The Uses of Botox : Cosmetic and Medical

Celebrities are frequently in the spotlight for looking younger than their age. Working out and eating properly help maintain a good life style, but sometimes it is just not enough. Wrinkles still appear despite staying healthy. Getting plastic surgery is an option but people have been turning to a less extreme solution to look younger, Botox.

Wrinkles are the number one sign of ageing. Creams are sold and advertised as the best way to get rid of them, but the growing popularity of Botox can temporarily erase wrinkles. Just like any other product Botox contains benefits and risks.

Botulinum Toxin Type A (Botox cosmetic) is a protein produced by the bacterium Clostridium botulinum. According to Medic8, a healthcare company in Scotland, Botox causes weakness of the near by muscle where the injection is done, blocking transmission between the nerve endings and muscle fibers, paralyzing the muscle. Which in turn makes wrinkles disappear.

Cosmetic procedures have grown in popularity over the years and from 1997 to 2009 has increased 147 per cent according to the American Society for Aesthetic Plastic Surgery (ASAPS). The top nonsurgical procedure for both men and women was Botox reaching a combined total of 2,557,068 procedures in the USA.

Repeat use of the product will result in thinning of the muscle. This causes less wrinkles to reappear when Botox looses its intensity after the three to four months it lasts, said Medic8.

“I know people who have been doing it for 10 years and they just don’t get Botox as often. Their Botox last six to eight months,” said Jeff Russell, executive director of the International Association for Physicians in Aesthetic Medicine (IAPAM).

He added that the muscles stop moving in the direction that would create wrinkles therefore paralyzing the muscle so the effect last longer.

Doctors, nurses and physicians who are trained to inject Botox have several guidelines provided by Allergan for both the USA and Canada. They are provided with an outline of the maximum and average number of units allowed to be injected in the facial muscles.



“A medical patient can receive from 200 to 500 units of Botox where a cosmetic patient can receive from 10 to 40 units, 30 being the average (in one session),” said Russell.

The number of units also depends on the size of the muscle. Men compared to women require more units because their muscles are generally larger, said IAPAM executive director.

“Botox and Botox Cosmetic are authorized for use in the treatment of a variety of conditions using a range of doses. Dosage guidelines are provided in the Product Monographs for Botox,” said Leslie Meerburg, media relations officer at the Health of Canada.

A medical assistant or doctor does a mandatory consultation to each patient to get approved for Botox and establish the amount of units. The most common area for Botox is the crow’s feet (the corner of the eyes) and the forehead. Hands, full face, and neck can also be enhanced with Botox.

Elizabeth Garces, a 54-year-old patient who has received Botox twice, said her main reason for the procedure is to get rid of wrinkles and look refreshed.

“The more wrinkles (you have) the older you look,” said Garces who was not completely satisfied with the outcome of her treatment. She received Botox in the crow’s feet but some wrinkles still remain.

“If you’ve done Botox right it looks like you just came from vacation and you’re rested,” said Russell. “It shouldn’t look like you got a face lift or hit a win tunnel.”

Some people, specially in L.A. want the frozen look effect said Russell, but the forehead should be relaxed and have muscle movement.

1990 marks the year Botox was marketed in Canada for medical purposes. It was first used in 1980 to treat strabismus (cross eyed). Botox strengthens the muscle and realigns the eye for a period of three months. In 1985 Botox treated cervical dystonia, when the neck muscles move abnormally into a spasm. Botox reduces the amount of movement and decreases the pain produced by Dystonia.

Migraines and excess amount of sweating (hyperhidrosis) are two of the medical treatments Botox is ussed for. It only takes one treatment to reduce the amount of sweating to an average amount, since it blocks the release of acetylcholine (sweat).

Dr. Gawel in 2001 performed a study on the effects of Botox for migraines. Eva Zani was a patient who took part in the year study which included four treatments of Botox. Zani said she saw change in her migraines after the second set of injections that included four vials of Botox, a total of 20 injections on the head and forehead.

“The sensation (of the injections) was horrible, it was the worst feeling ever,” explained Zani which despite the pain she found the treatment temporarily effective.

Botox Cosmetic has been distributed in Canada since 2001 and since the approval studies have been done showing serious side effects to the product.

In 2009 a revision of Botox by the Health of Canada discovered that Botox can now spread to other parts of the body. This can cause muscle weakness, swallowing difficulties, pneumonia, speech disorder, breathing problems and can be fatal.

No fatalities have been reported and the 39 reports submitted to the Health of Canada regarding side effects of Botox are based on the opinion of the patient and have not yet been assessed (as of 2011).

Headache, nausea, double vision, eye twitching, bruising, muscle weakness, flu-like symptoms, temporary eyelid droop, redness at injection site and facial pain are possible non-threatening side effects of Botox.

Carolina Batica, a patient who has received Botox three times, experienced slight bruising in the crow’s fee area.”Showed up the day after and lasted on one of the eyes for two days,” said Batica.

The McLean Clinic for plastic surgery, says that women who are breastfeeding or people who have neuromuscular disorder (affects the nerves that control the voluntary muscles like the arms and legs) should not receive Botox.

Dissatisfaction can also be considered a side effect. According to Russell a common casewould be a raised eyebrow. “This can be corrected by adding Botox to an opposing muscle,” said Russell. He added that it takes approximately three to 14 days for the muscle to show the final outcome. Some physicians will schedule an appointment two weeks after for touch-ups, said Russell.


Before Botox became used for cosmetic purposes creams where constantly advertised to reduce wrinkles. “It’s a risk every time you take something,” said Batica who was surprised by the amount of chemicals creams have. She decided it was better to inject something into her muscles than to wait for the cream to seep into her skin and work its magic. “I was tired of spending money on creams and having hopes it would work,” said Batica.

A unit of Botox cost $10, if you were to receive 10 units for the crow’s eye (five on each eye) that would equal $100 which a cream like Elizabeth Arden Prevage cost from $130 to $200.

“It is a bit cheaper to buy cream but the effect of Botox is a bit better,” said Garces. “Cream is supposed to make them better (softer looking wrinkles), but Botox is supposed to make them disappear.”

Combination of Botox and dermal fillers can remove 10 years off a person, said Russell.

“As you get baby boomers ageing into their 50s and 60s they want to look younger,” which is the probable reason in the increase of Botox, said Russell.

Botox has become a safer non-surgical way to look younger. Just like everything else we take there are possible side effects that everyone should be aware of. Russell suggests to do research on the person doing the procedure with the main question of how many times have they injected Botox? If the number is low compared to others than it is best to go to someone with more experience.

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