Posts Tagged last
New Botulinum toxin patients come with varying experiences with Botox and the other available toxins on the market. A natural question is:
How long should Botox last?
We have addressed the question indirectly before in stating that there are reasons Botulinum toxins might not work.
Patients often are at a loss to understand why the effects of the toxin might not be as pronounced as they had been before with continuing use. Even when the injections are properly performed, the bodies of some patients (more than others) can “get used to” the effects and continued injections might have diminished effects or duration compared to past treatments. These toxins are proteins and the human body makes antibodies to protect itself from foreign proteins.
Suffice it to say the effects of Botulinum injections will probably last 2-3 months on average and the duration will vary and might decline over time with continued treatments.
John Di Saia MD
Originally posted 2011-04-28 07:30:37.
Almost two decades after a national hue and cry arose after fears that leaking silicone breast implants might cause systemic disease, breast augmentation has become the country’s most popular cosmetic operation. The renaissance of breast enhancement surgery is fueled in part by the Food and Drug Administration’s decision in 2006 to approve a new generation of silicone implants, ending a 14-year moratorium on their general use.
But with such high rates of reoperation, a new debate is emerging over whether breast implants constitute the kind of annuity medicine that will entail regular surgical tuneups, exposing patients to increased medical risk and out-of-pocket expenses. At a time when manufacturers have provided the F.D.A. with clinical studies that follow patients for just a few years, there is no established medical consensus on how long implants last, leaving doctors to rely on their anecdotal experiences when discussing durability with patients.
Breast implant lifespan varies dependent upon several issues; their size being one of those issues. Despite the “conspiracy theory” undertone of the article, many plastic surgeons are very good at informing our patients. This story makes it sound like the “industry” might be trying to hide the facts. Nobody does that in my office.
The story also suffers from a bit of naivete’ in the sense that often breast implants don’t actually rupture resulting in the desire for more surgery, but rather the patient’s body changes over time partly in response to them, for example:
(1) Skin changes with pregnancies after implant surgery can change the skin envelope around them and result in a desire to have more surgery to improve it.
(2) Capsular contracture (hardening) can occur particularly in response to silicone gel implants resulting in a desire to surgically correct it.
(3) Gravity can cause over time breast sag in some patients who might want their implant removed or lifted.
(4) The patient may just come to the point where she wants different sized implants or none at all.
The bottom line is that breast implants do require maintenance and more surgery over time. The choices patients make initially have a good deal to do with how often and how extensive such additional surgery may be. There is no good data on how long implants last because choices on sizing, implant type and a patient’s body particulars weigh into this to a great extent.
Initial breast implant surgery can be designed for “low maintenance” meaning to reduce the potential that more surgery will be needed soon afterward. When patients come to the office looking for a low maintenance approach, I usually advise them to go smaller on the sizing and stick with saline filled implants under the muscle. Many of my clients who have gone this way are still happy with their implants 15 years later.
John Di Saia MD
Originally posted 2008-03-09 13:34:00.