Botulinum Toxin (BTX): New Cosmetic Uses, Expanded Applications

NEW YORK, NY (April 2, 2002) — -When most people aim for a shot of Botox, it's usually to diminish the appearance of wrinkles around their eyes, smooth the furrows on their forehead, soften the creases between their brows or improve a "turkey gobbler" neck. Usually, they are so pleased with the results, that botulinum toxin (BTX) injections (known by the trademarks Botox and Myobloc®) have become the number one cosmetic treatment in the United States. According to 2001 statistics from the American Society for Aesthetic Plastic Surgery (ASAPS), more than 1.6 million such procedures were performed last year, an increase of 46% over last year.

As a result of the effectiveness, safety and popularity of BTX injections, doctors have developed new cosmetic uses that offer additional benefits to patients. According to New York plastic surgeon Alan Matarasso, MD, who teaches a course on BTX injection at national meetings of the American Society for Aesthetic Plastic Surgery, treatments have also been shown to be effective at smoothing the nasolabial folds (creases alongside the nose and mouth), the vertical lines on the upper lip where lipstick tends to bleed, "cobblestone" chin (pebble-like bumps) and "marionette" lines (depressions on either side of the mouth extending toward the jaw line). BTX has also been used successfully to treat excessive sweating of the armpits, hands and feet. About 94 percent of patients with this condition, called hyperhidrosis, have been shown to respond to treatment.

These extended uses of BTX require some modification to the injection technique. For example, some surgeons may opt for smaller doses that result in partial, rather than full, deactivation of muscles in areas where total loss of animation may not be desirable.

"Patients must understand that the treatment can achieve improvements but not complete elimination of lines," says Dr. Matarasso. "Occasionally, BTX injections to these areas are used in conjunction with surgery or complemented with laser resurfacing or injectable fillers to enhance results."

Botox and Myobloc® are biological toxins transformed into a therapeutic agent that works by blocking the transmission of impulses from the nerve cells to the muscle. By selectively interfering with the muscle's ability to contract, existing lines are smoothed out over time and future lines may be prevented.

Aesthetic plastic surgeons have found that the type of lines and wrinkles that respond to BTX injections are those caused by muscles that contract during facial expressions such as frowning or squinting. In appropriate doses and administered by a physician in a medical environment, BTX has proven to be a safe and highly effective treatment for smoothing lines and wrinkles, albeit only temporarily. For most people, the effects of a BTX treatment last from 3 to 4 months, and injections need to be repeated to maintain the benefits. Recently there have been reports of people receiving BTX injections from non-medical practitioners in non-medical environments such as salons, gyms, hotel rooms, home-based offices and other similar locations. In such cases, patients run the risk of improper technique, inappropriate dosages and unsanitary conditions. In addition, non-medical practitioners do not have the ability to perform surgical procedures when indicated, or to administer laser treatments or injectable fillers. A board-certified plastic surgeon can perform a complete evaluation to determine the best possible treatment, or combination of treatments, for each individual patient.


This press release was issued on April 2, 2002. On April 15, 2002, the U.S. Food and Drug Administration (FDA) approved Botox, now to be marketed under the name Botox Cosmetic, for the treatment of moderate to severe glabellar frown lines (vertical creases between the brows). Other cosmetic uses of botulinum toxin will continue to be "off-label" — that is, not specifically approved. In addition to the approved cosmetic use, Botox therapy is currently approved in the U.S. for neurological disorders including treatment of crossed eyes, uncontrollable blinking, and head position and neck pain associated with cervical dystonia (a movement disorder characterized by involuntary muscle contractions).


The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world's leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.


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