Archive for category Botox
Nurses illegally inject Botox without Doctor’s Supervising
Posted by admin in Botox, plastic surgery news on September 13, 2011
The Cosmetic Physicians Association of Australia (CPSA) says it’s aware of doctors prescribing S4 medicines such as botulinum toxin, or botox, enabling nurses to administer unsupervised treatments.
Source: news.com.au/entertainment/story/0,28383,25756958-5007185,00.html
Interesting. This is done in the US all the time in Botox clinics in which doctors supposedly serve as medical directors, but are not present for the actual treatments. Botulinum toxin injections are not difficult, but there can be some problems is less trained hands.
Dr Caswell said it was illegal and against medical board guidelines for nurses to administer botox treatments without a doctor’s supervision.
However, she said there were cases of nurses holding botox parties and travelling interstate to carry out the treatments.
The practice is actually illegal in Australia. My malpractice carrier is not crazy about Botox parties unless we hold them in the office. I do all the actual injecting so they are happy.
It is cheaper to have your Botox injected by a nurse, there just might be some risk. It is the patient’s choice at least in the US.
Best Regards,
John Di Saia MD
Originally posted 2009-08-11 09:16:56.
Reader Question: Botox in my Mentalis Muscle?
Reader Question:
I was thinking of asking for Botox in my Mentalis muscle to combat my relatively minor butt chin. Ever heard of this kind of thing?
Botulinum toxin injections are becoming almost too commonplace. Now we are looking for new places to inject it. lol.
In all seriousness, Botulinum toxin currently has three FDA-approved versions: Botox, Myobloc and Dysport. They are a little bit different but work pretty much interchangeably. The differences are pretty small.
Botulinum toxins work by paralyzing the muscle(s) into which they are injected for a few months (at most.) The Mentalis muscles elevate the lower lip a bit and wrinkle the skin of the chin a bit. The real question is whether or not stopping or decreasing this action would be pleasing to you.
This is not a common injection point, so look at this as an experiment. The good news is that if you don’t like the effect, it will wear off.
Best Regards,
John Di Saia MD
Related:
Dr D’s Website Botulinum Toxin Page
Originally posted 2010-01-11 07:30:42.
Megan Fox Using Less Botox Picture
Posted by admin in Botox, celebrity plastic surgery on July 8, 2011
Apparently Megan Fox posted images of herself (including this one) showing forehead movement to prove she is not using Botox. These images however show decreased movement in the most popular Botulinum toxin treatment area [the Glabella at the interface between the nose and the forehead.] The rest of her forehead can move to form wrinkles indicating the Botox effect is not present.
The image Megan has here looks a lot like one I posted at my web site years ago of a woman I treated with Botox before and 4 days afterward with full Botox effect in the Glabella alone shot in over expression.
I tend to like to use Myobloc instead of Botox to get that partial effect that I prefer, but this is only my personal opinion of course.
Best Regards,
John Di Saia MD
Reader Question: Is There Ever Good Botox?
Reader Question:
All I see online is bad Botox stories. Can this ever be done well? Why is it so popular?
Botulinum toxin injections temporarily paralyze muscles where they injected. While this sounds scary, it can be done to reduce certain facial movements that make people look concerned (the look of consternation,) and older (crow’s feet,etc). As is usually the case in plastic surgery, too much of an otherwise good thing can make people look weird. Just look at a few celebrities who look like they might have had too much like Teri Hatcher maybe?
As the market movement with Botulinum injections has been toward less and less experienced injectors and decreasing price points, the landscape has changed. People are paying for it based upon the quantity injected now more and more, so some injectors are injecting more and more into areas other than the standard Glabella (the spot to reduce the look of consternation). This leads to stone faced outcomes or zombie faces and these of course are prominently featured in the news outlets.
To answer your question, you need to define your goal. If that goal is to look natural, reduce the amount you have injected and target fewer areas. In most patients I like to inject the Glabella plus or minus the Crow’s feet. Also seek an experienced injector (like maybe a real Plastic Surgeon?) or at least try to avoid the “Dr Cheapies” who can’t be doing it right.
Best Regards,
John Di Saia MD
Related:
Dr D’s Philosophy on Botulinum Toxin Injections
Originally posted 2009-10-26 07:30:54.
Reader Question – Botox in a Spa by Non-Plastic Surgeon?
Reader’s Comment:
I have been getting my wrinkle tox injection by a nurse (I think) at a spa in a mall nearby my home. Is this safe?
The reality is that simple cosmetic procedures are happening everywhere. The quality of injectors varies substantially. What they are injecting varies too. As long as they don’t go overboard and are using quality material, the risks are pretty low. Some injectors kinda go nuts though and others are not using enough toxin or the right toxin. Some don’t have the best technique. You should ask who is doing the injecting and what training he or she has had. Not knowing what kind of professional is injecting your face is scary.
Suffice it to say there is more risk when you go to an inexperienced or untrained injector. It will likely be cheaper, but you will have to accept that risk in trade for the lower price tag. I usually advise that people find an injector with whom they have had good results and stay there.
Best Regards,
John Di Saia MD
Droopy Eyelid Fix for Too Much Botox?
A patient of mine e-mailed recently. She lives kinda far from me so she goes to a local doc (a general practitioner) for Botox. She got more than usual for her forehead and nasal root (for the look of consternation I’d predict) and now she has a droopy eyelid.
Her doc put her on Apraclonidine drops and she e-mailed asking how long can she be on them safely. She reports that fortunately they seem to be helping.
Apraclonidine is a drug that compensates for the weakened eyelid opening muscle by tightening it chemically. As the droopy eyelid problem usually only last a few weeks she can probably be on them for that period of time without harm.
The lesson to be learned is to take it easy on the amount of botulinum toxin you have injected and consider that you might have more risk going to a non-plastic surgeon. I am not a fan of doing full foreheads and have only had one temporary eyelid droop in ten years of using these products.
Best Regards,
John Di Saia MD
Reader Laura on “Do It Yourself” Botox Bust
Reader Laura’s Comment:
Here’s another scary one. A do-it-yourself Botox business was busted in Mansfield, Texas. The police closed down her website where they had how to videos as well. I know the economy is really bad but some things you should never cut back on.
According to court documents, undercover investigators bought a “Newbie Starter Kit” from D’Alleva which contained the prescription Restylane in a filled syringe. They also purchased Dysport and Freeze, both of which contain purified neurotoxins, which are used for wrinkle-reduction.
Source: wfaa.com/home/Do-it-yourself-Botox-business-busted-in-Mansfield-73618542.html
This lady was selling “Do it Yourself” botulinum toxin, Restylane and other prescription drug kits with instructions it seems. The most interesting part may be how she was able to order the drugs. There is nothing here about anyone being hurt at least.
Best Regards,
John Di Saia MD
Fake Botox Prosecution
Posted by admin in Botox, Plastic Surgery legal, plastic surgery news on October 15, 2009
A New York Plastic Surgery practice has pled guilty to misleading the public. It used a botulinum toxin called “Tritox” produced by an Arizona company called Toxin Research International Inc on people who believed they were receiving Allergan’s Botox product. It turns out this “Tritox” substance was not FDA approved. It was not even approved for use in humans.
Source: cosmeticsurgerytimes.modernmedicine.com/cosmeticsurgerytimes/
article/articleDetail.jsp?id=630852
I have been asked to review such a case here in California for our medical board. From what I hear, we will likely be seeing more of these prosecutions in the coming months. This New York practice got off light.
Best Regards,
John Di Saia MD
Reader Laura on Washington State Fake Botox and Restylane Story
Posted by admin in Botox, soft tissue fillers on September 29, 2009
Reader Question:
Source 1: komonews.com/news/local/54859762.html
Source 2: komonews.com/news/local/54913492.html
“A salon owner in Washington state has been arrested for injecting fake Botox and Restylane into her customers”
I wonder what she was injecting since the story says the vial had Chinese characters. Obviously this should only be done in a doctor’s office but should patients ask to see the vial of anything you are being injected with? What is the normal procedure in a doctor’s office?
When you allow someone to inject soft tissue fillers and/or Botulinum toxin into your body, you need to have a level of trust. Doing these things in a salon may be cheap, but can have very disfiguring and/or expensive consequences. It sounds like this material with the Chinese characters had similar inflammatory consequences as liquid silicone and needed to be cut out. This woman is disfigured and will likely remain that way.
My patients can always see the material with which I inject them. They are being treated by a board-certified plastic surgeon not a less trained injector. If you do not trust the person injecting your face, he or she should probably not be doing it. Going to a reputable plastic surgeon’s office should cut your risk even though it will cost more.
Best Regards,
John Di Saia MD
Botox for an 18 year Old’s Birthday Present?
But for Margaret King, that didn’t mean offering young Jodie advice on the opposite sex or even guiding her on her wardrobe choices.
For her 18th birthday, she bought her Botox injections to get rid of the ‘wrinkles’ on the teenager’s forehead.
I think at 18, there were likely no wrinkles to treat, but I am admittedly conservative. See there are those in the UK just as crazy as we Americans.
Best Regards,
John Di Saia MD
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