Is your Botox really a Bargain?

Botox it seems is everywhere. Plastic surgeons and dermatologists have been very good at developing treatments and medication applications which have pushed Botox and now others like it, such as Dysport, into the top spot for most requested nonsurgical cosmetic procedures. With the success of botulinum toxin for dynamic wrinkles, there has been a trickle of treatments leaving the hands of plastic surgeons and dermatologists to ‘Botox parties’ and now a flood of treatments marketed in hair and nail salons and day spas all across the country. And not to be outdone by the hair salon next door, it is likely that your dental hygienist will offer Botox after your next cleaning.

If you somehow just can’t find Botox at a corner near you, try to Google ‘Botox Specials’ and work your way through the 10,000 plus listings for an offer near you. We dare you to give your e-mail, as the Botox specials and coupons will begin to arrive like owl letters for Harry Potter. Groupon? There is deal every day. Who will ‘do’ your Botox? It can be hard to say, though the weekend courses to teach ‘injectionists’ abound, some of which are sponsored by the manufacturers themselves. Some individuals we see race from special to special trying to get the best deal and lowest cost for the product without the concern for what the treatment will actually be. More time (and loyalty) might be spent selecting a hair colorist, because Botox is just Botox, right?

The word on the street is that not all Botox is equal. The medication is dose dependent, and the effectiveness depends on proper storage, and proper dilution. As the number of specials increase and the prices fall, corners can be cut just with dilution alone like a bartender watering a drink. Botox storage is also critical, as once mixed the medication will lose its effectiveness in a short period of time. When it comes to Botox, freshness is everything. Use it or lose it, and a salon just might not be willing to let it go.



So who will ‘do’ your Botox? We hope it will be us, your trusted plastic surgeon. Remember, the specialized service, knowledge of anatomy, facial aesthetics, proper application, and development of treatment plans has made Botox what it is today. Maintaining a record of where, how much, how often, will keep you looking consistently great time after time. The next deal of the day might not provide that. You probably spend a fortune at your special hair colorist, and give a nice tip to boot because they got you in. Why should you rush off with a coupon for your Botox application and see what you get. Otherwise Botox is just Botox, and it’s no bargain.

Botox and Juvederm, what is the difference?

With the extreme popularity of both products in our office, Botox and Juvederm, we continually have to sort out confusion between the two, and what each can accomplish. Just today on the Twitter stream the issue was raised. Do you need one, or the other, or will you need both?

In order to set the record straight let’s go back to the basics. Starting with Botox, the medication is a neurotoxin, which sounds a bit scary, though this is indeed how it works. There are now three formulations out there; Botox, Dysport, and now a new one from Merz called Xeomin. They are all formulations of botulinum toxin type A, and studies to date show a very similar result and duration for all three with skilled application. The toxin binds to the end of the motor nerves and stops the connection so the muscle cannot react. Over time, the nerve ends replenish themselves and the muscles again respond to commands to flex and frown. The key here is ‘flex and frown’. Botox, and the like, treat dynamic lines and folds from facial over expression. Wear your worries on your forehead, or smile and squint expressively from the corner of your eyes, Botox is your cure.

Juvederm is quite a different matter, and is one of a group of “fillers” based on hyluronic acid gel. The gel is a chemical which is a normal component of cell membranes, part of the regular stuff in the body and is importantly not a protein. The fact that it is not, prevents any reaction or inflammation which was a dread from collagen injection of days gone by. The hyluronic acid gel is a great plumper because it is hydrophilic, which means it attracts and holds water, and is slowly absorbed and recycled by the surrounding cells. A filler does just that, it plumps and softens lines and folds that are always there or have crept in during the aging process. Smile lines and folds are the first to come to mind.

So, Botox or Juvederm, what is the difference? Wrinkles at rest, Juvederm to fill and contour. Dynamic line or wrinkles with motion, Botox is the cure. Will you need both? Maybe.