What is Botox?

By: Alyssa Harvey The Daily News
Saturday, June 22, 2002

The latest cosmetic rage: An injection of Botulinum toxin, known as Botox, can temporarily remove severe frown lines from the face

Barbara believes she may have found a fountain of youth. This fountain flows from a syringe filled with the Botulinum toxin type A, a bacteria that is commonly associated with food poisoning.

The pretty poison is called Botox, and it was recently approved by the U.S. Food and Drug Administration to temporarily remove moderate to severe frown lines between the eyebrows, around the eyes and on the forehead by paralyzing the muscles. The results of the nonsurgical procedure usually last about four months and can be maintained through follow-up injections.

Barbara is a south-central Kentucky woman who doesn’t want to be identified because she doesn’t plan to tell her family and friends that she is receiving Botox injections. She thinks of the shots as more like a spa treatment than a doctor’s visit and a safe alternative to plastic surgery.

“I’d just turned 40 and I had wrinkles around my eyes,” she said of the reason she started getting Botox shots earlier this year. “I’ve had two treatments and I’m going to get a third shortly. I would recommend it. I’ve really seen results.” Barbara isn’t the only one.

Botox treatments, which involve a physician giving a few tiny injections in certain areas of the face, have caught on like wildfire across the country, including Bowling Green. And as the procedure becomes hotter, more medical professionals – from dermatologists to ophthalmologists – are getting training to administer Botox, said Dr. Tim Hulsey, medical director of the Physician Skin Care Center, which offers Botox. “If you have a medical license, the law does not require a particular doctor do this,” he said.

Dr. Victor Atalla, a plastic surgeon at the Center for Plastic Surgery, administered Barbara’s injections. He said he has had a lot of patients ask about Botox – enough so that he is having a Botox party at 5 p.m. Tuesday at the Center. “This is a time for them to learn about it,” he said of the party where patients can receive injections. “It’s quick, easy, zap and you walk out.”

Atalla has intimate knowledge of the procedure, which can cost between $300 and $700, depending on where in the country the injection is being given. “I’ve had it done a couple of times,” he said. “It’s a little uncomfortable, but it’s over quickly – 30 seconds to a minute. It’s not that bad to go through.”

Teresa Creek Midkiff agreed. The owner of Reflections Medi-Spa has had four Botox treatments and plans to offer them at her spa. Dr. Alexander Di Genis, a plastic surgeon from Louisville, will give the injections at the spa’s grand opening in July. Dr. Keith Bryson, a Bowling Green gynecologist, will administer the drug regularly after the grand opening. “It’s the greatest thing for beauty. It gives you more confidence in yourself,” Midkiff said of Botox. “It’s an instant lift. You look brighter. It’s instant youth in a syringe. People don’t realize you’ve had anything done.”

Although Botox injections are extremely safe because of the low amount of toxin being used, patients need to realize a few things about treatments, Hulsey said. “This doesn’t make the wrinkles go away permanently,” he stressed. “It keeps the muscle from bending the skin. It relaxes the muscle underneath.”

In fact, people often build antibodies against Botox after a period of time, causing it to be ineffective. “The worst side effect that I’ve seen is that it didn’t work,” Atalla said. “Researchers say some people may already have antibodies against it.”

According to the FDA Web site at www.fda.gov, “the most common adverse events following injection were headache, respiratory infection, flu syndrome, blepharitis (droopy eyelids) and nausea. Less frequent adverse reactions (less than three percent of patients) included pain in the face, redness at the injection site and muscle weakness. These reactions were generally temporary, but could last several months.”

Because there can be complications, the drug should only be administered under medical supervision, Atalla and Hulsey agreed. “I don’t allow any of my staff to inject Botox. I do it,” Atalla said. “This should be done in a controlled setting with a physician. That is the best way.” This is especially crucial since people are beginning to throw Botox parties where inexperienced people may perform the procedure and alcohol may be served, causing mistakes. A person injected improperly could suffer complications such as a droopy eyelid or mouth that remains until the treatment wears off. Atalla said his party will be alcohol-free.

Although it has been used to treat ailments such as headaches, muscle treatments and eye twitches, Botox can’t be used everywhere on the body, Hulsey said. “There are a limited number of places to use it,” he said. “As time goes on, we will learn more places where it can be used.”

For more information about the Botox party, call the Center for Plastic and Reconstructive Surgery at 796-8960.