The emergence of new formulations of botulinum toxin and other neuromodulators in the pipeline awaiting approval by the Food and Drug Administration signal a need for clinicians to stay abreast of the various uses and potential adverse events.
Since the start of its therapeutic use in the medical arena decades ago, the utilities for botulinum toxin have been expanding for clinical as well as cosmetic indications.
“Botulinum toxin has shown to be a very useful therapeutic tool in medicine employed for the treatment of varying indications including eye disorders, pain and neuromuscular disorders, but perhaps its most popular applications are seen in the field of aesthetic medicine for the treatment of frown lines,” says Alastair Carruthers, M.D., clinical professor, department of dermatology and skin science, Vancouver, British Columbia. “Despite its extensive use for numerous medical and aesthetic indications, I believe that we have only scratched the surface of its potential.”
Currently, four botulinum toxin serotype A (BoNTA) and B (BoNTB) formulations are approved by the FDA, namely onabotulinumtoxinA (Botox, Allergan), abobotulinumtoxinA (Dysport, Medicis), incobotulinumtoxinA (Xeomin, Merz) and rimabotulinumtoxinB (Myobloc, Solstice Neurosciences). Of these, the BoNTA preparations are the most widely used worldwide and the only ones FDA-approved for aesthetic use.
Bright future
The future of botulinum toxin therapies is very exciting, as new and innovative toxin delivery modalities are developed, such as the topical RT001 cream (Revance Therapeutics), which has yet to be approved by the FDA. This uncomplexed BoNTA topical product has been shown to traverse intact skin and achieve a result, Dr. Carruthers says, that could open doors for novel clinical applications, such as the reduction of redness, oiliness and sweating after a brief application of the neurotoxin.
“A topical neurotoxin that can target the sweat glands, sebaceous glands and vasculature could help to treat numerous dermatologic conditions. Although I don’t think that this is going to significantly impact the injectable market, such a topical modality may expand the market dramatically,” Dr. Carruthers says.
Injectable neurotoxins have been shown to be effective in the treatment of headaches and migraines, and topical neurotoxin products such as Revance have also been shown to improve this condition, representing a novel treatment option for patients.
Other evolving indications for neurotoxin therapy in medicine could be the treatment of depression. According to Dr. Carruthers, there is an increasing number of studies being reported demonstrating that the use of botulinum toxin in frown lines can help improve depression in many affected individuals. Other changes being made to the botulinum toxin molecule could result in radical changes in the treatment of pain syndromes in the future. Novel neurotoxin formulations in the works could significantly help alleviate the pain typically associated with those syndromes, he says.
“I have had experience with all of the available neurotoxins and though there are fine differences among them, I find them all to be effective. As we get to know these products better and learn from personal experiences and future studies, we may begin to distinguish areas for which one may be more suitable than the other for a given indication,” Dr. Carruthers says.
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Surgery & Med Spa
Shopping malls and airports aren’t the only places that see more action around the holidays. This is also the time of year that merry-makers crowd the offices of plastic surgeons everywhere. Whether it’s because people can take extra time off for recovery, or because they want to be in top form for parties, plastic surgeons struggle to keep up with demand in November and December. However, there’s a few things you should keep in mind before booking your pre-holiday procedure. At the office of Dr. Mark Bishara- we want you to take time to think about any procedure, whether it is during the holiday season or any other time of year.
Party Perfect
Holiday parties and family gatherings, while fun, can be pretty stressful. You often see people you haven’t seen in a long time or those you’d like to impress. You splurge on new clothes, get your hair done and dissect your appearance in the mirror, your eye immediately drawn to what you don’t like. We’ve all been there. This added pressure leads many to take a proactive approach and seek cosmetic surgery.
It’s common for those considering cosmetic procedures to be motivated by the opinions of others. Though this is an understandable desire, we encourage patients to think about their own perceptions of themselves above all else. Showing up your snobby cousin over Christmas dinner or attracting a cute colleague at the holiday work party might not be the right reason to undergo major surgery. The decision should be about self-perception, with the understanding that a change to one’s appearance is not life-changing in itself.
Realistic Recovery
Another reason many choose this time of year for their surgery is the fact that it may be easier to take time off from work to recover. However, patients should be realistic about recovery times when considering having a procedure done during such a busy period. Though many surgeries only require a few days of rest, it’s important to err on the side of caution when it comes to recuperating in time for important events.
Though you can recover from a breast augmentation or liposuction over a long weekend, it’s normal for patients to experience some soreness for a few weeks after these procedures. On the other hand, recovering from more invasive procedures, like tummy tucks, can take up to a month.
What may normally seem like effortless tasks could become challenging or even painful when you’re recovering from surgery. Patients may be determined to have a procedure done in time for holiday fun, but they should be realistic about how the surgery will impact their everyday lives for a little while. The last thing you want is to be restricted by a surgery that was meant to increase your enjoyment of the season.
Good options for those who want a beauty boost without the recovery are Botox and dermal fillers. At the office of Dr. Bishara & The Paragon Med Spa we offer, Botox, Xeomin, Juvederm Ultra Plus XC, Radiesse…..and soon the new Juvederm Voluma XC. These in-office, non-invasive procedures won’t put you out of commission for important holiday events. Dermal fillers are great for giving a bit of extra volume to lips, minimizing the appearance of wrinkles and enhancing contours. And Botox can be the perfect solution to wrinkles, crows feet and those pesky frown lines. Both procedures have immediate payoff and zero downtime, which may make them a better choice for those with packed calendars.
Other great options for short or no recovery time for the holidays are laser services, including laser hair removal, IPL fotofacials, VI Peel, skin resurfacing, skin tightening and skin remodeling. You can also do a quick microdermabrasion or facial treatment during your lunch hour to look refereshed for your holiday events.
We all know that the holiday season ends in a new year, full of resolutions. This time causes many to seek change, both inside and out…which can result in packed plastic surgery waiting rooms. It can be tempting to try to squeeze in a procedure in time for that Caribbean cruise or the return to work, but make sure that whatever you decide allows you to enjoy the season to the fullest.
Please call our office at (817) 473-2120 if you would like to speak with someone about scheduling an appointment so you can look refreshed for the holidays.
Start the Season Off as You…Only Better!
If you’re considering invasive or minimally invasive cosmetic surgery this fall or winter, getting it done during this time of year offers several benefits. There are often specials to take advantage of, and if you get your procedures done now you’ll be ready when summer comes.
Timing cosmetic surgery procedures towards the end of the year or earlier in the year allows for plenty of recovery time so that once it’s swimsuit season you’re ready to show off the results of your liposuction or breast augmentation.
This is also a great time of year for men to give the gift of a cosmetic procedure to their wives or girlfriends who want to start off the New Year with a new look for their face or body.
It’s the same reason health clubs are busy in January. They get up their resolve and they say this is the year they want to do it, and, of course, they want it done right away.
Dr. Mark Bishara offers cosmetic surgery for the breast, body and face, as well as a variety of non-surgical procedures, including robotic hair transplants, injectables and laser procedures.
Dr. Bishara and The Paragon Med Spa are currently running several specials through the end of December. Please call our office at (817) 473-2120 for more details.
December Holiday Specials:
* Buy 1 Laser 360 treatment and get 20 units of Botox for FREE
OR
* Buy 1 Laser Hair Removal session and get 2nd session FREE
OR
* Buy $100 or more of Botox, get a microdermabrasion treatment for free (Value of $85)
Specials Expire December 31, 2013
The US Food and Drug Administration (FDA) has approved use of onabotulinumtoxinA (Botox Cosmetic, Allergan) for temporary improvement in the appearance of moderate to severe lateral canthal lines, also known as crow’s feet, in adults. Botox Cosmetic is currently the only FDA-approved drug treatment option for lateral canthal lines, the FDA said today.
The agency approved Botox Cosmetic in 2002 for the temporary improvement of glabellar lines (frown lines) in adults. Botox Cosmetic works by keeping muscles from tightening, so wrinkles are less prominent.
Botox Cosmetic is administered via intramuscular injections. Treatment for both frown lines and crow’s feet can be given at the same time, the FDA said.
Boxed Warnings
The approval of Botox Cosmetic for treating lateral canthal lines was based on 2 clinical efficacy and safety studies involving 833 adults with moderate to severe lateral canthal lines who were randomly assigned to receive either Botox Cosmetic or placebo.
The results showed that those treated with Botox Cosmetic had greater improvement compared with placebo in the appearance of lateral canthal lines, the FDA said.
BOTOX® is a prescription medicine that is injected into muscles and also used for the following:
- to treat overactive bladder symptoms such as a strong need to urinate with leaking or wetting accidents (urge urinary incontinence), a strong need to urinate right away (urgency), and urinating often (frequency) in adults 18 years and older when another type of medicine (anticholinergic) does not work well enough or cannot be taken.
- to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older
- to treat increased muscle stiffness in elbow, wrist, and finger muscles in people 18 years and older with upper limb spasticity
- to treat the abnormal head position and neck pain that happens with cervical dystonia (CD) in people 16 years and older
- to treat certain types of eye muscle problems (strabismus) or abnormal spasm of the eyelids (blepharospasm) in people 12 years and older
- to treat the symptoms of severe underarm sweating (severe primary axillary hyperhidrosis) when medicines used on the skin (topical) do not work well enough in people 18 years and older
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Med Spa
Dr. Mark Bishara provides a wide range of cosmetic procedures, including Botox and fillers, to help patients look and feel their best. All injections are performed by Dr. Bishara in our office. Please call our office to schedule an appointment at (817) 473-2120.
Fall in love with your skin all over again! Join us in September and October for Fall Skin Rejuvenation. Until October 31, 2013 we are running the following special:
VI Peel for $199 (Value of $250)
VI Peel is a facial peel for ALL complexions. It helps improve the appearance of acne, unwanted pigmentation and melasma. It is the only peel of its kind to contain synergistic blend of TCA, Retin-A, Salicylic Acid, Phenol, and Vitamin C. It gives great results in as little as one treatment.
The VI Peel contains a synergistic blend of powerful ingredients suitable for all skin types. This peel provides dramatic results with virtually no pain, no skin preparation and little downtime. Why wait weeks or months for results? Enjoy radiant, younger looking skin in about a week with the VI Peel.
The VI Peel will improve the tone, texture and clarity of the skin; reduce or eliminate age spots, freckles, and hyper-pigmentation, including melasma; soften lines and wrinkles; clear acne skin conditions; reduce or eliminate acne scars; and stimulate the production of collagen, for firmer, more youthful skin. Vi Peel also works well in conjunction with lasers, injectables and post procedure.
At the office of Dr. Mark Bishara and The Paragon Mede Spa, we offer many cosmetic and med spa services to help patients look and feel their best. Please Call 817-473-2120 today to make an appointment.
Cosmetic Surgeon Dr. Mark A. Bishara, M.D., serving Fort Worth, Arlington, and the surrounding area.
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