Let's be real- nobody needs Botox Cosmetic, to smooth lines , help the skin glow and give you a pick up.
However , Botox really does help.
So, often, I come across people who say, " I don't think I really need Botox", " I don't think you’re ready for Botox ".
They say, "I don't need Botox, my skin is perfect ". I smile, and say Thank you! I don't need Botox either, but I have Botox in me. They look in amazement.
You see, Botox, paired with other skin treatments and lifestyle choices can help you look amazing, and look almost effortlessly natural.
Do we Really Need Botox?
Let’s start by understanding what Botox really is, how it works and how many different kinds of botox-like products are currently available on the market. Botox is a medication, just like any other medicine you take, but the story of how Botox was first discovered never ceases to fascinate me as it reveals how humans are getting better and faster at deciphering the language of the universe around us. This does not ignore good luck.
Botox was first discovered in 1978 and it was ophthalmologists who initially studied its effects on eye muscle hyperactivity and blepharospasm (twitching in the eyelids). Botulinum toxin (the active ingredient in Botox) is a protein that prevents the release of a neurotransmitter and hence shuts down a muscle, causing it to atrophy. At the start, they absolutely didn’t realize the other potential applications of Botox. They began to notice that people’s wrinkles started disappearing as they were getting treated with Botox for other ocular problems. Ten years later, Allergan acquired the rights to distribute the drug, but it was still being tested as a medication for twitching and cervical dystonia (uncontrollable contraction of the neck muscles). They eventually realized that as the muscles started getting deactivated, the appearance of lines and wrinkles improved. Like so many other off label uses, the discovery of anti-aging properties of Botox was accidental. Finally, in 1992 Alastair and Jean Carruthers issued the first report suggesting that Botox could be used for cosmetic purposes.
Now that we know how Botox evolved into the aesthetic world, let’s dive deeper. Botulinum toxin is a very potent protein produced by a bacterium (clostridium botulinum). It prevents the release of a neurotransmitter (a kind of fuel that makes the muscle contract and move) from the axon endings of nerves at neuromuscular junctions, thereby causing the muscle paralysis or reduced movement. In simpler words, it works by inactivating nerves that stimulate the muscles to contract. And the way it does that is by blocking the neurotransmitter acetylcholine from being received by a nerve. Without acetylcholine, the muscle atrophies, and it takes three to four months for the old terminal activity to get restored. The idea that the Botox molecule sits around actively blocking the acetylcholine is a misconception. In reality Botox does it’s job in three to four days and what you see over the next few months are simply the results.
Of course like many other things in this world, if used inappropriately, it can cause severe damage. Further, since the discovery of the anti-aging properties of Botox is relatively new, the doses injected are still based on trial and error. Some people need more, others need less, and only experienced doctors can best make these determinations. A scalpel in the hands of a surgeon can be life-saving, but in the hands of a child, it can hurt someone badly. Similarly, a car that’s being driven by a new driver can be a hazard, but an experienced driver will take you to your destination safely. Is there still a remote possibility of an accident? Of course, but that doesn’t make us stop driving cars. So what are the potential side effects when you use Botox for anti-aging your skin?
Top five common complications and how to prevent or manage them…
Pin-point bleeding. To be expected since the Botox is injected. Not a big deal—just apply pressure with a gauze pad as you would with any other injection.
Infection of injection site. Easily preventable if the injector cleans the skin with alcohol prior to injecting.
Ecchymosis (bruising). A very common side-effect, especially in patients who are on prescribed anticoagulants. They should be advised, if possible, to avoid these medications for 1-2 weeks before injections. In some cases it is not possible to avoid medication. Also some patients just bruise easily. An experienced doctor will apply ice immediately after injection.
Ptosis (a droopy or ‘dropped’ eyelid). Results from an inexperienced injector injecting in the wrong areas. Ptosis usually resolves itself in 2 to 3 weeks without additional interventions. 2.5% phenylephrine solution may be administered to the inside of the upper eyelid.
Diplopia (double vision). This occurs when the injector mistakenly injects the inferior oblique muscles, something experienced doctors know to avoid. (This is not permanent, but could take two to three months to resolve.)
The best way to avoid these complications? You must be an informed consumer, and ask the right questions to make sure the doctor is experienced, successful and a good match for you.
Contraindications:
Please don’t use Botox if you have:
a neuromuscular disorder
If you are on antibiotics, especially an aminoglycoside which can cause increased sensitivity to the drug
if you are pregnant
if you are actively trying to get pregnant
if you are breastfeeding
Please note: if you have an egg allergy, there might be a slight risk of cross reaction, since the Botox molecule is stabilized by human albumin, a protein similar to egg albumin. There is a risk, although Allergan representatives state that the chance of cross reaction is very low.
Can a Botox dose be lethal when used cosmetically? Humans have been using Botox regularly for over 20 years and there have been no known reports of death either directly or indirectly. Yes, people ask about risks of Botox but there are a lot of other things that harm or kill us daily; for example, poor quality food, pollution, lack of hydration, lack of quality sleep, and (perhaps worst of all) stress. It is equally important to note how these things can be lethal as well.
What are the other botox-like products and how are they used? There are 8 Botulinum types, referred to as A to H. Types A and B are capable of causing diseases in humans if used incorrectly by either companies or individuals but are also the ones used commercially and as medication. Commercial forms are marketed under different brand names.
Botox (onabotulinum toxin A, owned by Allergan)
Dysport (abobotulinum toxin A, owned by Galderma)
Xeomin (incobotulinum toxin A, owned by Merz)
Jeuveau (prabotulinum toxin A, owned by Evolus)
The indications for the use of Botox or the above mentioned botox-like-drugs are ever increasing. This is especially true where muscle spasticity is an issue. It’s used to treat post spinal cord injury spasms, head and neck spasms, jaw spasms, lower urinary tract spasms, esophagus spasms, improper eye alignment, and even to relax the anal sphincter in people who suffer from really painful anal fissures. Dysport has been FDA approved for use in pediatric spasticity in the lower limbs of children over the age of two years old. Botox is approved for treating excessive underarm sweating or hyperhidrosis, which can’t be treated with topical agents. Botox is also used in prophylactic management of chronic migraine headaches and it is now even recommended for arthritic shoulder joints to reduce chronic pain and improve range of motion.
The cosmetic application of Botox is considered safe and effective for reducing the appearance of facial wrinkles, especially in the upper third of the face. It is FDA approved for the glabellar lines in the center of the forehead. We also use Botox ‘off label’ (i.e. in a way not explicitly medically approved by the FDA) for crow’s feet and forehead lines. The effect starts three to seven days after the injection and lasts two to four months (and sometimes longer) depending on age, gender and lifestyle.
Do we really need Botox—regularly?
This is a philosophical as well as a spiritual question as far as I am concerned. One must never really “need” anything, but there is nothing wrong with desiring things that can help you live with vigor, kindness and beauty.
As you reach your 40s and 50s, your face starts losing collagen by 2-3% every year. For most people, the body stops producing new collagen around age 35. Using Botox can arrest the rapid aging of your skin in the upper parts of your face where most of your dynamic muscles are located. These are the muscles that make you frown and look shocked, or make creases around your eyes when you are smiling..
The Pros
1. It is effective.
There’s no denying the effectiveness of these treatments. Whether it is for cosmetic or medical use, when the treatment is performed properly the results are almost always guaranteed to be satisfying.
For those who use it cosmetically and for aesthetic purposes, the confidence gained is significant indeed. It allows people to have a sort of self-assurance that will undoubtedly affect their overall happiness and state of mind. For those who use it for medical purposes, the relief must be immense. To be freed from distracting and embarrassing medical symptoms does wonders in improving the comfort and overall quality of life of these patients.
2. It is relatively affordable in the short term.
Compared to other cosmetic and medical procedures, botulinum toxin injections certainly cost less per treatment. All things considered, $10-15/unit is a reasonable price to pay for the potential benefits, especially if your looks are crucial to your career. Many offices and clinics even have discounts or sales that bring the price down even further. More importantly, no price can pay for the comfort, confidence, and improved sense of self that these injections can give to some people - whatever purpose they may be using it for.
3. It is easy and non-invasive.
Just one injection and it’s done! The procedure itself takes no more than an hour at a time and a long and drawn-out recovery time is not necessary. It doesn’t require extensive preparation, whether from the one getting the treatment or the one administering it. This saves time, resources, and money.
For a quick and easy fix of the conditions it can treat, one would be hard-pressed to find something better than botulinum toxin injections.
4. It is easy to find.
Lastly, because it is so popular, there is no shortage in providers of the treatment. Patients can have their pick of facilities while keeping in mind the price and skill of personnel, among other considerations. The competition also results to better prices for the people getting the treatment, as many practices lower their prices in an attempt to attract more customers and outmatch their competitors.
Competition is healthy for businesses and customers in a lot of ways. Just remember to not be swayed too quickly by low prices. Paying a little extra for better quality is always preferable to paying cheap and then spending more trying to fix a “botched” job. As with many other commercial goods, the maxim, “you get what you pay for,” applies.
The Cons
1. It is temporary.
Botulinum toxin injections are temporary and the effects usually last an average of 3 to 4 months. The duration varies from person to person, but there’s no escaping the fact that to maintain the effect, subsequent treatments are a necessity. This leads to the second disadvantage on this list.
2. It costs a lot in the long term.
Although these treatments are relatively inexpensive, the fact that one has to keep maintaining them will inevitably lead to more expenses. The costs can add up over the years and may eventually prove to be too much to continue indefinitely.
Of course, one could always stop treatment, but the truth is no one wants to be treated for something only to have it come back. No one wants to be wrinkle-free for a time only to go back to having wrinkles once that period is over.
3. It can have many side effects
These side effects have all been outlined earlier. They are an inevitable part of the treatment and may affect some people more than others. Although there are steps to reduce the risks of these side effects, there is no way to guarantee that they will not occur. The potential for danger may be low, but it is there. People should have that fact in mind as they consent to these treatments.
4. How do I pick an injector?
This is basically the flipside of the fourth advantage listed in the “Pros” section. Although more practitioners mean better availability, it cannot be denied that some of these “practitioners” are actually not very skilled or even qualified for the job.
Because sub-par practitioners usually charge lower-than-average rates, they still manage to attract a great number of customers. Sadly, a lot of these customers end up dissatisfied with the results or, worse, get botched jobs that lower their confidence instead of raising it.
To avoid falling victim to these cons, research and investigate thoroughly before deciding who and where to have treatments done.
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