Botox is already a controlled substance, but in practice this means that only someone with a medical license can order the product. There are very few limitations on who can administer the shots, and while the injections are not particularly dangerous except in rare instances, a poorly placed injection can cause undesirable side effects.

Botox has made waves across the country and around the world. In China, it is frequently and openly administered by beauty parlors with no training or qualifications, which has led to widespread calls for stricter controls. Last year, the UK considered implementing tighter regulation on Botox, but this was ultimately dismissed for being too expensive to enforce.

Stateside, Botox regulation has become a hot topic in Texas and New Jersey, as politicians, doctors, and concerned citizens worry that the lack of controls is endangering many patients. The Texas Medical Board has considered making changes to the rules about who can perform cosmetic procedures involving prescription medications. This would include injectable fillers.

In New Jersey, legislators have introduced a bill that would ban Botox for minors, except in cases where a doctor affirms that the treatment is medically necessary. Before it became a popular cosmetic procedure, Botox was (and continues to be) used for a variety of medical purposes, including the treatment of certain migraines and cerebral palsy symptoms.

Botox regulation is supported by many people who fear that unscrupulous providers are capitalizing on the treatment’s rising popularity without taking into account the safety and ethical issues involved. You should always make sure that your Botox is being administered by an accredited professional with years of experience. Only these providers are qualified to target specific facial muscles and deliver predictable results with consistency.

Though both Botox and Dysport are hugely popular non-surgical options for diminishing many facial lines and wrinkles, new alternatives are often being researched. This treatment, which is called cryoneuromodulation, “appears to have the same clinical efficacy and safety comparable to the existing techniques,” according to Francis Palmer, director of facial plastic surgery at the University of Southern California School of Medicine in Los Angeles, who co-authored the study.

Rather than paralyzing the underlying muscle to smooth out the wrinkle as Botox and Dysport do, this new method freezes specific nerves in the forehead using small needles. This stops the nerve from communicating with the muscle, which causes it to relax. The smoothing effect is almost immediate and lasts about as long as botulinum toxin-based methods—three to four months.

The procedure takes about 15 minutes to complete while the patient is under a local anesthetic. Patients said the level of discomfort was similar to that experienced with Botox.

Though you may want to jump at the chance to try this new wrinkle-fighting treatment, it is still in the early stages of trails and has only been tested on forehead wrinkles. In the meantime, Botox is known to beautifully treat forehead lines, frown lines and crow’s feet.

Botox, produced by Allergan and Dysport, produced by Medicis, contain similar components of the botulinum toxin, which controls muscle movement when injected between the brows and diminishes glabellar lines and wrinkles. On top of this cosmetic use, botulinum toxin-based products have been used to treat excessive sweating and migraines and now the makers are taking the next steps in making their products widely available to those averse to injections.

So far, the news is good for consumers. The second phase in trials for topical Botox, which was completed in October, was successful. While no market date has been set for the topical version of Botox, nor for its Medicis-produced rival Dysport, needle-shy individuals can still test the possible effects of Botox by using Allergan’s Treatment Visualizer.

To learn more about injectable treatments as well as other skin care options, we encourage you to join the mailing list of Owensboro based cosmetic surgeon Dr. Edds and to call to schedule a consultation.

However, new data released by researchers at the University of Iowa suggests that among Americans, medical tourism is actually less popular than previously supposed.

Brandon Alleman and his team of researchers at the University of Iowa surveyed 45 companies that facilitate medical tourism for U.S. patients and found that these companies have referred only about 13,500 U.S. residents to healthcare and cosmetic surgery facilities outside the country.

These companies represent about 70 percent of the market serving U.S. medical tourists, so if, say 23,000 American patients traveled abroad for medical treatments, that makes up only a tiny fraction of the number of patients treated in the U.S. each year.

This is good news to Owensboro cosmetic surgeon Dr. Gerald Edds, as he and many of his colleagues discourage American patients from traveling abroad for cosmetic procedures like liposuction, breast augmentation and even injectables for a number of reasons.

For instance, countries outside the U.S. where cosmetic surgery is less expensive often do not have adequate standards of care and official oversight designed to prevent avoidable complications and poor outcomes.

There is also concern over whether medical tourists actually receive treatment with the products or devices they think they are getting, and that they paid for. Many patients think they’re getting Botox, but end up getting cheap knock-offs of the real thing, along with poor results.

In addition, most surgeons agree that it is important to receive follow-up care from the physician who performed the procedure, which is not usually possible weeks or months after surgery, when patients have returned to their homes in the U.S.

In fact, the study results showed that 93 percent of companies brokering medical tourism packages expect follow-up care to be performed by U.S. physicians.

Given the fact that many physicians are uncomfortable providing follow-up care to patients on whom they did not perform the initial surgical procedure, it can be not only difficult to find a physician who will provide post-surgical follow-up care after traveling abroad for cosmetic surgery, but costly to hire a new physician as well, especially if complications arise and revision surgery is needed.

To avoid the potential risks and difficulties with follow-up care that can arise from medical tourism, it’s best to first choose an accessible, board-certified cosmetic surgeon who performs procedures in an AAAHC accredited U.S. surgical facility.

Let cost be your final consideration in choosing a surgeon, as paying slightly more for a great outcome the first time can end up being much less expensive than paying separately for follow-up care and multiple revision procedures down the road.

There are also a number of financing options available to Americans who do not have the cash in-hand needed to pay for cosmetic surgery, so there is little reason to travel abroad when some of the world’s best surgeons are in your own backyard.

Each of the women questing for the ‘Bridalplasty’ prize has a wish list of cosmetic procedures they would seek should they beat out the competition, in addition to ideas for their wedding cake, dress, invitations and more.

According to an article in the Chicago Sun-Times, the show’s oldest contestant, Allyson, is a 33-year-old who plans to claim a wedding suited to her “old-school rocker chick” tastes and other prizes in the form of liposuction, a breast lift, a breast reduction and Botox, as well as some cosmetic dentistry, if named the show’s victor.

Before I was pregnant with my son, I was in the best physical shape of my life,” Allyson says. “I would love to get back to that and I’m sure [my fiance] would NOT mind some smaller perky boobies on me. I’m 33 and they sag down to my belly. What will happen when I’m 50? Will I have to roll them up and tuck them in my bra?”

Many women face the same troubling physical changes after undergoing the rigors of pregnancy and childbirth, however they are rarely so public as on reality TV shows.

The Sun-Times noted some particularly cringe-worthy scenes on Bridalplasty, such as the one where Allyson uses the spare tire of fat around her stomach to tell Dr. Terry Dubrow, the plastic surgeon featured on the show, “Help me, please. Suck me out.”

Dr. Dubrow is also shown using a marker to circle the problem areas on his topless patients, a scene that, according to the Sun-Times, calls to mind the behavior of a “sorority mean girl.”

“There is something beyond sensational with these cosmetic surgery makeover shows.  There is some indignity involved in the process,” says Owensboro cosmetic surgeon Dr. Gerald Edds.

Although, as Dr. Edds points out, there are certainly humiliating undertones present in Bridalplasty (and most other reality TV shows, for that matter), he like most critics acquiesces to the makeover competition, saying, “As long as the result is good and there are no complications, I suppose it is a win-win for both the ‘winner’ and the celebrity cosmetic surgeon.”

The new refinement technique, which essentially involves joining and rebuilding Botox molecules, may also improve the production process for Botox-based medicines, including the popular wrinkle relaxer Botox Cosmetic.

“It will now be possible to produce Botox-based medicines in a safer and more economical way,” said Bazbek Davletov, the leader of the study that uncovered the new refinement method.

The refining technique discovered by Davletov and his research team could allow scientists to create new and improved forms of the drug, expanding the practical medicinal uses for Botox, for instance as a long-term painkiller that could last four to six months.

“This is the first time we have been able to treat protein molecules like Lego building blocks, mixing and matching them to create the basis for treatments that would not previously have been possible,” Davletov said.

Although Botox has been used for years to smooth wrinkles, as well as treat problems like excessive sweating (hyperhidrosis), migraines, Parkinson’s, cerebral palsy and other diseases that cause spasms, tremors and chronic nerve pain, this latest scientific breakthrough will likely make the drug even more widely used.

It remains to be seen whether the “more economical” production process for Botox made possible with the new refinement technique will trickle down to doctors and consumers. It seems unlikely to decrease the cost of Botox injections, given the fact that the introduction of Botox-competitor Dysport to the cosmetic medicine marketplace didn’t lower the Botox cost.

Botox is currently FDA-approved to treat wrinkles, dystonia and migraines, and Botox will likely become even more widely used as scientific advances continue to improve and expand its uses.

With only one month before the promotional program expires, Medicis has released some preliminary data suggesting that consumers who have used Dysport are satisfied with the results.

If you’re not familiar with the Dysport Challenge, here’s how the program works:

• Dysport is injected to reduce forehead creases, frown lines or crow’s feet
• Patients enroll in the Dysport Challenge program and indicate whether they wish to continue using Dysport (“Love It”) or wish to switch from Dysport to Botox (“Leave It”).
• Patients receive $150 in rebates on two Dysport treatments if they choose “Love It.”
• Patients who choose “Leave It” and opt for Botox injections during their next wrinkle treatment receive a $75 rebate.

Medicis reported that of all the patients who have registered for the Dysport Challenge thus far, only 2.6% have decided to “Leave It” since the program was launched, however this does not necessarily mean that most patients preferred Dysport over Botox, only that they are happy with Dysport results.

Similarly, expert opinion has not definitively swayed in favor of either Dysport or Botox, in part because physicians are still learning how to most effectively use the new product.  Additionally, there are very few differences between Botox and Dysport, although some studies indicate that Dysport may have a tendency to spread or migrate more than Botox after injection.

Dermatologist Dr. Michael Gold commented that Dysport data shows no difference in migration tendencies as compared to Botox “depending upon whose study you read,” and added, “If you’re experienced enough with Dysport, the spread factor is a nonissue.”

Ultimately, injector preference for Botox or Dysport will likely be determined not by differences in the two products but by differences in physicians’ comfort level using one product over another and their affiliations to the product manufacturers.

“There’s a major tug-of-war going on between physicians who utilize those toxins,” Dr. Gold said.  “Depending on whose team you’re on, your statements will generally favor that toxin over another.”

Whatever you call these criminals, they are changing the face of cosmetic medicine and forcing more and more doctors to require prepayment for facial rejuvenation, skin care treatments like microdermabrasion and other services.  Many are also no longer accept checks for services rendered and instead require cash or card payment for elective procedures that are not billed through insurance.

“From talking to our doctors, this is a problem that’s occurring from coast to coast,” said Jeff Karzen, spokesman for the American Academy of Cosmetic Surgery.

Physicians in a number of U.S. cities, including Arizona, Texas, California, Nevada and Florida, as well as internationally in the UK and Australia, have reported patients who received thousands in injectable filler and wrinkle relaxing treatments, such as Restylane and Botox, only to flee the doctor’s office without paying the bill.

After their cosmetic treatments are complete, those intending to pull the old dine-and-dash, or in this case, the prick-and-run routine typically give the doctor’s office staff some sort of excuse to leave, such as needing to withdraw cash from an ATM or go out to their car to get their purse or check on a waiting child.

Check fraud is another common practice for “Beauty Bandits,” as the doctor’s office won’t find out until the crook is long gone that they’ve knowingly written a bad check for cosmetic services they don’t have the means to pay for.

Highly publicized cases like those of Jaime Merk and Maria Chrysson, two “Beatuy Bandits” who got busted by Florida law enforcement after stiffing area doctors for thousands in beauty treatments, have forced physicians to become more aware of this increasingly common criminal practice.

So, when seeking cosmetic treatment, especially for the first time with a new clinic, don’t be alarmed if you are asked to pay with cash or credit upfront.  This is simply a precautionary measure that has become necessary for doctors to prevent fraud and revenue loss.

In this youtube video of an ABC News segment, Dr. Bruce Genter, a surgeon well known in Philadelphia is critical of acupuncture as a wrinkle treatment, citing the lack of scientific evidence for that purpose.

But when people claim that it works, are they seeing real results?  If so, is it a cost effective treatment method?

Julia Engstrom, who is featured in the video, says she has undergone Botox treatment and laser treatment in the past. She believes facial acupuncture has improved her skin texture and reduced her wrinkles. Nearing the end of 10 treatments, she says her improvements are a result of improved sleep and relaxation after acupuncture. “I’ve noticed that my skin is a lot smoother, [there’s] a lot less red pigment in there and the wrinkling seems to be a lot less,” Engstrom said.

Acupuncture, a process of strategic needle placement on the body, is said to bring improved health and well-being. In an article for Prevention magazine, licensed acupuncturist and Traditional Chinese Medicine practitioner Phyllis Olson asserts that acupuncture can indeed lessen the appearance of wrinkles. She attributes this to a core premise of acupuncture – that health is reliant upon the healthy flow of chi (energy) in the body, which can be disrupted for a myriad of reasons. Acupuncture treatments are believed to break up energy blockages that prevent optimal blood flow to certain places in the body, improving circulation.

Acupuncturist Beata Maslanka acknowledges that acupuncture doesn’t yield visible results that compare to Botox or other facial fillers, but claims that beauty actually comes from within; when internal imbalances are resolved, people look better overall. Olson agrees, noting that the treatments foster relaxation of facial muscles, thereby reducing wrinkles. “Aside from the light, momentary stings, acupuncture is really quite relaxing,” she adds.

The results Engstrom points to are hard to discern from the video, but one can wonder about the salutary effects of relaxation and optimism. Of course, people also have a tendency to see (and believe) what they want to see.

If acupuncture does produce any wrinkle-relaxing effects, how long can one expect them to last? NYC dermatologic surgeon Barney Kenet, MD tells Prevention: “If acupuncture relaxes the muscles, it might reduce wrinkling temporarily. As for the increased blood flow, at most it will probably give you a temporary rosy complexion–something you don’t want if you have an inflammatory condition such as acne or rosacea,” he warns. “Otherwise, cosmetic acupuncture is relatively harmless.”

Maybe it is harmless if you ignore the cost of acupuncture. The average price is about $60 to $100 per session, with 10 sessions recommended by Olson, followed by monthly maintenance procedures.

In contrast, the average Botox treatment in the US costs $472 and a single treatment will last 3-6 months. By comparison, this makes acupuncture wrinkle treatments appear costly as well as unproven. Dr. Genter, whose Philadelphia Botox patients offer proof of visible wrinkle reduction, says: ”If it increases your well-being that’s great, I just don’t know that it can make your face look younger.”

Have you considered BOTOX?

By now, you probably know that BOTOX is a highly diluted form of the botulinum toxin used to correct certain facial lines and wrinkles. FDA-approved in 2002, BOTOX injections may be the single most popular non-surgical procedure to reduce or eliminate facial lines, wrinkles and grooves.

Have wrinkles appeared out of nowhere?

Crow’s feet, lines and even deep grooves appear on our faces over the years, the result of our natural expressiveness, lifestyle habits, and the tendency to move our facial muscles in habitual ways. For instance, you may squint a lot (when you’re concentrating, when you’re worried, when the sun is bright, or when you are trying to focus your vision.) As the years go by, this repetitive motion begins to carve lines in your face and can eventually result in a permanent expression of worry or intense concentration.

On others, you might notice facial lines and wrinkles and wonder, “Why is she so angry?” or “Why is he so uptight and stressed?” You’re probably noticing that vertical line that runs down the center of the forehead: one of the most obvious facial flaws, in otherwise attractive men and women.

Why BOTOX?

BOTOX injections are a quick and cost-effective way to improve your looks. Performed by a highly experienced hand, the results are truly gratifying, softening the appearance of common lines and wrinkles:

• Around the eyes (crow’s feet)
• On the forehead (both vertical and horizontal lines and creases)
• Around the mouth (smile lines)

For days after BOTOX is administered, you will look in the mirror and continue to see increased improvement in your face as the treatment reaches its full effect. BOTOX requires only local anesthesia, if any at all. The procedure effectively blocks signals relayed between certain nerves and muscles, causing a temporary paralysis in specific facial muscles.

After Botox treatment, you’ll still be able to smile, frown, and make normal facial expressions. BOTOX generally lasts 4-6 months before it needs to be replenished. Over time, many of our patients notice that their facial wrinkles continue to diminish even when they have BOTOX treatments less often. It almost seems to “train” the muscles to be more relaxed, resulting in a more serene, pleasing image as time goes by.

You only have one face

A word of caution: You may have heard about “BOTOX parties,” where the treatment is administered to a group of women in someone’s home. We strongly recommend that you avoid this route. You only have one face. Don’t place it in the hands of someone whose knowledge of facial anatomy may be insufficient. Just because someone can inject BOTOX doesn’t mean he or she can do it properly or with an eye trained to give the best aesthetic result. A trained cosmetic surgeon will administer the treatment with your very own unique face taken into consideration. The only BOTOX party worth attending is the one done safely in our Owensboro, Kentucky office.

If you are between age 18 and 65, are not pregnant, nursing or living with a muscular disorder, you’re probably a good candidate. Talk to us about BOTOX and start the New Year on a brighter, more attractive note.