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Often times patients who return and complain that their Botox “didn’t work” are saying so because they are looking for a much more extreme result. As Pearlman states, “The most difficult situation is someone who wants no lines at all and no movement but doesn’t want to risk dropping their brows.” A thorough consult with before and after pictures is necessary to prepare patients for what to expect post injectoin. Although it is a rare occassion when Botox is inffective it does occasionally happen. A as one surgeon, Shumway, responded with the simplest solution of all: “Try, try again. It always works if performed correctly, 99% of the time.”
Mark A Bishara, M.D., P.A. Medical Director
This Information is Brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery and Med Spa in Mansfield and Southlake.
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Medicis Pharmaceutical Corp is proud to  announce that the FDA has approved the use of the Restylane hyaluronic acid dermal filler to incorporate lip augmentation. Restylane was formerly approved to treat moderate to severe facial wrinkles and folds, such as the lines from the nose to the nasolabial folds. The new label will now include an indication for submucosal implantation for lip augmentation in patients over the age of 21.
Chairman and CEO of Medicis Jonah Shacknai, is pleased with FDA’s decision to expand the Restylane label to include lip augmentation. Restylane is now the first and only hyaluronic acid dermal filler approved in the United States for lip augmentation. 180 patients were evaluated during the study for six months. Safety was measured by adverse events reported throughout the study and patient diaries kept for two weeks after lip augmentation treatment.
Furthermore, Medicis designed nine lip safety assessments which were preformed at various intervals throughout the six month case study, including 72 hours after each treatment and again at two weeks after each treatment.
Mark A Bishara, M.D., P.A. Medical Director
This Information is Brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery and Med Spa in Mansfield and Southlake.
Please also visit our Facebook page at Paragon Plastic Surgery and Medspa

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Botox showed a statistically significant benefit for Botox over placebo. Without a headache indication the company can not promote data as U.S. Department of Justice is already investigating the off-label promotion of Botox for migraine. Allergan is said to be fully cooperating. Still, favorable data in studies will make physicians more likely to try it on patients suffering from migraines.
Botox costs $525 a vial, and 1.5 vials were used to treat headaches in the studies. Dr. David Simpson, a neurology professor at Mount Sinai School of Medicine, says there is a lot of off-label use in headaches now. He noted that in May of 2008, The American Academy of Neurology concluded that botulinum toxin type A was not an effective treatment for chronic headaches.
Biegelsen says current off-label use of Botox for migraine accounts for about $50 million, or 5% of total Botox sales and if Allergen gets the migraine indication, he believes sales could increase to about $400 million by 2012.
Mark A Bishara, M.D., P.A. Medical Director
This Information is Brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery and Med Spa in Mansfield and Southlake.
Please also visit our Facebook page at Paragon Plastic Surgery and Medspa

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