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Smile - If You Can

By James Barber M.D.
Cosmetic Surgery Expert
Updated: July 03, 2008
Everyone has heard about it lately, many have read articles in national magazines dedicated to it, and several have even been invited to parties bearing its name. Botox (attenuated botulism toxin) is taking America by storm. It seems to be giving everyone that quick fix they are looking for, and the ability to walk into a class reunion or wedding knowing that they look younger.

Over the years, people have tried nearly everything to erase the inevitable aging that comes from sun exposure, skin atrophy, excessive muscle activity, and the loss of elastic fibers. Procedures have ranged from laser resurfacing to fillers such as Collagen, Alloderm, Cosmoplast, and most recently, Artell and Restalyne. But the only way to directly address the hyperactivity of muscles beneath the skin, the real cause of wrinkling, is Botox.

Botox is a safe form of botulism toxin that temporarily paralyzes the muscle it is injected into. Most commonly, botox injections are made into the muscles responsible for facial expression. These muscles differ from all our other muscles because they connect bone to skin, rather than bone to bone. This direct connection to the skin causes it to wrinkle every time the muscle is contracted. Years of wrinkling in the same way lead to creases. Botox safely and temporarily interrupts the nerve transmission to the muscle's "end plate", paralyzing the action of the muscle and softening the wrinkles and creases.
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Botox is prepared on the day of the injection. It must be administered with in 12 hours because its potency diminishes over time. Vials are usually large enough to treat more than one patient, so they are scheduled on the same day to share to cost of the vial. The botox is usually injected into the forehead, the area between the eyes (glabellas area), or the "crows feet" at the lateral comers of the eyes. Over a four to five day period, the botox paralyzes the muscle, rarely erasing the wrinkle but almost always softening it to a great extent. The remaining lines then become much more amenable to laser resurfacing or the fillers mention earlier.

Contrary to general perception, botox is very safe. Their have been no long term complications or hazards related to its use, and it is now being used to as more than just a cosmetic procedure. Other uses of botox are the treatment of migraines, on cerebral palsy patients with talipes equines, hyperhydrosis (excessive sweating), and strabismus (lazy eye). For patients who do not have the time or ambition to undergo a more aggressive procedure such as a facelift or laser resurfacing, botox is the most popular new alternative for softening the wrinkles that come with aging.

Forever Facts:

1. New research from Stanford discounts early concerns about Viagra's risk to men's vision by showing that even large doses do not have damaging effects on the eyes.

2. Your driver's license could say "face donor" one day. A new operation at Royal Free Hospital in London allows skin to be removed from the deceased and transplanted to other individuals. While scary to some, it could be a miracle for those who have been disfigured in fires or accidents.

3. A UCLA report shows that men have over twice the likelihood of developing life-threatening complications during gastric-bypass surgery.

Words of Wisdom:

"Things should be made as simple as possible, but not any simpler." -Albert Einstein

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