a result, there has been a significant increase in the number of non-surgical and minimally invasive procedures available to efficiently contour the jawline and restore lost facial volume.

Patient Analysis

Dr. Kate Goldie, an aesthetic practitioner, utilizes a full-face consultation to educate patients about the complex interplay of different facial structures, including the skin, fat, ligaments, bones, and muscles.

During a consultation, it’s important for the practitioner to discuss with their patients the cause and effect of each aesthetic concern. This allows patients to understand that addressing mid-face deficits is necessary for an overall positive effect. As cosmetic surgery evolves, many patients are seeking less invasive treatments with fewer side effects and faster recovery time. Although there are many therapeutic options available today, natural-looking results and patient safety have become the focus of modern aesthetic procedures.

The chin and jawline are common areas of concern and patients are particularly concered with loss of jawline definition, the formation of jowls, and deepening of the pre-jowl sulcus. The redistribution in volume and position of the soft tissue of the lower face creates undesirable shadows that detract from a patient’s appearance. Knowledge of age-related anatomy is vital in restoring a youthful face. Furthermore, a practitioner must recognize the form of an attractive chin and sculpted or well-contoured jawline.

Jawline Rejuvenation

In addition to age-associated volume loss that contributes to the structural changes of the face, the process of aging also visibly manifests in the skin. A multi-pronged approach is essential when contouring the jawline to deal with sagging, jowl formation, and chin widening.

While distinct age-related changes in the lower third of the face and neck can be addressed dramatically by a traditional face-lift or genioplasty, the last decade has seen minimally invasive procedures become the gold standard for facial rejuvenation. Soft tissue augmentation using dermal fillers and botulinum toxins are growing in popularity.

Plastic surgeons and aesthetic practitioners must include minimally invasive techniques in their treatment strategies for the lower face and neck. While both surgical and non-surgical procedures have varying degrees of risk, minimally invasive methods may soon go head to head with traditional aesthetic procedures or become a worthy replacement.

Soft Tissue Fillers

There are different dermal filler materials available for soft tissue augmentation, but not all are suited for jawline contouring. Hyaluronic acid (HA) is the most popular and widely used material for dermal filler treatment; it restores volume loss efficiently and can be reversed with hyaluronidase should overcorrection occurs.

However, many physician’s treatment of choice is Radiesse (Merz Aesthetics), a Food and Drug Administration (FDA)-cleared injectable filler made of small calcium hydroxylapatite (CaHA) microspheres. The 25–45μm microspheres of synthetic calcium hydroxylapatite are suspended in water, glycerin, and carboxymethylcellulose and can be used for volume restoration, lines and wrinkles, as well as lip augmentation.

Calcium Hydroxylapatite Fillers

Although CaHA can replenish lost volume in the mid and lower face and create a youthful, sculpted jawline, proper injection technique plays a critical role in achieving optimal results. The treatment area should be evaluated with the patient in an upright position. Photographs should be taken prior to treatment and the patient should be informed of any facial asymmetries before starting the procedure.

The filler is injected supraperiostally above the ala-tragus line and deep dermally below the ala-tragus line. In both areas, a 1:1 correction factor is enough and overcorrection is not necessary. Thread multiple tracks through one puncture using fanning technique to minimize the number of injections.

Treatment results usually last for 12 to 18 months. The patient should be counseled about the limitations of the product, potential risks and side effects, expected duration of results, and post-treatment care. Consent should be obtained after adequate briefing and counseling.

Hyaluronic Acid Fillers

Patients with thicker skin and poorly-defined bony structure of the mandible require incompressible or stiff fillers, such as Radiesse, to support the overlying tissues while contouring the jawline. However, those with thin skin over a well-defined mandible require a highly elastic HA filler such as Restylane Lyft (Galderma) and Juvederm Voluma XC (Allergan).

The injector should thoroughly examine the patient’s jawline to determine the best product or combination of products to use. Patients with thick skin and a reasonably prominent mandibular structure are suitable for both CaHA and HA products, the latter of which is reversible using hyaluronidase.

Dr. Goldie, like many practitioners, recommends the use of a cannula when treating the jawline to avoid vascular compromise. The superficial muscular aponeurotic system, also known as the SMAS, protects the facial artery in that region. While the injector may unknowingly go underneath the fascia using a long needle, the use of a cannula allows the injector to stay in the plane where no major arteries are present.

Botulinum Toxin

When contouring the jawline using injectables, the practitioner must consider the patient’s preferences, as those seeking cosmetic procedures are often influenced by culturally determined standards of beauty. An ideal female face, for example, is generally perceived as delicate, contoured, and oval-shaped while a square lower face is considered masculine. In some cultures, increased lower facial volume is seen as “rude.”

The main causes of a square face are muscle hypertrophy and prominent mandibular angle. In the Asian population, masseter hypertrophy, resulting in short, wide faces, is frequently observed while Caucasians often possess long, narrow faces.

Botulinum toxin injection is a non-surgical method of correcting masseteric muscle hypertrophy. In the past, surgical resection of the masseter or bony angle of the mandible was the only option for reshaping the lower jaw. Associated with side effects like pain, hematoma, infection, and facial nerve paralysis, it was not very popular. In 1994, Smyth, Moore, and Wood introduced the injection of botulinum toxin type A into the masseter muscle; the results were decreased masseteric girth and a gentler, more rounded jawline.

In 2005, Kim and colleagues treated 1,021 patients with botulinum toxin to reduce the volume of the masseter muscle. The team concluded that neurotoxin injection for aesthetic purposes requires simple technique, with few side effects and reduced recovery time, making it a better alternative to surgical masseter resection. Studies also claimed that botulinum toxin injection to the masseter could treat bruxism, indicating reduced frequency of teeth grinding events and decreased bruxism-associated pain, as well as high anecdotal patient satisfaction.

Thread Lifting

Threads are a safe and effective alternative to traditional lifting methods. According to Dr. Jacques Otto, polydioxanone (PDO) threads made of biodegradable synthetic polymer are great for lifting and tightening the jawline. The sutures stimulate collagen synthesis and elastin production for an overall rejuvenated effect, making this an ideal choice for patients with very lax and/or severely wrinkled skin.

An 18G needle is recommended for creating an entry point before inserting the threads with a blunt cannula. Practitioners should avoid using needles for thread insertion due to the risk of injuring blood vessels and nerves. When treating the lower face, combining thread lifting with botulinum toxin will produce even better results. Dr. Otto recommends injecting botulinum toxin at least two weeks before thread lifting to relax the platysma muscle. Thread lift side effects can include bruising, swelling, puckering or rippling, asymmetry, and visible threads under the skin; however, extensive practitioner training lowers these risks.

Patients should be informed that a thread lift is not a one-time treatment, as biodegradable threads are absorbed by the body over time. Post-treatment care and consistent follow-ups are necessary. Anti-inflammatory medications to minimize swelling must be avoided as they can interfere with collagen formation.

Radiofrequency and Ultrasound Therapy

For patients who are needle-averse or unsure about receiving injectables, ULTRAcel is a non-surgical facelift therapy that is a great initial treatment for patients with lower face concerns. An ULTRAcel machine combines high intensity focused ultrasound (HIFU) technology, radiofrequency, and fractional microneedling to lift and tighten facial contours without the downtime associated with surgical procedures. Radiofrequency stimulates fibroblasts and promotes the production and remodeling of collagen. Only trained practitioners should perform microneedling and radiofrequency; potential side effects include burns and pigmentation changes.

In contrast with ULTRAcel treatment, Ultherapy is an FDA-approved procedure that uses microfocused ultrasound energy to target different depths within the skin, which lifts and tightens the jawline and neck. This collagen-boosting procedure incorporates ultrasound imaging, which allows practitioners to visualize the layers of tissue being treated, ensuring precise administration without needles or incisions. Ultherapy may be combined with dermal filler injection, although a two-week interval is required. Patients may experience slight bruising or redness, but nothing significant or persistent.

Skin Care

In aesthetic practice, skincare is an important part of any successful treatment. A healthy and functioning skin barrier protects the skin from dehydration, penetration of allergens, irritants, microorganisms, and radiation. While a daily skin care regimen that increases cell regeneration is necessary for smoother and more radiant skin, preventing the degradation of primary structural constituents like elastin and collagen is critical. Counseling patients about the importance of sunscreen to protect the skin should be every practitioner’s priority.

While the cosmeceutical market is notorious for making false claims, some products are indeed better than others. The use of products containing Vitamin A is recommended because it stimulates the production of collagen, glycosaminoglycans, and elastic fibers. Alpha Hydroxy Acids (AHA) are also beneficial as they increase skin cell turnover, resulting in reduced discoloration and evenly pigmented skin, reduced pore size and the softening of lines and wrinkles. Keeping the skin hydrated with a good humectant is an important final skin care step.

Conclusion

When it comes to contouring the jawline, aesthetic practitioners must recognize patient’s motivation in seeking less invasive procedures. If deemed appropriate, one should offer alternative non-surgical treatments for addressing the lower face and neck.

In the surgeon’s pre-operative evaluation, proper patient selection is critical to successful treatment. The practitioner can only plan the best treatment strategy if he or she is familiar with the benefits and limitations of each technique.

Medical warehouse as an example of Storing Dysport, Bocouture, Azzalure & Myobloc

How to Store Dysport, Bocouture, Azzalure & Myobloc

Botox, Botulinum Toxins / By  Medical Community

10 Jul

Storing Xeomin and Bocouture

If you use an alternative brand of botulinum toxin, such as Xeomin or its cosmetic version Bocouture, we have good news! These products do not require refrigeration normally and may last longer than the manufacturer suggests.

Merz suggests that Xeomin medication can be used up to 36 months after its manufacturer date, but research suggests that, after 48 months in the refrigerator or stored at up to 25° C, the neurotoxin is just as effective. Additionally, when they tested Xeomin that had been stored for 18 months at 30° C and six months at 40° C, the neurotoxin was still stable. Even at 60° C for one month and 80° C for five days, Xeomin still showed at least partial activity.

According to Merz, reconistituted Xeomin or Bocouture can be placed in the refrigerator for up to 24 hours. However, researchers believe that this too may be unnecessarily conservative. After leaving Xeomin solution at room temperature for one week, researchers found no statistical difference in effectiveness or duration compared to freshly-prepared solution. Even if you prepare your Xeomin before a last-minute cancellation and then forget it on the counter, it may still be suitable for use, saving hundreds of dollars in wasted product.

Storing Dysport and Azzalure

Another popular botulinum toxin brand is Dysport, and its cosmetic version Azzalure. These products should be stable and effective after 24 months of storage in the refrigerator, as long as they have not been frozen. A study by L. Parraga et al. discovered that Dysport medications could be stored at room temperature for up to three days without a reduction in efficacy. That is peace of mind!

Storing Myobloc and Neurobloc

Botulinum aren’t just for cosmetic clinics. Some doctors use Myobloc, also known as Neurobloc, to treat muscle spasms. This botulinum toxin type B solution cannot be frozen, but can be left at room temperature for some time according to its manufacturer, Eisai. After keeping Myobloc in the refrigerator, they suggest that it can then be stored at room temperature for up to three months, but not placed back in the refrigerator. However, research suggests that, even after leaving your Myobloc in the refrigerator for 21 months and then keeping it at room temperature for six months, you can still move it back to the refrigerator. It seems that if you move your botulinum toxin from cold storage, you can still change your mind.

Although it is safest to follow the manufacturer’s storage recommendations, scenarios out of a doctor’s control sometimes occur. Research suggests that even if your botulinum toxin is left in the hot delivery truck or on the table, or if the refrigerator breaks down or a patient cancels their appointment, there is no need to worry. It will still be effective.

Dysport bocouture azzalure myobloc
a curly-hair woman shows the sign OK because she understood the Similarities and Differences between Botox vs Dysport

Botox vs Dysport: Similarities and Differences Reviewed

Botox / By  Medical Community

09 Jul

Both Dysport and Botox Contain Botulinum Toxin

In 2009, a new competitor for Botox was approved for the US market, under the brand Dysport (abobotulinumtoxinA). Like Botox, Dysport is a botulinum toxin treatment indicated for wrinkle correction as well as certain movement disorders like spasticity and cervical dystonia. However, these two botulinum neurotoxin preparations were manufactured and purified via distinct, proprietary manufacturing processes. As such, injectables from Dysport and Botox have different properties in terms of duration of results, diffusion, adverse event profile, and potency.

Botox (onabotulinumtoxin a) is primarily known as a cosmetic injectable that treats wrinkles like glabellar lines; however, it has many more therapeutic uses. As a neurotoxin, it causes chemical denervation in cholinergic neurons, thus impacting signal transmission between these nerves to other cells. It is for this reason that Botox has many therapeutic applications. For instance, Botox is indicated in the treatment of various neuromuscular disorders like cervical dystonia and blepharospasm, and recently has been implicated in conditions associated with pain, like chronic migraines, and urologic conditions affecting bladder control, like overactive bladder. Botox has immense therapeutic benefits for patients from a wide spectrum of neurological disorders.

Differences Between Botox and Dysport Preparations

As stated previously, both products are very similar; they are both type A botulinum toxins with similar modes of action and established safety profiles. However, studies examining the composition of these 2 preparations have demonstrated notable differences in the structure of the active substrates. Botulinum toxin type A exists in nature as a 150-kDa protein surrounded by nontoxic, accessory proteins. These accessory proteins, together with the toxin, form complexes as a way to confer stability and prevent degradation. This difference in composition has striking effects on each preparation’s clinical activity and adverse event profile via its impact on diffusion potential.

Differences in Dosing for Botox and Dysport

It is well-established in the literature and through clinical use that these two preparations do not have the same bioactivity and are not bioequivalent to each other. In other words, one unit of Botox is not the same as one unit of Dysport. Various clinical studies have been conducted to elucidate the clinical equivalence of the two formulations for various indications. For these cases, Dysport-Botox ratios used ranged from 3:1 to 6:1 and for the most part, produced similar results to each other in the patients. The dose equivalency ratio of botulinum toxin preparations like Botox and Dysport is an issue that is still being debated on and studied to date.

A study on the actual doses used in clinical settings for cervical dystonia and blepharospasm determined that Dysport to Botox ratios used in clinical practice ranged from a low of 2:1 to a high of 11:1. As well, 31% of patients fell into the Dysport-to-Botox group of 5:1 to less than 6:1, while 30% of patients were in the Dysport-to-Botox group of 4:1 to less than 5:1, and 21% of patients studied were treated with a Dysport-to-Botox dose ratio between 3:1 to less than 4:1. Taken together, this data suggests that a consensus for an empirically-derived ratio that will deliver consistent, reliable effects has not been reached currently, which further implies that a simple conversion factor does not exist.

Dysport Diffuses More Than Botox

The physical characteristics of the neurotoxins differ as well. Practitioners have noted the tendency of Dysport to diffuse, or spread more easily, than Botox. In a published study by Ranoux et al., the authors noted an increase in side effects with Dysport, and posited that the cause behind the increased adverse event profile may be associated with the higher diffusion rate Dysport has compared with Botox. This was further evidenced in a study by Nüβgens and Roggenkämper, which resulted in a similar enhanced adverse event profile with Dysport in the form of a significant increase in occurrence of ptosis.

With the previously mentioned study, this was suggested to be due to the difference in diffusibility of the 2 preparations. In a review by de Almeida and de Boulle, it was suggested, from an analysis of studies examining the diffusion characteristics of neurotoxin properties including Dysport and Botox, that Botox appeared to diffuse less than Dysport. Differences in diffusion has its own advantages and disadvantages, and will perform differently in different applications. Some practitioners find the increased diffusion rate of Dysport useful when treating larger areas, like in men or in the forehead, while Botox is considered better for situations where precision in placement is important.

In conclusion, various clinical studies with head-to-head comparisons of Botox with Dysport have found significant differences in their composition, which further translated to application differences like diffusion potential, potencies, adverse event profile, and duration of effect. Aesthetic practitioners should always keep in mind the non-bioequivalency of these two preparations it prohibits dose-conversion between each other.

An open hand presents the explanation of the usage Botox for Hyperhidrosis

Botox for Hyperhidrosis

Botox, Botulinum Toxins / By  Medical Community

26 Jul

Hyperhidrosis is defined as abnormally increased sweating, more than that needed for thermoregulation. Individuals with a special type of hyperhidrosis, known as focal hyperhidrosis, can excessively sweat from their underarms (axillary hyperhidrosis) or from their palms and soles of the feet (palmoplantar hyperhidrosis). In clinical practice, a patient presenting with excessive sweating lasting for longer than 6 months is diagnosed with hyperhidrosis if they also fulfill at least two out of the following criteria: cessation of focal sweating while asleep, bilateral symmetric sweating, frequency greater than once a week, onset before age 25, positive family history, and daily activity impairment. Patients with this condition are often emotionally and psychologically impacted to the degree that their daily life is disrupted. As a consequence, they usually live with increased anxiety, difficulty in social and work settings, and decreased socialization. For these patients, treatment options are either short-acting or ineffective (as in the case of topical antiperspirants), or invasive, costly, and associated with serious complications (such as the arthroscopic shaving of the glands, excision of sweat glands, and endoscopic transthoracic sympathectomy).

Does Botox for hyperhidrosis work?

Botox was first put forward as a possible treatment for excessive sweating when it was reported as an inadvertent effect in patients receiving Botox for other indications. Botox is a neurotoxin that acts on motor and autonomic nerve terminals, blocking signal transmission between the nervous system and the muscles. When injected intradermally, the toxin causes the chemical denervation of the eccrine sweat glands via prevention of the release of the neurotransmitter acetylcholine, resulting in a localized reduction in sweat production. Generally, Botox is vastly preferable to other traditional treatments for hyperhidrosis, as it is minimally invasive, durable and effective.

Treating hyperhidrosis in the palms and soles of the feet can cause major discomfort due to the high number of nerve endings in these areas. The significant pain associated with treatment can dissuade patients from undergoing the procedure. Several options for anesthesia are available, which include oral and intravenous sedation, nerve blocks, topical lidocaine cream, Bier’s block, and an ice block.

Treatment with Botox

The procedure for injecting Botox usually begins with marking out the area of treatment. Determination of the treatment area can be performed either by administering the Minor’s starch iodine test (saturating the clean and dry underarm with an iodine solution and starch powder to determine hyperhidrotic areas), or via demarcation according to the hair bearing area. Using a tuberculin syringe fitted with a 26- or 30-gauge needle, administer subdermal injections along 40 sites spaced about 8mm apart in each axilla. The needle is inserted into the dermis at a 45° angle with the bevel side up, and roughly 0.05ml of the solution is deposited. Perform the injection in one smooth motion, so as to not cause excessive trauma to the skin. The recommended dose per axilla is 50U (units), which should be diluted in 2ml of sterile saline, or 3ml for patients with larger axillae. When treating for palmar and plantar hyperhidrosis, the injection sites are defined as a grid on the palm and sole. The recommended dose is a total of 100U per palm diluted in 3–4ml of sterile saline, which should be injected with a 26- or 30-gauge needle. Meanwhile, the recommended dose for the sole is 150 U, as it covers a greater surface area.

Post-procedure

After the procedure, it is best to keep the patient for a brief 15-minute observation period to monitor for any immediate reactions to the treatment. Patients will start to note an improvement in their condition as soon as one week after treatment. It has been shown that hyperhidrosis patients treated with Botox can experience a 75% decrease in sweat production, with results lasting between three to six months.

Is Botox for hyperhidrosis right for me?

While generally regarded as a safe and well-tolerated treatment, some patients should be dissuaded from Botox treatment. These include patients who have undergone previous surgical debulking of the sweat glands, who suffer from hyperhidrosis secondary to an underlying disease, or who have severe blood-clotting disorders. As well, patients with an existing medical condition that may interfere with neuromuscular function, such as Eaton-Lambert syndrome, myasthenia gravis, or amyotrophic lateral sclerosis, should not be treated with Botox. If a patient has a concurrent infection at the injection site or systemic infection, they should only be treated after the infection has cleared. Lastly, female patients who are pregnant or breastfeeding should not be treated with Botox.

Treating hyperhidrosis can bring great emotional and occupational benefits to the patient, as not worrying about their excessive sweating reduces time and difficulty in social and occupational settings3. For patients with hyperhidrosis, Botox treatment represents a new way to manage their excessive sweating in an effective manner that also has the added benefits of being non-surgical, convenient, and relatively durable.

a pregnant woman explains What studies say about Botox and Pregnancy

Botox and Pregnancy: What do studies say? Review

Botox / By  Medical Community

19 Jul

There are various aspects of interest when discussing the use of Botox on pregnant women. For example, would ongoing Botox treatments on the mother have a negative effect on the fetus? Could it cause a miscarriage or malformation to her baby?. Other interesting questions would happen after giving birth to the child and can often refer to breastfeeding. In this article, we’ll review what studies have found in situations where pregnant women have continuously received Botox injections and other studies involving animal tests.

Women of childbearing age often use Botox

Because Botox is a cosmetic treatment, the majority of patients who receive Botox injections are women of childbearing age. Additionally, many patients receive Botox injections regularly to alleviate symptoms associated with medical conditions. Given the high frequency of Botox use among fertile women, it is therefore important that safety of Botox use during pregnancy be established, as many patients in the early stages of pregnancy may not be aware that they are pregnant at the time of treatment.

What does Allergan say about using Botox on pregnant women?

In the patient label for Botox, it is stated that to date, no adequate data or studies are present on the likelihood of developmental risks, birth defects and miscarriage associated with use of Botox in pregnant women. However, it was shown in a study involving rabbits that daily doses of Botox in days 8–18 of pregnancy resulted in abortions, fetal malformations, and maternal toxicity. The mechanism by which this occurred is not known, but further animal studies suggest that botulinum toxin does not cross the placenta, possibly because of its large size. In one study involving pregnant rabbits, no measurable levels of botulinum toxin were present in the placenta or foetuses of mothers given a highly lethal intravenous dose.

A study found comparable results between pregnant women using Botox and not using Botox

The most recent and comprehensive study on pregnancy outcomes following Botox exposure was done in 2015 by Brin et al. In this retrospective study, the authors analysed pregnancy outcome data culled from the Allergan Global Safety Database collected over a 24-year period (1990–2013) and compared the rate of fetal defects in mothers exposed to Botox with background rates in the general population. Of the 110 live births included in this study, 106 or 96.4% of them resulted in normal births, while four had abnormal birth outcomes, consisting of one major fetal defect, one birth complication, and two minor fetal malformations. The resultant prevalence rate for overall fetal defects, 2.7%, was found to be comparable to rates found in the general population (2–4%). The authors concluded that the rates of abnormal pregnancy outcomes in pregnant women who received Botox treatment were similar to background rates in the general population. In addition, the study did not identify any new safety concerns, nor did they observe any consistent organ malformations.

No association found between fetal harm or to mother using Botox while pregnant another survey found

A preliminary survey done by Morgan et al. in 2006 asked physicians if they had injected pregnant women with Botox, as well as their comfort level with administering Botox to pregnant women. Of the 900 physicians surveyed, 12 out of the 396 physicians who responded reported injecting a total of 16 expecting women with botulinum toxin. While the data was limited (16 pregnant women), it seemed to indicate that the treatment appears to be quite safe for both expectant mother and fetus as no definite qualitative association of fetal harm with the mother receiving Botox injections was discovered.

Women used Botox for cervical dystonia while pregnant four times without harm to babies

Case reports in the literature are scarce; in 2004 Newman et al. described the clinical use and outcomes of a patient who underwent regular Botox treatment for idiopathic cervical dystonia. Due to the severity of her condition, and after assessing the risk and benefits of Botox treatment, the 26-year old patient, with the input of her neonatal neurologist and obstetrician, was recommended to continue with Botox injections even after it was discovered that she was pregnant with her first child. This patient continued receiving Botox treatment through four pregnancies that were carried to full-term with seemingly no complications. The authors also report that there were no indications of any developmental delays in the children.

Women using Botox for facial wrinkles gave birth to unharmed children

In 2007, Monteiro describes the two cases of patients receiving Botox treatment for facial wrinkle correction while pregnant; both were injected in their first trimester and did not experience any complications or adverse effects pertaining to the pregnancy and fetuses.

 

Because pregnant women with illnesses need safe and effective treatment, determination of safety of a medication during pregnancy is crucial. However, due to the ethical challenges of including pregnant women in clinical trials, research in this special population is sadly lacking.

Can I get botox when pregnant?

There is not enough evidence to say definitively yes or no, the data taken collectively from retrospective and animal studies, surveys of physicians who use Botox to treat patients, and case reports strongly suggest that Botox, if used as recommended, does not impact the fetus of the expecting patient. However, many practitioners practice a “better to be safe than sorry” method, advising their patients not to have Botox injections while they are pregnant unless absolutely necessary. To further establish the safety of Botox use during pregnancy, additional research is warranted.

What makes Botox so popular?

Botox (onabotulinumtoxin A ) is chiefly known as a cosmetic injectable that treats wrinkles; however, its medical uses extend beyond the aesthetic realm. As a neurotoxin, it impacts signal transmission between cholinergic neurons to other cells, and it is for this reason that Botox has many therapeutic applications. For example, Botox is indicated in the treatment of various neuromuscular disorders like cervical dystonia and blepharospasm, and recently has been implicated in conditions associated with pain, such as chronic migraine, and urologic conditions affecting bladder control, like overactive bladder. Botox has helped patients with a wide spectrum of neurological disorders in improving their symptoms.

A doctor is preparing woman for the Botox injection and explains the difference between Botulinum Toxin A and B

Botulinum Toxin A vs B: What is Botulinum Toxin Used For?

Botox, Botulinum Toxins General Public / By  Medical Community

02 Jul

Botulinum toxin is produced by a bacterium called Clostridium botulinum. It is a neurotoxin protein and is used to treat a variety of aesthetic concerns and medical conditions, including dynamic wrinkles, excessive sweating, chronic migraines, and cervical dystonia, to name a few.
There are various types of botulinum toxin, but the ones used for treatment are types A and B. Botox, available Dysport products, and Xeomin injectables are examples of brands that use type A. Type B is an alternative treatment for those who are hypersensitive or don’t respond to type A. The only approved type B toxin is Myobloc (also known as NeuroBloc).

Treatment with botulinum toxin

Botulinum toxin injections are administered intramuscularly. Treatments are given a minimum of every 3 months. Both type A and B are injectable treatments. Only a trained medical professional should give Botox injections. Type A is available in a powdered form and can be used in injections by adding saline. Type B comes as an injectable solution, which may be diluted depending on the condition being treated.
Successful treatment requires repeated injections of botulinum toxin. Prior to treatment, you may be required to get a skin test to determine your suitability. A small amount of the toxin will be injected, and your reaction will be monitored over the text few weeks. A second injection may be done as a precaution.

Mechanism of action

Botulinum toxin is a blocking agent. It prevents the release of neurotransmitters, specifically acetylcholine.
Once it is injected into the muscles, the nerve signals that tell the muscles to contract are blocked. As a result, the muscles become temporarily paralyzed or weakened.

Side effects

The botulinum toxin has been used for decades and is considered an extremely safe treatment when administered by a trained professional. Type A and type B both cause mild side effects, including redness around the injection site, swelling, and tenderness. Other side effects are specific to the area of treatment, including headache, dry mouth, dry eye, and mild eye ptosis. Discuss all possible adverse reactions with your medical practitioner prior to treatment.

How is it made?

When it comes to discussing the material that makes up type A and type B, the origins are the same. The only difference is the form in which both types are available to health professionals to treat a variety of ailments or for cosmetic procedures.  

Type A

The material that makes up type A includes purified protein from the bacterium Clostridium botulinum. It’s available in a powdered form.

Type B

This type is also made from the Clostridium botulinum toxin. It comes in the form of a solution.

Type A and type B botulinum toxin is measured in units specific to the brands. These units are not interchangeable and should not be used in combination for treatment.

How much does treatment cost?

The cost of both kinds of the botulinum toxin injections varies and depends on many factors, such as:

•  The severity of the condition;

•  The number of units used;

•  The expertise of the health-care practitioner performing the treatment;

•  The brand of toxin used.

Depending on the treatment, the cost may be determined by the number of units or may be done at a flat rate. The average cost of Botox cosmetic treatment is around $375.
Due to the versatility of botulinum toxin, it has become a popular treatment for a variety of cosmetic and medical concerns. If you are interested in receiving treatment with Botox, Azzalure injections, Xeomin, Myobloc, or any other botulinum toxin brand, be sure to discuss your options with a licensed practitioner.

A woman touches her face with a fresh flower and explains What is Botulinum Toxin

What is Botulinum Toxin? BTX Risks and Benefits

Botox, Botulinum Toxins / By  Medical Community

05 Jun

Botulinum toxin injections are widely used for rejuvenating aging skin and for reducing wrinkles. Although the effects of these injections are temporary, they require no recovery time and can be done quickly, unlike invasive surgical procedures.During treatment, a miniscule amount of Botox is injected into the muscle to be treated. This blocks the nerve signals that cause the muscle to contract, temporarily paralyzing it. When used cosmetically, this relaxes the facial muscles, smoothing out fine lines and wrinkles.

Types of Botulinum Toxin Treatments

Botulinum toxin type A injections are by far the most common: in fact, they are the most popular cosmetic treatment worldwide. These injections contain neurotoxins that help to smooth out dynamic wrinkles caused by various facial expressions, such as smiling, frowning, and squinting. This particular treatment helps to relax the facial muscles by blocking nerve impulses. With this, facial expressions become softer, and wrinkles are significantly reduced. Currently, there are many brands available that contain botulinum toxin type A including: Botox, injections from Dysport, and Botullinums by Xeomin.

Botulinum toxin type B injections also block nerve signals in the muscles, causing a temporary reduction in muscle activity. Myobloc uses botulinum toxin type B to treat muscular conditions, such as cervical dystonia.

Benefits of Botox

Botox allows patients to achieve a youthful appearance without ever having to go under the knife.

Botox can treat drooping eyebrows

Also known as eyebrow ptosis, drooping brows makes the face appear constantly tired. Botox relaxes and raises the eyebrow muscles, stopping the eyebrows from drooping for a couple of months.

Botox can treat wrinkles on the neck

As people age, the neck muscles begin to pull on the facial muscles, causing sagging. The Botox necklace technique, in which a small amount of Botox is injected into the neck muscles, treats horizontal wrinkles on the neck. As the neck muscles relax, the face lifts, helping to create a more youthful appearance overall.

Botox can be used to manage acne

Botox curbs oil production in the skin, which helps to reduce acne. A tiny amount of Botox, when used properly, reduces oil production while still allowing patients to move their face normally.

Botox is especially beneficial at a young age

Getting Botox done at a young age can help to prevent deep wrinkles from developing. Prevention is important, because once these wrinkles develop, they are very difficult to get rid of. These wrinkles usually form around the eyes and mouth, so they are the best places to receive preventative Botox treatment.

While cosmetic surgeries are expensive and difficult to recover from, Botox injections are much less expensive and do not require intensive recovery time. This makes them an attractive option for patients who wish to liven up their face—without breaking the bank.

Risks of Botox

Botox injections do help to reduce the signs of aging, but they also come with potential side effects, including bladder issues, difficulty breathing, blurred vision, demobilization of facial muscles, hoarse voice, facial asymmetry, and difficulty swallowing.

Botox can also cause severe headaches, droopy eyelids, and fat bulges near the injection site. Muscle weakness and dizziness may also occur.

Please note that pregnant women cannot receive Botox injections, as the toxin could affect the baby, as well.

Overall, Botox injections are considered to be effective for preventing and treating wrinkles. However, patients must consult their doctor before receiving Botox treatments. Patients should consider all of their options and know what to expect before deciding to get these injections.

the sheet of paper has the handwritten heading "Botox" symbolizes the 20 Questions That Patients Ask Before Botox Treatment

20 Questions That Patients Ask Before Botox Treatment

Botox, Botulinum Toxins / By  Medical Community

02 Apr

While Botox injections have become a normal way to treat aging skin, it is important for patients to know what they are getting into. Patients should always consult their doctor and do their research before any medical procedure. The below list of 20 common questions patients have regarding Botox and their answers is a good place to start.

1. What is Botox used for?

Botox is used to reduce lines and wrinkles on the face by relaxing the facial muscles. Wrinkles and lines are often caused by repetitive facial expressions. Relaxing the facial muscles prevents these expressions and results in fewer wrinkles and lines on the face.

2. Where does it work best?

Botox works best on the horizontal surprise lines on the forehead, frown lines (vertical lines between the eyebrows), crow’s feet (fan-shaped lines extending from the outer corner of each eye), smile lines (lines that extend from the nose to the corners of the mouth), and smoker’s lines (vertical lines around the lips).

3. What is getting Botox like?

Common concerns patients have include the amount of pain from the injections and the amount of swelling of the face after treatment. When performed by a professional, Botox injections rarely cause bleeding and are relatively painless. Oftentimes, the pinch of the injection ends before the pain is even registered. Some slight puffiness is to be expected immediately following the procedure.

4. Do the injections hurt?

Any injection can hurt but choosing a skilled doctor can help to minimize pain. The needles used for Botox injections are very small, so pain is minimal or even non-existent. In addition, topical anesthetic creams or cold packs may be applied to reduce pain.

5. How long does it take to work?

Botox results do not appear instantly. It can take 5 to 7 days before patients start to see a reduction in the appearance of wrinkles and other facial lines. Maximum results appear after 2 weeks.

6. How long does it last?

The effects of Botox last for about 3 months. As its effects start to wear off and the facial muscles begin to move freely again, lines and wrinkles start to reappear. To maintain a line-free look, Botox injections need to be administered several times each year.

7. If I’m getting Botox for a special event, when should I book my treatment?

Botox appointments should be booked 2 to 3 weeks before a big event, since that is how long it takes to see the full effects of the treatment. Some redness, swelling, and tenderness may occur in the first seven days after treatment, but these effects subside quickly. Patients can expect a line-free look by the second or third week.

8. What is the best age for Botox treatments?

This depends upon the patient’s sun exposure, lifestyle, and skin color. In general, patients start to receive Botox is between the ages of 35 and 40. Regardless, younger patients are now starting to look to Botox as a preventative treatment.

9. What happens to the botulinum toxin once it’s in the body?

Once botulinum toxin enters the body through Botox injections, it may migrate up to 3cm from the injection site. When botulinum toxin remains in its intended position, it blocks the nerve endings, thus relaxing the affected facial muscles. However, even if some molecules were to enter the bloodstream, the cosmetic dose (<100 units) is too low to cause systemic toxic effects, and the molecules would be quickly broken down into harmless amino acids.

10. Who can get Botox? Is it only for celebrities and older people?

Like any other medical procedure, there are side effects and eligibility factors that patients should discuss with their physician prior to treatment. Some factors that may prevent a person from receiving Botox treatment include pregnancy, breastfeeding, botulism, myasthenia gravis, and double or blurred vision.

11. Can Botox be used in combination with other treatments for better results?

Botox and dermal fillers are commonly used together. When these two treatments are combined, their results can last for as long as a year, whereas the results of Botox alone last for a maximum of 6 months. Botox relaxes the facial muscles and fillers add volume, resulting in smoother skin.

12. Who can give Botox injections?

A Botox treatment is a medical procedure and must be performed by a qualified medical doctor. This treatment may also be performed by a fully trained nurse under the on-site supervision of a medical doctor. Botox treatment should always be performed in a proper medical facility.

13. How can I be certain that what I’m getting is actually Botox?

It can be very difficult to distinguish real Botox from counterfeit Botox. This is why it is important for patients to have confidence in their medical practitioner. Board-certified dermatologists and plastic surgeons would never risk their reputation by using fake Botox. In addition, always check the bottle and its box to ensure the Botox injection is sealed and fresh.

14. Are there any medical side effects?

If properly injected, the side effects of Botox are minimal. Common side effects include muscle weakness, bruising, bleeding, pain, redness, and swelling at or near the injection site. Headache, neck or back pain, muscle stiffness, dizziness, drowsiness and lethargy can also result from Botox treatment. Others side effects include flu-like symptoms such as fever, cough, sore throat, and runny nose. It is also possible to have an allergic reaction to Botox.

15. Does Botox have unwanted cosmetic side effects?

The most severe side effects include permanent disfiguration and loss of facial muscle functionality due to paralysis of the facial nerve. Less severe side effects include drooping of the brows and upper eyelid, partial or slight paralysis of the face, swelling of the eyelids, eyes pointing upward or downward instead of straight ahead, and skin rash. Patients should consult their physician for more information about the possible side effects of Botox treatment.

16. Are there alternatives to Botox?

Although Botox is considered to be the best anti-wrinkle treatment on the market, there are other botulinum toxins available. Dysport medications and Myobloc (Neurobloc) are injectables that work similarly to Botox. Other treatments include facial creams and chemical peels, which have received positive reviews for their anti-aging effects. As well, cosmetic injectable are also extremely effective. However, none of these treatments are permanent.

17. What is the difference between Botox and dermal fillers?

Botox is a neurotoxin that reduces the activity of the facial muscles that cause wrinkling. Dermal fillers fill the affected areas with a substance such as hyaluronic acid, which is naturally found in the skin. This not only plumps the skin but also lifts and tightens it.

18. What are some common myths about Botox?

1.  Myth: Botox has immediate effects.
Fact: The effects of Botox are seen after 2 weeks.

2.  Myth: Botox is made from pure botulinum toxin.
Fact: Botox is made from a protein derivative and is relatively harmless.

3.  Myth: People who exercise a lot need more Botox.
Fact: A person’s workout routine does not affect the amount of Botox required.

19. How much does Botox cost?

On average, the cost of Botox treatment ranges from $350 to $500 for each treated area. In terms of cost per unit of Botox, the price ranges from $9 to $20 per unit. Special discounts or offers may be available to make this treatment more affordable.

20. What happens on the day of Botox treatment?

The doctor providing the treatment will make a series of injections in the desired areas of the patient’s face. The patient can then return to regular activities, but should follow aftercare methods given by their doctor until any adverse effects have subsided.

Disclaimer: The contents of this article are not to be constructed as medical advise but for informational purposes only. MedicaDepot staff does not review any of this articles for medical validity. Opinions and views expressed in this article are not endorsed by MedicaDepot. Please always consult your doctor for professional medical advise.