MEDICAL SPAS: BOTOX UPDATE 2008

by Dr. John Goldhar

Consumer resistance to Botox seems to have several bases but one of the most common is that it will leave the person with an expressionless or plastic looking face that they see on some of Hollywood’s most famous.

Unfortunately, this is most often due to poor technique on the part of the physician or to unrealistic demands of the client.

Before administering Botox, it is important to understand the mechanism of action of this drug - that’s right Botox is a DRUG.

Here’s what it is and how it works:

Botox is a natural product of the bacteria Clostridium botulinum and the mechanism of its action is to temporarily interrupt the message that goes from the nerve to the muscle. This “interruption of the message” puts the muscle to rest for about three to four months. Since Botox doesn’t diffuse or migrate very far from the injection site, we can very precisely control which muscles are to be affected and - in addition to facial lines - lines can therefore successfully treat conditions such as back pain, facial spasms, double vision, excessive sweating of the hands, armpits forehead and groin areas as well as prevent contractures in people who have had strokes or who have cerebral palsy.

Most of the cosmetic uses of Botox are directed at treating wrinkles and grooves created by repeated muscle use. Repeated use exercises, strengthens and increases the size of muscles, which get strong enough to bend the skin and form the wrinkles that we see on the forehead, frown lines, crows feet, lipstick bleeding lines and downward frown of the mouth.

The main function of Botox in these cases is to relax and de-exercise the muscles so that they can return to their ‘normal’ size and strength. An experienced physician (Botox should
only be injected by a physician who has had special training with this drug), will understand the interrelationships of the muscle groups, the dosage of Botox required and the result of altering the direction of the muscle forces. Consequently, the medical practitioner will be able to achieve a very natural, non-frozen appearance for the client.

One of the newest and exciting applications of Botox is its use in the masseter region. The masseters are the muscles of the angles of the jaws and they are often enlarged as a result of clenching or grinding the teeth. When the masseters enlarge, they give the face a square appearance. Injection of the muscles, often in conjunction with a dental appliance prescribed by a dentist can result in an attractive, tapering profile, relief of TMJ pain and arresting erosion of the enamel of the molars. Generally this requires about 30-40 units
of Botox (a very small amount considering that about 20,000U are required to cause toxicity from Botox). Botox is indeed a safe medication in the medical armament when given by trained, experienced physicians.

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Dr. John Goldhar can be reached though Cosmedix MD or e-mail info@cosmedixmd.com