The popularity of BOTOX® for the use in cosmetic facial
wrinkle treatment, known as BOTOX® cosmetic, is due to
its simplicity and tremendous effectiveness. It has become
so familiar by popular culture and media communications
that its name is often used as both a noun and a verb.
(which is both disturbing and discouraged by the
manufacturer) Recent negative publicity with its use in
children with neuromuscular disorders has not accurately
represented its safety record in cosmetic applications. To
allay potential patient concerns, it is useful to review
some of the factual information about this drug to clear up
any confusion created by these recent media reports.
BOTOX® cosmetic and Botulinum Toxin Type A is
manufactured by only one proprietary provider, Allergan out
of Irvine, California. It has been 18 years since it was
initially approved for the treatment of blepharospasm
(excessive eyelid twitching) and 6 years since its approval
for the cosmetic treatment of the vertical lines between
the brows. While accurate numbers are impossible to know,
tens of millions of cosmetic patients have been treated
around the world with the manufacturer reporting more than
13 million doses given since 2002. According to the
American Society of Plastic Surgery, BOTOX® cosmetic is
the most commonly performed cosmetic procedure performed in
the United States with over 3 million doses alone
administered in 2006. These large patient numbers, combined
with thousands of patients enrolled in various studies and
over 3,000 published medical articles on the subject,
provide a wealth of safety information. Despite the large
amount of doses administered and patients treated,
significant adverse reactions to the use of BOTOX®
cosmetic is extremely rare.I am not aware of any true
allergies to its use. To date, there has never been a
single reported death associated with its use either.
These cosmetic experiences must be contrasted with the
media reports where its use has been in limb spasticity,
which is not an FDA-approved application. In these
neuromuscular uses, substantially larger doses (up to 100
times) are given compared to what is given in cosmetic
doses and are injected in patients who are often ill and
weakened from their disease. There simply is not a
correlation between these two patient populations. The FDA
appears to recognize these differences and has issued no
stoppage of its use for any application to any health care
provider at the present time.
The accurate portrayal of the safety data on BOTOX®
cosmetic should provide great comfort to those patients who
regularly receive aesthetic treatments or to those
considering it in the near future.
----------------------------------------------------
Dr Barry Eppley is a board-certified plastic surgeon in
private practice at Clarian Health in Indianapolis,
Indiana. He writes a daily blog on trends in plastic
surgery at http://www.exploreplasticsurgery.com
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