By THÉRÈSE MARGOLIS
Ever since 1987, when the Canadian dermatologist Alastair Carruthers first stumbled upon the discovery that botulinum toxin, a medication used in the treatment of Parkinson’s disease and other neurological conditions, had a secondary effect of diminishing the appearance of facial wrinkles, women around the globe have been lining up by the thousands for Botox treatments to soften the appearance of crow’s feet, frown lines and tiny wrinkles around their foreheads.
In fact, Botox (which is a commercial name for the medication distributed by Allergan, although it is generally used to refer to all botulinum toxin injections) has become the number one cosmetic procedure in the world today.
And while the effects of the procedure are transitory, the treatment is extremely affordable and the results can be dramatic.
This simple outpatient procedure, which can run between 5,000 and 8,000 pesos depending on the physician and the amount of neurotoxin used, can significantly reduce the appearance of fine lines and relax facial muscles that can cause wrinkles and creases.
But for all its popularity, Botox and other cosmetic botulinum toxin treatments (the other main brands are Dysport and Xeomin, both of which have the same key ingredients and work essentially in the same way as Botox), there is still a wealth of misinformation and confusion about what the neurotoxin does and what a patient can expect.
“One of the most common myths about Botox is that it is dangerous,” said plastic surgeon José Romeo Jr. Castillo Moreno of the JR Plastic, Aesthetic and Reconstructive Surgery Spa Clinic in Mexico City’s upscale Colonia Polanco.
“That is ridiculous. If administered by a certified plastic surgeon or dermatologist, Botox is one of the safest medications on the market today.”
Castillo Moreno went on to note that there are very few patients who are not candidates for botulinum toxin treatments, although he advised against administering it to pregnant women and those that are lactating, as well as to those with clotting problems.
Botox has been around since 1989 and has been approved both in the United States and Mexico since 2002 for cosmetic purposes.
Since that time, millions of patients have been given the neurotoxin with almost no secondary health concerns.
“The important thing is that it be administered by a certified physician because, even though it is a safe medication, it does affect the nervous system, so you need someone with years of medical training to know where it can and cannot be injected.”
Another common misconception about Botox is that it can lead to botulism, a rare and potentially deadly disease caused by the clostridium botulinum bacterium.
Romero Castillo explained that while Botox is derived from botulinum toxin, it is a purified protein that no longer is toxic and cannot infect a patient with botulism.
Moreover, he said, Botox and other cosmetic neurotoxins are designed to remain at the site of the injection and cannot usually migrate to other parts of the body.
The third myth that Castillo Moreno noted was that many patients still fear that Botox will leave them with unnaturally frozen faces, unable to express emotion.
“That really isn’t a likelihood today,” he told Pulse News Mexico.
“In the right hands, Botox can be applied judiciously so that patient looks natural without a startled or frozen face. There are all kinds of botulinum toxins available that can relax but not freeze facial muscles.”
Castillo Moreno added that in most cases when a patient does end up with a frozen or expressionless appearance it is the result of a Botox overdose, usually applied by a nonprofessional.
“The secret of any cosmetic procedure is that it should leave the patient looking fresh and natural, rather than making it obvious that they have had a treatment,” he said.
“If you can tell that a patient has had a Botox treatment, then the person who conducted the procedure has done a poor job.”
Finally, Castillo Moreno said that a lot of patients are afraid that if they stop using Botox, their faces will age faster.
“Aging is a natural process,” he said.
“We cannot stop it, but we can slow the process and make our aging more dignified.”
Castillo Moreno also said that while the effects of Botox usually last about four months (although the pharmaceutical companies that make botulinum toxins claim that they can last up to six months), once the effect wears off, the muscles in the face will once again begin to contract and the lines will naturally begin to reappear.
“Botox will prevent your wrinkles from worsening as long as you keep up with your treatments,” he said.
“But if you stop having Botox treatments, the muscles in your face will stop being relaxed and resume their normal movement, which will lead to the development of wrinkles, just as they did before you had the treatment.”
And what can a patient expect after a Botox treatment?
“Botox is a fantastic medication, but it is not a magic potion,” Castillo Moreno said.
“It will reduce the appearance of tiny lines and slow the progress of deep wrinkles, but it is not going to remove 30 years of aging.”
He also pointed out that it usually takes a few days for the neurotoxin to take full effect, although most patients will notice a difference in their appearance within 24 hours.
“Botox works by relaxing facial muscles that can cause frown lines or make you look like you are squinting, but it will not heal thin or sagging skin,” he said.
“There are other treatments, such as dermal fillers and laser treatments that can help with those issues. That is why we at the JR Plastic, Aesthetic and Reconstructive Surgery Spa Clinic take an integrated approach to cosmetic treatments, working to resolve all the patient’s problems through a variety of specialized treatments for their specific conditions. It doesn’t make sense to just treat the wrinkles in the forehead if the patient also has a sagging jawline. The idea is to incorporate different treatments so that the patient comes away looking better and younger in all their features.”
José Romeo Castillo Moreno is a plastic and reconstructive surgeon with a private practice at the JR Plastic, Aesthetic and Reconstructive Surgery Spa Clinic.
The JR Spa Clinic is located at Presidente Masaryk 134, interior 303, in Mexico City’s Colonia Polanco (5254-4006).
Castillo Moreno receives patients with prior appointments Monday through Friday from 10 a.m. to 6 p.m.