Botox Mania

Written by Shabir

“Mirror, mirror on the wall, who is the fairest of them all”

BOTOX Mania has gently arrived in North America. Once covertly used to conceal the effects of aging in Hollywood personalities and the affluent, it is now inexpensive, affordable, accessible and simply done over a lunch break. More fashionable than breast augmentation surgery and a possible blockbuster, Botox is viewed by some as the ultimate fountain of youth.

Botulinum Toxin (Botox Cosmetic) is a protein complex made by the bacterium Clostridium botulinum, which contains the same toxin that causes food poisoning. When used medically in small doses as an injectable form of sterile, purified botulinum toxin, it blocks certain nerve cells that cause muscle contraction. B selectively injecting underlying muscles and blocking their ability to contract, existing frown lines are evened out and the face appears wrinkle free within a week.

Ever since its approval for cosmetic use, Botox mania has grown, both in terms of use and revenues generated, eclipsing all past records of successful drugs. Predicted revenues for 2004-5, are in the mega millions. The toxin was initially used to treat spastic disorders of the face, eyes and neck. Drug industry analysts claim that it is one the top money makers and outbids drugs for diabetes, hypertension and even, Viagra.

Botox is the most popular cosmetic procedure done in offices, clinics, spas, at the dentist, the eye clinic, and yes, for a few bucks more, even done at the massage and spa parlors. All it involves is injection of botulinum toxin into the muscles of the face, and viola, look ma, no wrinkles.

Botox was first approved in 1989 to treat two eye muscle disorders--uncontrollable blinking (blepharospasm) and misaligned eyes (strabismus). In 2000, the toxin was approved to treat a neurological movement disorder that causes severe neck and shoulder contractions, known as cervical dystonia. A distinct side effect observed during the treatment of the eye disorder was disappearance of the frown (glabellar) lines between the eyebrows. This made the patient looked younger, less angry and infact pleasing.

Botox is not the only advance in cosmetic surgery but it is by far the least invasive, the fastest to carry out and the results are immediate. Traditional plastic surgery required complicated incisions in the skin, muscles, pulling or pushing, taking something out and sometimes putting things back in. The existing variety of prescribed treatments used by doctors to plug or reduce wrinkles and scars alone is astonishing: Alloderm, Autologen, collagen, Cymetra, Dermaplast, and the list goes on.  And the results are not immediate and the surgery may be prolonged and complicated.  In addition, the cost of these open plastic surgery may cost anywhere from 10-20,000$. And the results are never guaranteed.

In contrast the lunch time Botox special, may cost $3-800, take a few minutes, results are immediate, there are no scars, less hassles and sometimes even get free food and drinks, if the procedure is done at a Botox Party (see later).

Botox mania has altered the face of Hollywood. Almost everyone on the screen has a spotless and wrinkle free face. Gone are the days when someone laughed/cried and you saw the wrinkles. Gone are the days when you saw furrowed eyebrows when someone got angry on the screen. Gone are the days when it was easy to predict the age of the person. Today, everyone smiles no matter what the occasion or event and everyone looks young.

"We will look at wrinkles the way we look at cracked or discolored teeth — remnants of the past, just something to be fixed," said Dr. Nancy Etcoff, a psychologist at the Harvard Medical School and the author of "Survival of the Prettiest: The Science of Beauty" (Doubleday). "You still see young women smoking and sitting in the sun, and they can just get rid of the wrinkles.

"It's very much about having your cake and eating it too," Dr. Etcoff said. "It is as though we have given up on authenticity."

The Botox therapy has an attraction for the generation between 30-45 years. People, older than 45 generally have a few more things than wrinkles and also require body sculpturing, liposuction, face lifts and removal of fat from here and there. Nose and ear surgery are sought after by those ages 20 to 40. And women between 25 and 35 are most likely to want breast augmentation.

While women are the largest consumers of cosmetic surgery, men are now catching up and rival women in procedures involving body sculpturing and hair replacement procedures.

Today, Botox injections make up a significant proportion of all cosmetic procedures. With the lure of quick easy cash, doctors in almost every specialty are injecting Botox. There are thousands of spas all over the country, run by nurses who even perform the procedure. To make it legal, the nurses usually get a doctor to be a pseudo director of the spa, and then proceed to massage, apply facial creams, touch up with a laser here and there and of course, a couple of jabs with a needle to erase the wrinkle. Most spas today rival the best Beverly Hills plastic surgery clinics in their offerings. 

Yes, Botox mania has arrived and money is the name of the game.

A vial of Botox only costs $ 400 and can easily generates a couple of 1000$ in revenue. A number of doctors use the same ampoule in many patients, thus generating even more income. To increase the revenues, some doctors have even diluted the Botox and thus doubling or tripling their income. There is no other treatment that can rival Botox in terms of profitability.

Botox already has some competition from another related product called, Myobloc, botulinum toxin b. Myobloc has one distinct advantage over Botox: it works within hours, whereas Botox usually takes several days to take full effect. But the effects of Myobloc do not last as long. So much the better say same doctors, even more revenue with returning patients

The current rise in the attractiveness of Botox has much to do with the manner in which it is frequently marketed. Some physicians obtain the product in bulk and arrange get-togethers, such as Botox parties, for patient requiring multiple plastic surgery procedures. As in business, volume discounts are available in cosmetic surgery.

Plastic surgery events known as Botox parties--also held under the guise of seminars, evenings and socials--are an important element of Botox marketing in much of the United States. These so called “seminars” are an opportune means of selling and providing Botox treatments more inexpensively. These doctors claim that treating people in groups allows them to make the procedure more affordable to their patients. Hopefully, the same vial is not used to treat multiple patients.

The typical party is held at a posh restaurant or hotel, food and drinks are on the house, of course. One by one, the individual is taken into a separate room, injected and quietly returned to the socializing area. The money is collected up front, the consent signed and within 10-15 minutes, just like branding cattle, one by one, the process is repeated at countless hotels all over America.

All Botox vials are intended for single use in a single patient. Once opened and diluted, the product must be used within a few hours. However, at the Botox parties, more often than not, the same vial is generally used for multiple patients. And lately there have even been reports of physicians diluting the Botox more than the recommended amount and there is even fake Botox around. So buyer-beware.

In a Botox treatment, a diluted form of the drug is injected into a patient's facial muscles. Over the next few days, the toxin paralyzes the muscles that control facial wrinkling. This stops newer wrinkles and also erases the existing ones. Botox does not numb the area nor does it change the texture but makes the skin more smooth.

There is a very low risk of becoming infected with botulism from Botox treatment, because the drug has been diluted out. Still, there are complications. Patients are advised to stay upright for a few hours to prevent the toxin from spreading and paralyzing other nearby muscles. If too much toxin is injected, or if it is injected into the wrong facial area, the individual may develop a droopy eyelid muscles (ptosis) that may last for several weeks. This particular complication has been frequently observed and does occur with many beginners.

Other common side effects may include headache, respiratory infection, flu syndrome, and nausea. Less frequent side effects include pain in the face, redness at the injection site and muscle weakness. These reactions are transient and not disabling but can last a few weeks to several months.

Botox generally involves simple multiple needle sticks, but with almost everyone having ago at it, it is only a matter of time before we will see a complication

Botox is not a permanent cure for wrinkles and most patients do not mind getting repeat procedures every 4-6 months. The FDA has recommended that Botox Cosmetic should not be injected more than once every three months, and that the lowest effective dose should be used. The cost of maintaining a pristine face can add to about 1-2000$ a year.

Vanity has its price. Because Botox paralyzes muscles that create wrinkles, some physicians recommend that Botox should not be applied on muscles of facial expression. Otherwise the individual may appear with an expressionless face without emotions.

The line between uncreased youth and facial emotive power, however, is not always clear. Mr. Luhrmann, the director of "Moulin Rouge," said last week that many actresses abuse Botox. "Their faces can't really move properly," he said, assuming a blank stare meant to mimic overuse.

There is also the potential for what some doctors call the Dorian Gray effect. Because Botox does wear off, more injections are required to maintain its effects or the patient's face will return to its wrinkly state. So one day you may marry the women with the perfect face and a few months down the road, you will be sleeping next to Godzilla.

Botox's market potential has finally tapped into the public. Once plastic surgery was a domain of the rich and famous. Botox has brought plastic surgery into the average home and made it slightly affordable for everyone.  Dorian Gray, please move over, vanity and Botox are here.