A Board Certified Plastic Surgeon in Scottsdale
Posts tagged Botox
A painless Botox in the future?
01 year ago
Scottsdale – According to Aesthetic Medicine News, Emergent Health Corporation announced today that a new patent under which it has a license to market a painless Botox® type cream (not requiring an injection) has been allowed by the US Patent and Trademark office. Emergent is seeking a joint venture with firms capable of assisting entry into this estimated $6 Billion dollar cosmetic market. While Botox® Cosmetic as a registered trademark of Allergan and Restylane™ Dermal Filler as a registered trademark of Medicis are the dominant leaders in pharmaceutical cosmetic delivery.
Emergent believes there is a viable and sizeable niche for its Painless BO(tm) Cream with the appropriate partners. Emergent believes there is a possibility Painless BO(tm) Cream could not only make penetration into the large currently available markets but also open totally new markets for those who still fear needles.
Emergent is a company which engages in the discovery, development and marketing of products designed to better mankind.
Emergent believes it is positioning itself as a leader in the field of Regenerative Medicine defined by the National Institute of Health using nutritionally designed products. Emergent is focusing current efforts on marketing licensed patent pending natural stem cell propagating agents capable of enhancing each individual’s ability to increase their own adult stem cells from their bone marrow and under a patent pending application to market a dual acting all natural diet aid designed to help control hunger through normal body signals to the brain and stomach.
No more scowling! What you can do.
02 years ago
by Dr. Aldo
in Facial Surgery
The no scowling allowed zone!
Scottsdale – Do you sometimes walk by a mirror and catch yourself scowling? It happens to all of us. Those wrinkles that form between the eyebrows, can be tough to reduce. There are a few ways of reducing the frown lines that I am going to blog about today.
Before we get to that, let’s talk about what causes these lines to form?
The lines actually result from the repetitive motion of the skin in the frown area. The muscles underneath, called the glabellar muscles, cause the skin to move and wrinkle up the way it does. If you look carefully, you will notice three set of lines in most people. There is a horizontal line that occurs most often at the bridge of the nose. Then there is the two vertical lines just inside the eyebrows. The more times the skin moves through these motions, the greater the number and the more pronounced the lines become.
Therefore, the older you get, then deeper and more noticeable the lines become.
It is a good idea to reduce the number of times the lines are made by weakening these muscles using one of two techniques.
Botox is the best way to do this if you don’t want surgery. Botulinum Type-A has been shown to be safe and effective in reducing the lines in the frown area, and it’s FDA-approved. Botox works great to prevent and reduce, and perhaps, even to temporarily erase the milder lines.
If you have well-formed lines that are fairly deep and stable, Botox still works to reduce these lines. Some people may also require a filler injection into the really deep creases and lines for better results. An examination by a board certified plastic surgeon, can let you know what you need for your specific case.
A more permanent reduction in these lines can be obtained with surgical techniques. This procedure is called a glabellar muscle reduction, and involves removal of part of the muscle body of each one of the three muscles that cause these lines to form. Removing this portion of the muscle more permanently weakens it so it cannot pull the skin and cause the wrinkles to form. Occasionally, we see the muscle ends reattach and after some time the patient can frown again. I normally replace the muscle body that is removed with a small piece of fat, from the patient, for this reason. With the fat spanning the space between the two muscle heads, then it cannot reattach. The fat helps to keep the normal shape to the frown area and prevents any depressions.
What is nice about glabellar muscle reduction in Scottsdale, is that it can be performed through a standard forehead lift, a mini forehead lit, and endoscopic forehead lift and through an upper eyelid lift incision. With so many options, patients can have the freedom to choose the operation that best suits their needs (model used in illustration).
To find out about Scottsdale Botox days, I recommend you go to JoniRoney.com.
New study: Botox used to treat unsightly (hypertrophic) scars.
12 years ago
Scottsdale – Hypertrophic scarring is best described as a refractory skin disease. Patients with this disease experience major physical deformities, restricted range of motion, pain, and itching where this scarring occurs. Because the basis for hypertrophic scar has not been fully elucidated, the clinical management of these thickened scars remains a problem. A recent article in the journal, Aesthetic Plastic Surgery, demonstrates the efficacy of using botulinum type A, also known as Botox, for the treatment of these thick and unpleasant scars that offers hope for patients.
Nineteen patients were enrolled in the study. All patients had only one lesion, each one had persisted for at least 2 years and had maintained active hypertrophic characteristics. All patients were treated once a month with intralesional botulinum type A for a total of 3 months. Each lesion was injected until slight blanching was visible. The dosage was adjusted to 2.5 U per cubic centimeter of lesion.
The lesions were found, 3 on the face and neck, 5 on the chest, 6 on the back, 3 on the earlobe, and 2 on the buttocks. Patients and surgeons were allowed to assess the results with an average follow up period at 6 months.
All the lesions had some positive response. In the assessment from the plastic surgeons, improvement was seen in 15 lesions that reached a ‘‘good,’’ rating, including 1 on the face, 2 on the neck, 3 on the chest, 5 on the back, 2 on the earlobe, and 2 on the buttocks. Four lesions reached an ‘‘excellent’’ rating, including 1 on the back, 2 on the chest, and 1 on the earlobe.
The authors speculate that botulinum type A affects the cell cycle distribution of fibroblasts derived from the hypertrophic scars as the most likely explanation for their findings.
I like this study because injection of Botox is simple and safe and the before and after photos of the lesions are quite impressive. However, the study has limitations. First, it did not include a control group and was not double blinded, which may affect the degree of confidence. Additionally, the follow-up period was only six months.
It may be possible to offer Botox to some patients based on this research, but it should be made clear to patients that more research will be needed to see how well this technique works and what the long-term results actually last. Moreover, use if Botox in such cases would be off -label.
Botox appears to help patients with chronic ischemia hand pain – a novel use!
02 years ago
by Dr. Aldo
in In the news
Scottsdale – The July issue of Plastic and Reconstructive Surgery, the Official Journal of the American Society of Plastic Surgeons reports on a novel use of Botox for the treatment of patients with Raynaud’s phenomenon who have chronic pain and ulcerations of their digits.
Patients with Raynaud’s phenomenon can have unrelenting pain that frequently leads to dysfunction and disuse, rendering the patient debilitated and depressed. Pharmacologic blood vessel dilators and surgical options offer variable benefits. Outcomes of symptomatic patients treated with botulinum toxin type A (Botox) injections for Raynaud’s phenomenon are presented after a retrospective study focused on patient outcomes when performed on 19 patients diagnosed with Raynaud’s phenomenon.
All patients in the study, suffered from chronic ischemic hand pain. All patients had vascular studies to rule out occlusive disease. Fifty to 100 units of Botox were injected into the palm around each involved neurovascular bundle. Preinjection and postinjection laser Doppler scanning was performed on most patients to measure blood flow and measure differences.
Sixteen of 19 patients (84 percent) reported pain reduction at rest. Thirteen patients reported immediate relief. Three reported more gradual pain reduction over 1 to 2 months. Three patients had no or minimal pain relief. Tissue perfusion results demonstrated a marked change in blood flow to the digits. All patients with chronic finger ulcers healed within 60 days. Sixty three percent of patients remained pain-free for 13 to 59 months after a single injection. Four patients (21 percent) required repeated injections because of recurrent pain.
In this particular study, the researchers make a case for the use of Botox in the treatment of vascular dysfunction is patients with Raynaud’s phenomenon. Although the mechanism is unknown, Botox injections, yielded a distinct improvement in perfusion and reduction of pain for these patients. Unfortunately, with such a small study groupd, continued research is required to obtain more specific and reliable treatment for Raynaud’s patients.
New study suggests Botox may help patients with diabetic foot pain
32 years ago
by Dr. Aldo
in In the news
SCOTTSDALE, AZ – Taiwanese doctors treating diabetic foot pain say that injections of Botulinum toxin type A (A.K.A. Botox) may help to substantially reduce the foot pain experienced by diabetic patients. After many years with the disease, people with diabetes can suffer from chronic foot pain due to peripheral nerve damage. Injections performed to the top of the foot, used in a randomized study, demonstrated reduced neuropathic related pain in study subjects (Source: Reuters Health).
The study was published in the journal, Neurology. A total of 18 patients were studied. The article pointed out that there is recent evidence to suggests that botulinum toxin type A not only inhibits the release of acetylcholine at the neuro-muscular junction, but may also affect afferent sensory nerve fiber firing, relieving neuropathic pain. The participants were randomly assigned to get injections of Botox or saline, then 12 weeks later crossed over to receive the opposite treatment. Because the study was performed in a double-blind manner, it is useful. However, the small sample number makes it difficult to extrapolate the data on effectiveness in larger populations. This pilot study is encouraging but more research is needed according to the authors.
“intradermal botox injections are an effective and safe method of relieving diabetic neuropathic pain in the feet,”said Dr. Chaur-Jong Hu, at Taipei Medical University, the senior researcher on the study. He cautioned that, “the detailed underlying mechanisms, optimal dosage, and precise course of therapy require further evaluation.”
At the beginning of the study, the average pain score on a scale of 0-10 points was 6.36. At 12 weeks, the score was reduced by 2.53 points with Botox injections compared with 0.53 points with the saline injections. The difference is statistically significant. Up to 44 percent of study subjects experienced a reduction of at least 3 points in their pain score within 12 weeks after the injections. The patients also experienced an improved quality of sleep.
I have not used Botox for this type of medical treatment. If patients are considering such a treatment, they should know that the U.S. Food and Drug Administration has not approved the medication for this usage. Patients would have to consent to this off-label usage for Botulinum A.
Dysport – a Botox alternative approved by FDA
02 years ago
by Dr. Aldo
in In the news
Dysport was approved by the Food and Drug Administration in early May (2009) and is injected at the site of frown wrinkles. The drug temporarily immobilizes the muscles one uses to frown and can effectively reduce wrinkles. The FDA approval is based on the results of clinical trials involving 2,900 subjects. These trials showed that 93 to 95 percent of subjects experienced improvement in the appearance of wrinkles within seven days after treatment, and multiple treatments produced effects that lasted for more than 13 months. Dysport (previously known as Reloxin), manufactured by Ipsen Biopharm Ltd. (France) and distributed by Medicis Pharmaceutical Corp. (Scottsdale, AZ, USA), contains the same active ingredient, botulinum type A, as that of Botox.
I am excited that we have another option for patients. However, Botox has extremely good reliability and is currently considered the “gold standard” for botulinum type A treatments and wrinkle reduction. It is estimated that Dysport will be about 10 to 20 percent less expensive than Botox. The wrinkle treatment should be available for use in the U.S. in the next 30 to 60 days.
