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The Real Score Between Botox and Doctors

Botox Patient — Tue, 26 Oct 2010 21:49:43 +0000

Ever wondered about the relationship between Botox and doctors? Well, today is the day when you’re wondering ends…

Every patient is aware that Botox treatments are expensive. In fact, we’d wager that this is the first consideration of most of them. But what very few realize is that doctors usually get so little profit from doing Botox. The fact of the matter is that it’s not a big ticket item in cosmetic medicine. Here’s the simple reason why: the drug, by itself, is expensive. Which means that even your trusty clinic bears the brunt of the high price of the drug.

According to this report, a vial of Botox containing 100 units carried a price tag of $525 last year, 2009. That translates to a bottom line cost of $5.25 per unit.

While prices vary per region, clinics typically charge their patients $10 per unit. That’s a little less than twice the cost of the drug itself! Let’s consider this for a moment. The $4.75 you pay on top of the cost of Botox will cover the following expenses: utilities (electricity and water), salary of all of the staff (yes, you pay not only for your Botox injector but also for everybody in the payroll), operating expenses and lease expenses (for the office and equipments), among other things. Of course all these costs are distributed among all the clients and you only shoulder a fraction of the overall expense. But, do you see how far doctors and clinics stretch the little margin they get per treatment?

Here’s an illustration so you may see the situation even better. A regular treatment of the glabellar lines for women require 20 units of Botox so, you will be paying the clinic $200 dollars for the procedure – $105 for the Botox, $95 for all of the other expenses that was already mentioned. Can you imagine what will be left as net profit? Gets you thinking, huh?

You might now be wondering why a lot of physicians are still deciding to add Botox to the services they offer. Here’s the answer to that one: Botox is a great introductory service and since it’s one of the most sought after treatments, it’s a fabulous way to obtain new clients. Making Botox patients happy can lead to a long term relationship that will (hopefully) include some of the ‘big ticket’ procedures. We know it sounds very utilitarian but this is the reality of the business side of things…

Now, let us make it clear that we aren’t divulging this info to disillusion you or to make you cynical. We just want you to see the other side of the coin. Before you think that your doctor is ripping you off with the price of his services, you should consider the things we pointed out above. Keeping these little bits of info in mind may help you understand your Botox provider and get you better treatments.

The Real Score Between Botox and Doctors is a post from: Botox Patient

In Your Botox Doctor’s Shoes

Botox Patient — Tue, 19 Oct 2010 22:50:32 +0000

Hey guys! Have we got a treat for you!

We’re going on a 3-day journey… one, we’re sure, you never thought you needed to take.

By way of introduction, let us share with you the reason why we’re doing this.

While we were doing research for the Botox Guide (which, by the way, we can’t wait to share with you!), we realized how getting into the mind of your physician can help you get safer, cheaper and better Botox treatments. It will help you see things through their eyes and sortof learn to play their game… but you create your own rules.

If you want to discover how they learn to inject Botox, what they actually think of the treatment and how medical malpractice figures into the equation, then you better bookmark our site now. We’ll be dishing out insider information you won’t get anywhere else!

So, without further ado, here is where your 3 days in the shoes of your Botox provider begins:

Day 1: the crash course that is the Botox Training

Medical practitioners, who seek to add Botox to their respective roster of services, usually start with training. Here’s a sample schedule of one such Botox training course:

8:00am – 12:00nn: Botox Training

Lessons include the following:

history of the drug,
the science behind how the drug works (or what is known as pharmacology)
proper storage, handling and reconstitution,
indications, contraindications and side effects
human facial anatomy and physiology
injection techniques for different treatment areas
pre and post treatment care

12:00nn – 1:00pm: Lunch

1:00pm – 3:30pm: Training on Dermal Fillers

Yes, the other half of the day is devoted to other cosmetic procedures. Botox is usually lumped with dermal fillers because they are both injectables and are, in that sense, similar.

3:30pm onwards: Hands-on Training for Botox and Fillers

This is where the day gets exciting. The physicians attending the seminar get to practice their new-found knowledge on actual people. However, there’s a catch. There’s a limited number of ‘live models’ on whom they can practice. We’re venturing a guess of a maximum of 3-5 people per attendee. While some may think that’s enough, we believe otherwise.

There’s a difference between those who are legally allowed and who are qualified to perform Botox treatments. Anyone with a medical license can inject Botox. But being qualified takes more than just a day’s worth of lectures.

Also, merely reading materials and watching other people perform the treatments do not result in Botox expertise. Experience, specifically performing the procedure on hundreds (even thousands) of patients is still the best way to perfect this skill.

It is through experience that the injector learns about the differences in the facial musculature of every individual, how such differences would affect where the Botox is injected and how much of the drug is used as well as what techniques increase or decrease the risk of side effects. This kind of knowledge cannot be acquired in just a few hours. This is why we can’t stress enough how important it is to check how long your doctor’s been administering Botox and how many patients he’s already treated. Knowing these may help you decide on who you will trust to wield that Botox laden needle.

Note though that the more experienced injectors charge higher than the new ones. Think of it this way: the new Botox doctors charge less because they get to practice on you. You, then, become a prelude to their expertise. We’re not saying that this is wrong. We just wanted to let you know so you can make an informed choice on the matter. At the end of the day, your decision will prevail and we trust that you will weigh the pros and cons carefully.

In Your Botox Doctor’s Shoes is a post from: Botox Patient

Top 5 Botox Treatment FAQs

Botox Patient — Wed, 15 Sep 2010 05:49:54 +0000

Here are 5 of the most frequently asked questions about Botox treatments that we’ve collected from blogs, forums and comments all over the web. These are real concerns that real women have expressed on the topic of Botox treatment.

1. How long will the procedure last?

A Botox treatment lasts an average of 20 minutes.

2. What part of the face does it work best on?

Botox will work best on parts of the face that have dynamic wrinkles. While the topic of dynamic wrinkles is best discussed separately, I will say that they can be found in the following areas of the face: forehead, crow’s feet, between the eyebrows and smile lines.

3. What happens during the procedure?

A Botox treatment begins with the reconstitution of the drug, followed by the treatment proper where the doctor will use a very fine needle to inject the drug into the body of the muscle. Yes, you read right, Botox is injected into the muscle and not the skin.

4. Does is hurt?

Some patients have experienced slight discomfort during injection but they also said that it didn’t last longer than a few seconds. Because there is little to no pain involved, a Botox treatment usually does not require any anesthesia.

5. Can I resume my regular activities after treatment?

Yes, you can go back to your regular activities after treatment. There is no downtime after a procedure but you do have to follow some post treatment measures to prevent side effects from occurring.

-o-

These are just a handful of the important issues that we will be talking about in the Guide. Other topics include how to choose your doctor, questions that you should ask during your consultation and tips on lowering the cost of your Botox treatment.

Leave us a comment below if you have any other concerns that you want us to include. This Guide is for you and is being made with you in mind. We want to address most, if not all, of your concerns so sound off and get your Botox concern heard and answered!

Top 5 Botox Treatment FAQs is a post from: Botox Patient

Common Botox Safety Concerns

Botox Patient — Mon, 06 Sep 2010 13:36:40 +0000

Botox, like every other word, has an etymology that can tell you so much about what the word denotes.

Most people overlook the fact that Botox is the brand name that Allergan gave the drug it manufactures for the treatment of wrinkles. This commercial name is actually a contraction of the words Botulinum Toxin from which the drug is derived.

BOTOX = BOtulinum TOXin

Let us now deal with the 2 main words involved:

Bot·u·li·num* (n): a spore-forming bacterium that secretes Botulinum Toxin. [From the German word "Botulismus"; coined from the Latin term "Botulus" which means sausage. The word 'sausage' is a depiction of the shape of Clostridium Botulinum, the bacteria that produces the toxin]
Tox·in* (n): a poisonous substance… usually very unstable, notably toxic when introduced into the tissues… [From the Latin term “Toxicum” which means poison]

Bacterium. Poison.

The two main words associated with Botox involve things that people usually stay far away from. No wonder most women’s primary concern is the safety of using Botox!

The Insider’s Guide that we are currently creating will include a section that will delve into the safety issues commonly associated with Botox treatments such as:

Is it safe? If so, how?
Important things you need to know to do Botox safely
How things can go wrong in a Botox treatment and how to avoid them
Possible side effects and measures you can take to prevent them from occurring
Botox pitfalls that you should avoid at all costs

We’re hoping that tackling this issue head on will give you the answers to common questions you may have regarding the safety of using Botox. The ultimate goal is to give you eveything you will need to make smart choices every step of the way.

*definition from merriam-webster online

Common Botox Safety Concerns is a post from: Botox Patient

Debunking Botox Myths

Botox Patient — Thu, 02 Sep 2010 19:27:10 +0000

We’ve started writing the Insider’s Guide To Botox and are keeping you in mind the whole time — as much as possible, we’d like to address your Botox concerns from the moment you start deliberating if you’re a good candidate for the procedure until the time you schedule your next treatment.

One of the things that we decided to do is address the myths surrounding Botox and give you the correct information.

We came across several erroneous and misleading articles and commentaries online while conducting our initial research and this propelled our efforts into separating Botox myths from facts. We also took note of common misconceptions and will distinguish which ones are true and which are not.

We figured that if we were to put ourselves in the shoes of someone searching around online for information that will help them decide if they’re going to go through with the procedure, we’d end up having to wrestle with confusing literature especially with topics relating to when you should schedule your next treatment, who are authorized to administer the drug and something as basic as how the drug works.

All this is geared towards creating the ultimate guide for the smart Botox patient.

Here are the general headlines of the Guide:

Botox Basics: Everything you need to know even before your first consult
Botox Treatment: Overcoming Botox Jitters
Botox Aftermath: Making the effects of Botox last

Debunking Botox Myths is a post from: Botox Patient

Botox Without Needles

Botox Patient — Fri, 12 Feb 2010 16:20:30 +0000

New news on Botox without needles or injections.

Botox Without Needles is a post from: Botox Patient

Creating a Better Smile with Botox

Botox Patient — Thu, 17 Dec 2009 16:38:45 +0000

A simple procedure that can give you a brand new smile that is less gummy – without surgery!

A gummy smile is normally corrected through surgical procedures called Gingivectomies and Crown Lengthening. While relatively painless, the surgeries involve a dental laser that removes the excess gum that shows up in gummy smiles. Healing time can take up to several weeks and further restorations may be necessary dependent on the appearance of the newly exposed teeth.

As seen on The Doctors, now a less painful and less expensive option is available for those wanting to change the appearance of their smiles. By injecting Botox into the muscles that elevate the upper lip, the Botox effectively blocks and relaxes those muscles thus hiding more of the gums. There is no downtime and results are seen within 24-36 hours. Botox lasts for three to six months so repeat visits will be necessary.

When seeking a physician regarding Botox treatment for your smile, make sure to ask not only if they’re familiar with Botox injections, but if they’re familiar with Botox for smiles specifically.

Creating a Better Smile with Botox is a post from: Botox Patient

Do it yourself Botox, Restylane, & Juvederm Disasters.

Botox Patient — Fri, 04 Dec 2009 21:46:45 +0000

So while there are still a number of people posting on how much the love Laurie D’Alleva and her videos touting the benefits of do it yourself Botox, there are a growing number of people who still have a non-paralyzed thought or two that are coming forward to talk about the problems you might have pumping fillers into your face. Perhaps the do it yourself Botox crew are also attracted to Trepanation.

Here’s a story from ABC:

Some consumers are ordering prescription-only cosmetic products online and injecting themselves at home. One woman who self-injected her face with filler said it caused bags and lumps under her eyes, and a hard, infected pustule on her cheek.

For millions of Americans, the solution to crow’s feet, thin lips, and frown lines is at the end of a syringe, or in a bottle. A quick trip to a medical spa, dermatologist or plastic surgeon for a Botox injection, lip augmentation or chemical peel offers the promise of a youthful look.

But these cosmetic procedures — and the medical expertise that comes with them — don’t come cheap. For a single treatment of Botox, doctors charge about $380; for lip-plumping injections, over $500; and for a chemical peel, a whopping $700.

These high prices are enough for some consumers to take their business away from medical professionals, and go instead to the Web. They are “doing it themselves,” ordering prescription-only products online, and injecting themselves at home.

Laurie D’Alleva, of Mansfield, Texas, is a big fan of “DIY” beauty injections and treatments. She is the face of a DiscountMedSpa.com, a website stocked with what she claims are pharmaceutical-grade cosmetics, similar to Botox, Restylane, and Retin-A.

Self-injecting botulinum toxin might sound dangerous, but D’Alleva, 39, tries to put her customers at ease with informational videos, complete with tips and pointers on how, and where, to inject. “It doesn’t hurt… It’s easy,” D’Alleva claims in one video, as she stands in front of a mirror and injects her face repeatedly.

Watch the investigation on “20/20″ TONIGHT at 10 p.m. ET

Disaster isn’t what “Alex,” a paramedic, had in mind when she visited DiscountMedSpa.com a few months ago. In her 40s and dating, she just wanted to improve her look, and save some money. She asked ABC News not to disclose her identity.

After viewing “every one” of the instructional self-injection videos on D’Alleva’s site, Alex was convinced she could do it herself, since using needles was part of her job.

“Why should I pay somebody else that got a few hours of training to do something I think I can do pretty easily?” she said she thought at the time.

Alex paid $450 for a DiscountMedSpa.com products including an injectable facial filler. She says she injected the products under her eyes and alongside her mouth.

But “the next morning, I woke up horrified by what I saw,” she said. “Literally, my heart started pounding, and I thought, ‘What have I done, what am I going to do?’”

DiscountMedSpa.com isn’t the only website selling treatments normally reserved for a doctor’s office. Chemical peels are readily obtainable from dozens of Web sites, and like Alex, the people who buy them don’t always know what they are getting.

Alex said the injections caused bags and lumps under her eyes, and a hard, infected pustule on her cheek. Desperate, she turned to Dr. Jerome Potozkin for help.

“I had an ‘Oh-my-God’ moment,” Potozkin said, “when I looked at her and I saw this huge abscess on her cheek. Then she told me it was from a filler that she ordered from an Internet Web site and injected into herself.”

Although Alex’s condition was serious, it could have been worse. Potozkin told “20/20” that if she had gone just a few millimeters in the wrong direction, she could have “literally punctured an eyeball,” or hit a blood vessel — potentially causing blindness.

The product Alex ordered from DiscountMedSpa.com was labeled “Vitalift,” but there is no such product on the list of FDA-approved pharmaceuticals.

Other products for sale included injectables “Restylin” and “Artefil,” and a “chemical peel” whose description included a “mystery” ingredient.

Do it yourself Botox, Restylane, & Juvederm Disasters. is a post from: Botox Patient

Cosmetic Surgeons enlist patients to fight Botox Botax.

Botox Patient — Fri, 04 Dec 2009 00:32:23 +0000

Your plastic surgeon of dermatologist may be asking for your help to fight the Botox Botax shortly. Here’s what the ASDS (American Society for Dermatologic Surgery) is giving it’s members to solicit the support of Botox consumers:

The U.S. Senate health care reform bill (Patient Protection and Affordable Care Act) contains a proposed 5 percent tax on “elective cosmetic medical procedures.” While this may look like an attractive option to Senators looking for ways to pay for health care reform, we know that:

Cosmetic medical procedures taxes are an unreliable and risky revenue source, which has proved to be a failure at the state level;

A tax on cosmetic surgery discriminates against working women;

The definition of cosmetic procedures is arbitrary and almost impossible to administer; and

enforcement would necessitate review of patient medical records by tax collectors, a clear invasion of privacy.

Please enter your zip code below to be connected to an automatic email system which allows you to send a quick message to your Senator asking him/her to vote against this tax.

Cosmetic Surgeons enlist patients to fight Botox Botax. is a post from: Botox Patient

Blue Collar Botox

Botox Patient — Thu, 03 Dec 2009 17:12:26 +0000

Via Tyler Cowen, it turns out that the proposed tax on cosmetic surgeries (like Botox) might be highly regressive:

… look around. See that cosmetic surgeon down the street? The walk-in Botox clinic next door? That’s because cosmetic surgery spread from the rich and famous to the rest of us because of increasing access to credit. That’s right- the deregulation of banking that happened in the 1980s meant more and more Americans were taking out credit- either on credit cards or with medical credit companies like GE’s “CareCredit.”

What this means is that cosmetic surgery is now primarily consumed not by the rich, but by the working and lower-middle classes, sometimes even by the poor. According to the American Society for Aesthetic Plastic Surgery (ASAPS), about 1/3 of cosmetic surgery is consumed by people who make less than $30,000 a year. About 70% of it is consumed by people who make less than $60,000 a year. It is mostly women (90%) and mostly white, middle-aged women (80% and between 35-55 years old).

It would be interesting to know if these trends vary depending on the procedure. I would suspect, for instance, that nose jobs and facelifts are common among the affluent and highly-educated, whereas breast implants, which still carry something of a class-based stigma, are a more heavily downscale phenomenon. And I would imagine there are interesting regional variations as well. (Perhaps some of these questions are addressed in the forthcoming book from the author of the post quoted above.)

Riffing on the data, Tyler writes that “cosmetic surgery is not just a zero-sum game but rather it leads to better matches, more matches, and more people who are happy with their looks or with the looks of their partner(s).” I would go halfway with him, and say that it’s certainly a rational response to a culture where airbrushed images of perfect beauty flood the airwaves and supermarket aisles, where male instincts about sex are increasingly influenced by the siliconed imagery of hard-core pornography, and where high divorce rates (which are especially high among the working class) ensure that large numbers of women find themselves re-entering the dating pool in middle age. Whether it’s something to be welcomed, though, is another question entirely.

Question: Should Botox, Restylane, Juvederm, liposuction and cosmetic surgery be taxed like you luxury car?

Blue Collar Botox is a post from: Botox Patient

Botox Patient: A boob job for Tiger’s mistress?

Botox Patient — Wed, 02 Dec 2009 20:39:41 +0000

Photos: Above, recent online photos of Rachel Uchitel. (Photos courtesy of Gala.de and TheImproper.com) Below, Rachel Uchitel yesterday in Los Angeles. (AP photo)

Plastic surgeons and celebrity watchers gave party hostess Rachel Uchitel a once-over as soon as the tabloids thrust her into the spotlight last week as the alleged mistress of golfing great Tiger Woods.

She flatly denies the allegation, but Uchitel’s photos on the Web have provided evidence for cosmetic doctors to analyze. For example, plastic surgeon and blogger Dr. John Di Saia of San Clemente and Huntington Beach wrote:

[Her photos] show her to be an attractive woman who has probably seen the inside of a plastic surgeon’s office before. She seems to have had breast implants at the least from the images we have seen.

The online Plastic Surgery Channel commented on the uncertainties surrounding Uchitel:

Her lips do suggest lip injections, (perhaps Botox) and her chest suggests breast augmentation. Uchitel would likely deny rumors of plastic surgery, just as she has denied other rumors. But, in all cases, she may be telling the truth.

skin clinic, plastic surgery, Botox

Botox Patient: A boob job for Tiger’s mistress? is a post from: Botox Patient

Resylane + Juvederm + Filler Injection Tips for Medical Spa Physicians.

Botox Patient — Fri, 27 Nov 2009 18:50:03 +0000

Restylane, Juverderm and filler injections tips for physicians running medical spas and laser clinics.

The following is from a string of emails that were circulating among some of Medical Spa MDs Members. I’ve edited this somewhat to make it readable and get rid of all the extraneous copies. I’m also not displaying the identity or email addresses of the physicians in this thread.

Note: Some of the comments below might be out of order from the original thread. Emails’ somewhat difficult to follow as a thread but you’ll get the gist.

Filler Injection Discussion & Tips: Restylane | Juevederm | Evolence

1. When I use the “push ahead” technique, I feel that I get better “plumping” per cc of filler. I learned this from Kevin (thanks Kevin).

2. When I use the “push ahead” technique, the filler fills a few millimeters in front of the needle tip. You need to realize this to be able to put the material exactly where you want it. Sometimes you have to “feel” the injection because you can’t “see” the plumping.

3. I mix 0.1 cc of lidocaine with epinephrine with my Juvederm. This helps with bruising (epinephrine) and when the lidocaine goes away and the Juvederm attracts water, the two effects cancel each other and there is not as much enhancement after the injection due to the hydrophilic nature of the Juvederm.

4. I use Juvederm Ultra under the eye and above the lip. I use Juvederm UltraPlus everywhere else.

5. I constantly complain to my Juvederm Rep about the 0.8 cc syringes. I use lots of Radiesse because you get almost twice as much material for the same price. Volume, volume, volume. Please complain to your rep, maybe we can get them to change.

6. I hear the Evolence is very good. We will be getting trained and start using it next month.

Thanks for the filler tips.Can you explain how you get the Lido with epi mixed into the Juvederm syringe? –PD

Fluid Dispensing Connector from Braun Medical Inc (you can get from PSS)

BD 1 ml Luer-Lok Syringe

This syringe allows you to get very precise amount of lidocaine (swish back and forth 20 times).

I use this syringe to put exaclty 1 cc of saline in my Botox Bottle. When I reconstitute the Botox (this gives it full strength per unit). The chances of intravascular injection might be lower with push ahead because the material will push the vessels out of the way as you advance – Jeff

Hi Jeff,–I agree w/ #6. I seem to get good augmentation, less redness, swelling and bruising with Evolence. I use it for deeper fills in cheeks, NLF, etc. Don’t use it for lips or under eyes. I do same with Lido w/ epi. I tend to use Juvederm in lips. Perlane / Restylane for other areas. I agree w/ why Allergan uses 0.8 cc syringes. I’ve moved away from Radiesse. I feel that the duration is not that much longer than a good correction with the HA’s. Besides, I believe a fair amount of the volume of Radiesse is a gel carrier, thus needing touch-ups at 2-3 months. Perhaps that’s why the went to the larger syringes? — Don

The push ahead technique also moves small blood vessels out of the way, so you may notice less ecchymosis is overall pts. — Greg

Jeff: –”Push ahead” has a higher risk of vessel cannulation & potential for vascular effects – skin necrosis in glabella, even potential for retro-grade flow to eye (causing visual loss). I wouldn’t recommend that technique for the periorbital area.

Restylane is recommended for the tear troughs; it’s less hydrophilic than juvederm – which means less post-treatment swelling.–Tom – [note from Jeff: Tom is a plastic surgeon]

I would not use push ahead around the eye, I agree with Tom’s comments. It works great for NLF. I was actually taught this by a PS — Greg

Thanks Jeff for your kind comments. However I must make a few points in regards to fillers:

1) There are some areas that one has to still do the retrograde injection either b/c the purpose was to make a straight line (eyebrow lift and vermillion border and the bow-tie (the vertical lines connecting the base of nose and the upper lip border) AND when injecting the most inner 1/3 of the tear-trough to avoid risk of filler getting into the orbital space due to its close proximity to the orbital rim.

2) On the glabellar injection, it is best to first push and pull the needle thru the space underneath to break up the tissue before actually injecting the filler both in an anterograde and retrograde pattern

3) I ONLY use the 1/2 inch needles in all my injections

4) One can inject even Radiesse and/or Perlane via an 1/2 inch 30 gage needle. Why is this noteworthy to mention?? When I work on the lips and Marrionette’s lines, I ususally first build the Vermillion border with Radiesse or Perlane (I get the best “lifting outcome” with heavier filler). I push the 1/2inch needle all the way forward then slowly and steadily inject while withdrawing (retrograde method). Then I re-evaluate how much of a correction I already get of the Marrionette’ line and lifting up of the lip body. My next step is to inject into the most lateral lip section (about 1 cm distance) starting at the corner (using Perlane or Restylane or Juverderm). This time I inject slowly as I push forward (anterograde). Often I ended up correcting about 50% of the marrionette’s line by going after the lip’s border and most lateral body. Besides, the patient loveto see that they now could see their lip body all the way to the corner and more “smiley shape”. The last step is the trickiest one, I use either Radiesse or Perlane on an 1/2 inch 27 gage needle. First placing my left thumb at the patient’s lower half NLF’s I retract the skin upward (about 2-3cm upward) then I approach my needle in an upward (vertical) position at about one centimeter lateral and one cm below the mouth corner of that same side. Then I aim diagonally toward the corner and start injecting anterograde just 1-2 mm below the imaginary horizontal line of the mouth corner (about 0.2 cc), then I withdraw the needle and reaim straight up and inject just below the horizonal line (0.2cc) then I do it one more time aiming diagonally outward (0.2cc). What was I attempting to do?? I was laying down a new flooring along the imaginary horizontal line. After the injection, release the left thumb. You will be surprised to see the retracted portion just rest right along this new floor, thus the Marrionette’line has been corrected. This is different from the common fanning technique of using the filler to “blow up” around the Marrionette’s line. If you look carefully at those company’s issued photos, the area around the Marrionette’s line now appeared very swollen and puffed up. It is aesthetically unpleasant. It looked like the patient was beat up below the mouth. It reduced the profile of the chin.

5) For those of you that use fillers on the highly vascularized and shallow areas such as the temporal, crow’s feet, undereye area lateral to the submalar area and along the lateral border of the cheek prominence (especially in those older skinny Caucasian ladies with much excessive very thin skin) I now emulate the same technique used in the hand. I would pinch to levitate the skin itself above the bony structure, then I bolus Restylane into the empty space. Then I massage it down. This elimates the risks of injecting into the vessels and nodules.

Interesting discussion. So Kevin, how do you account for the difference in that anterograde injection you need less filler than in retrograde injections, assuming all else being equal?

Second, I am understanding one group claims anterograde injection carries a higher risk of vessel cannulation and possible intravascular injection, while another group claims that anterograde injection “pushes away” blood vessels, thus decreasing the risk. Not sure how anterograde increases risk of intravascular injection any more than retrograde. If you push the needle ahead, transfixing a vessel, then begin injection, you can still conceivably deposit some material intravascularly, can you not? Am I missing something here?

I also found an interesting idea of sub q bolus technique in areas of thin skin, ie crowsfeet, etc. Anyone else try this method? ~ Don

Tom:

I do agree with you about those risks with anterograde injection. The key is always the skills in doing it, be it retrograde or anterograde. One always has to be very carefully doing anything around the eyes. However, the anterograde techinique has been advocated some of the best known experts such as Arnold Klein, MD and Kent Remington, MD. I also believed that the filler amount used was critical. It takes much more amount to get the same result with the often taught retrograde technique compared with the anterograde one. For example, I almost never required more than one full syringe in correcting bilateral NLF’s vs what was typically used ( 2 syringes) by most others. I attached the before and after of a case wherein I used Readiesse to correct her NLF’s and Marrionette’s lines with anterograde technique. The after photo was taken right after. You can still see some of needle marks. I used one full 1.3 cc syringe, 1/2inch 30g for the Vermillion border and 1/2inch for NLF’s and Marrionette’s line. Notice also there was no “puffy/swollen look” medial to the Marrionette’s line often seen with retrograde and fanning technique used by most others. ~ Kevin

All interesting comments. The only place, I use “push ahead” is in the cheeks when doing them via the intra-oral route. (Apparently Radiesse is no longer teaching this method because may practitioners couldn’t get the hang of it but it works for me.) I might try it in the “safe” areas such as NL folds. We use only Radiesse and Juvederm and I find that neither filler lasts as long as advertised in “first-timers”. I’ve also had disappointing longevity in my older patients (>65) with both types fillers despite using numerous syringes. I’m sure this has to do with their inability to generate collagen around the filler once the carrier gel is gone. Does anyone know the age range of patients done in the filler studies? ~ SD

I came across this old thread way down in my inbox and read it again. I’m not sure who wrote #4 below. It sounds interesting but I’m having a hard time visualizing it. Do you steadily move the needle forward toward the lip edge as you are injecting or do you hold it in place while the area fills? I’d love to see a drawing on where you start. ~ SD

SD: I wrote those threads. The techniques that I described were similar to what you could see watching the video instruction on www.thederm.org by Kent Remington and his colleagues (lower face injection portion) THe only thing new from my thread was when fixing the Marrionette’s line, his doctor (Nowell Solish) injection upward and anterograde from the lower part toward the lip corner only one time vs what I now do is I do the same thing but with a fanning pattern where (with the skin lifted about 1-2cm upward with the other thumb) I laid down “three such “anchoring points” along an imaginary horizontal floor starting from the lip corner going laterally for about 3-5cm long. Here I used something firmer such as Radiesse or Perlane. Having done this, you would release the thumb letting the skin go back down. Often you will see the Marrionetter’s line is much improved because “part of that Marrionette’s line” now is positioned along the horizontal flooring that you just created. ~ Kevin

PS: It is hard for me to send over some graphic illustration but I will attempt to do this in the future

via Medical Spa MD: Juvederma, Restylane, & Filler Injection Tips for Physicians.

Something worth knowing. How is your plastic surgeon or dermatologist communicating with other physicians to keep abreast of the latest information about treatments?

Botox Patient: Posted from Medical Spa RX: Wholesale Botox

Resylane + Juvederm + Filler Injection Tips for Medical Spa Physicians. is a post from: Botox Patient

Radiesse Filler Injections Tips

Botox Patient — Fri, 13 Nov 2009 19:15:11 +0000

Radiesse & Your Local Laser Clinic or Med Spa

Radiesse is a filler injection composed of very small and smooth calcium hydroxylapitite microspheres which are suspended in a water-based gel carrier. Calcium Hydroxylapitite is a biocompatible, biodegradable material identical in composition to the mineral portion of teeth and bone. Radiesse is used to fill moderate to severe facial wrinkles and folds such as nasolabial folds. Radiesse is generally not used to enhance the lips or lip line.

The Radiesse gel and microspheres form a “scaffold” that stimulates natural collagen production and encourages tissue growth in and around the injection area. The body absorbs the gel carrier as collagen has begun to infiltrate the area thus replacing the gel with natural tissue. The microspheres continue to provide support while the body completes this process. Eventually, the microspheres are safely absorbed by the body. This entire reconstruction process can take anywhere up to 3 years providing additional injections are administered to maintain even results.

Radiesse injections are very similar other Hyaluronic Acid fillers.

After the injection the medical provider should provide the patient with specific post-care instructions which may include:

Avoiding rubbing, movement or massaging of the area that could cause the Radiesse to migrate.

Don’t apply makeup for the next 24 hours.

No sun and heat exposure.

Injections for Radiesse can typically last from 6 to 18 months with an average of 11 months for nasolabial folds.

Pain? Physicians use a variety of pain management techniques during treatment to ensure patient comfort. Ask your physician about which techniques are right for you.

Are there any side effects? There have been very few side effects reported in clinical trials and actual usage. However, you may experience some common injection-related reactions, such as mild irritation, edema, swelling, itching, discoloration, or tenderness at the injection site. These conditions typically resolve themselves within one to two days.

Botox, Restylane, Juvederm and other filler injections with less pain.

Botox Patient — Fri, 13 Nov 2009 19:05:27 +0000

Botox, Restylane and Juvederm filler injections with far less pain.

A team at UT Southwestern has been combining 2% lidocaine with Radiesse, Restylane and other hyaluronic acid fillers. Tissue is immediately numbed and immediately treated—simultaneously—giving the patient a faster and more comfortable wrinkle-filling experience.

“There is significant time savings in not having to wait for traditional dental block anesthesia to take hold,” explains UT Southwestern plastic surgery chairman Dr. Rod Rohrich, “and the procedure is more pain-free with shorter recovery time.” His team’s findings appear in the journal Plastic and Reconstructive Surgery.

Although the aforementioned formulas require manual mixing, manufacturers have begun offering fillers with lidocaine already built in, like Hydrelle and Prevelle.

This couldn’t come soon enough for most of the medical spas and plastic surgery offices I know. And if you’ve ever had Botox or Restylane injections you know what I mean.

Botox Patient: Posted from Medical Spa RX: Wholesale Botox

Botox, Restylane, Juvederm and other filler injections with less pain. is a post from: Botox Patient

How much does Botox cost your local doctor?

Botox Patient — Tue, 10 Nov 2009 20:55:20 +0000

What do doctors pay for Botox? Botox pricing

Prior to the slowing economy and rise of new competition (i.e. Dysport, Allergan has exercised incredible pricing power with Botox.

Based on data furnished to RealSelf, from 1998 to 2008 Allergan price increases for Botox exceeded the rate of inflation 9 out of 11 years.

Since 1997, the cost of Botox moved up $190 to $525 per vial, or 57%. If Botox prices were only adjusted with inflation, the same vial would price out at $447. The price per unit (paid by the doctor) has climbed from $3.35 to $5.25. Botox vials hold 100 units.

Here’s a table showing the historical cost of Botox to doctors (most doctors markup about 2X):

	vial cost	unit cost	% change	Inflation
1997	$335	$3.35	-	2.34%
1998	$352	$3.52	5.1%	1.55%
1999	$369	$3.69	4.8%	2.19%
2000	$370	$3.70	0.3%	3.38%
2001	$392	$3.92	5.9%	2.83%
2002	$392	$3.92	0%	1.59%
2003	$417	$4.17	6.4%	2.27%
2004	$448	$4.48	7.4%	2.68%
2005	$466	$4.66	4.0%	3.39%
2006	$485	$4.85	4.1%	3.24%
2007	$505	$5.05	4.1%	2.85%
2008	$525	$5.25	4.0%	3.85%
2009	$525	$5.25	0%

Botox Patient: Posted from Medical Spa RX: Wholesale Botox

How much does Botox cost your local doctor? is a post from: Botox Patient

Do it yourself home Botox injections? ABC News want’s to talk.

Botox Patient — Tue, 10 Nov 2009 19:22:19 +0000

Have you tried do-it yourself plastic surgery? In tough economic times, many try to cut costs, including in their beauty regimen. Despite the risks, some people have decided to skip the doctor — and obtain and self-administer cosmetic treatments.

If you have self-injected products like Botox, Restylane, Juvederm, silicone, and other substances, 20/20 would like to hear your story.

Please fill out the form below, including information about your experience, and a producer may be in contact with you.

You can tell ABC all about it here.

via medicalspamd.com

Amazing that anyone would give themselves Botox or Restylane injections at home.

Botox Patient: Posted from Laser Treatment MD

Do it yourself home Botox injections? ABC News want’s to talk. is a post from: Botox Patient

Wholesale Dysport from Medical Spa RX

Botox Patient — Mon, 09 Nov 2009 01:36:20 +0000

Wholesale Dysport from Canada

Dysport is botulinum toxin type A that is manufactured by Ipsen. In the USA, Dysport has been approved under the trade name Reloxin. Reloxin and Dysport are exactly the same product and manufactured by the same company. We guarantee that all products we supply are 100% genuine and that you will be satisfied with your order.

We source Dysport from Europe where there are government implemented price regulations allowing us to bring you the best possible price for Dysport.

Through the partnership of Medical Spa Rx and Medical Spa Md we now offer you a new purchasing option so you can save even more. By selecting the option Group Buy above, your order will become a part of a group buy with other clients, getting you the absolute lowest price possible.

When you choose the group buy option, you order will not be shipped to you immediately. Instead, your order will only be shipped once there are enough orders collected to meet the minimum amount for the Group Buy. You will receive your order approximately 10 working days after this has been met.

The Group Buy option does take much longer to get your order, but it gives you the ability to make uncomparable savings. So, if you can wait longer, or order ahead of time, the Group Buy option will be perfect for you.

If you need your order urgently and can not wait that long for the Group Buy, we still offer our regular services at the most competitive prices around.

via Wholesale Dysport

The Dysport group buy allows medical spas, laser clinics and plastic surgery clinics to group their buying power and buy Dysport at a discount. it’s a much more efficient way to buy Dysport if you’re a heavy Dysport user.

Botox Patient: Posted from Medical Spa RX: Wholesale Botox

Wholesale Dysport from Medical Spa RX is a post from: Botox Patient

Wholesale Botox

Botox Patient — Mon, 09 Nov 2009 01:21:39 +0000

Wholesale Botox: Botox is botulinum toxin type A that is manufactured by Allergan. The Botox that is supplied on MedicalSpaRx.com is original Botox manufactured by Allergan in Ireland. We guarantee that all Botox that you buy wholesale through is is 100% original and will meet your expectations.

The Botox that is supplied through MedicalSpaRx.com is sourced from European countries that have government implemented price regulations, allowing us to bring you the best possible price.

Through the partnership of MedicalSpaRx.com and MedicalSpaMd.com we now offer you a new purchasing option so you can save even more. By selecting the option Group Buy above, your order will become a part of a group buy with other clients, getting you the absolute lowest price possible.

When you chose the group buy option, you order will not be shipped to you immediately. Instead, your order will only be shipped once there are enough orders collected to meet the minimum amount for the Group Buy. You will receive your order approximately 10 working days after this has been met.

If you need your order urgently and can not wait that long for the Group Buy, we still offer our regular services at the most competitive prices around.

via medicalsparx.com

If you haven’t checked out the ‘Group Botox Buy’ from Medical Spa RX, you’re not doing your medspa or laser clinic any good.

Botox Patient: Posted from Medical Spa RX: Wholesale Botox

Wholesale Botox is a post from: Botox Patient

Dysport + Botox

Botox Patient — Sun, 08 Nov 2009 21:51:13 +0000

Is Dysport the new Botox?

Dysport is often called the “New Botox.” However, Dypsort has actually been available in Europe for therapeutic indications since 1991 and for cosmetic applications since 2001. In April 2009, Dysport (officially known as BoNT-A/D) was approved in the United States for the “temporary improvement in the appearance of moderate to severe glabellar lines.” These are the lines between your eyebrows. However, just like Botox Cosmetic, Dysport can be used “off-lable” for treatment of crow’s feet (squinting lines around your eyes), forehead wrinkles, chemical brow lifts, platysmal bands (neck bands) and sweaty palms and armpits.

The molecule in Dysport is exactly like Botox Cosmetic but is covered by a different coating, which dissociates (dissolves) at a different rate. That is why the onset of action of Dysport is thought to be faster than Botox Cosmetic since the coating comes off faster. In Botox Cosmetic Treatment the usual onset of action is 3 to 7 days where the Dysport onset of action seems to be a few days faster. The dosing is different with Dysport, so there may be some confusion when translating Botox “units” with Dysport “units.” This is why you need to see an injector who has experience specifically in Dysport injections. Also, there is a learning curve with Dysport injections, so you may not initially achieve the same results as you are used to receiving with Botox Cosmetic.

There is also some confusion about the pricing of Dysport with many reports on the Internet and advertising claiming that it is cheaper than Botox Cosmetic. There is a discrepancy in the potency of units. A “unit” of Botox is not equivalent to a “unit” of Dysport, so unit pricing is not comparable. There is a slight savings with Dysport, but it is about 5% – nothing substantial. So, do not expect to go to your plastic surgeon, medical spa, laser center or skin clinic to achieve the same results as Botox Cosmetic for half the price. However, with competition, hopefully prices will come down. Allergan (Botox Cosmetic) is currently offering a $50 mail-in rebate for Botox Cosmetic customers and Medicis Aesthetics (Dysport) is offering a $75 mail-in rebate. With these rebates and introductory pricing, you may be able to get a better deal than your last injection.

In the end, it is great to have another minimally invasive product approved on the market which can give consistent and noticeable results with virtually no downtime and minimal risks.

via Medical Spa RX: Dysport

Botox Patient: Posted from Medical Spa RX: Wholesale Botox

Dysport + Botox is a post from: Botox Patient

Medical Assistant injection Botox.

Botox Patient — Sun, 08 Nov 2009 21:44:30 +0000

I’ve seen and head about medical estheticians, medical assistants and even front desk staff administering Botox injections.

If you’re a plastic surgeon or dermatologist running a skin clinic, laser clinic or medical spa you might want make sure that your medical estheticans and medical assistants are well within the guidelines for their individual scope of practice.

It’s not legal, as this story on the prosicution of a medical assistant clearly shows.

Betty Guerra’s monthslong nightmare is over.

The 45-year-old former medical assistant learned today from her attorney that the 10 felony counts against her on allegations of “unlawful practice of medicine” will be dismissed, she said.

“I always believed things would work out the right way,” she said tearfully. “I cannot be punished for something I didn’t do.”

Guerra’s July arrest sparked controversy over what medical assistants can and cannot do. Specifically, there was confusion over whether they are able to give shots.

Guerra was accused of unlawfully administering cosmetic injections, an act commonly performed by medical assistants throughout Nevada.

The state attorney general’s office did not specifically say charges against Guerra would be dropped but indicated it won’t be pursuing the case.

“The complaint against Betty Guerra submitted to the Attorney General’s Office by the Board of Medical Examiners has been contradicted by the subsequent actions by the Board,” Attorney General Catherine Cortez Masto said in a statement. “Therefore, it is fair for us to conclude that it would be difficult to prosecute this case beyond a reasonable doubt.”

Guerra’s attorney, Jason Weiner, said this evening that the attorney general’s office had sent him a copy of an unfiled motion dismissing the case earlier in the day. He would not be able to provide the Review-Journal with a copy of that motion until Wednesday, he said.

After Guerra’s arrest, physicians became concerned about what duties their medical assistants could perform.

Former medical board director Louis Ling said that upon reading a 30-year-old law, he concluded that the assistants could not give shots. With flu season coming on, he then attempted to draft emergency regulations that would allow them to give flu shots, but not Botox or other cosmetic injections.

However, that effort was shot down when a judge recently ruled that the board, in considering the regulations, had violated the open meeting law.

via medicalspamd.com

The board later reversed its position, determining that state law allows medical assistants to administer everything from flu shots to Botox. Medical assistants could give shots as long as they are under the “direct supervision” of a physician. Most health officials and doctors take that to mean the physician is on premises.

Botox Patient: Posted from Medical Spa RX: Wholesale Botox

Medical Assistant injection Botox. is a post from: Botox Patient

Botox: Single use?

Botox Patient — Sat, 07 Nov 2009 17:24:36 +0000

Is your medical spa using a new vial of Botox for every patient?

If your medical spa is using a new vial of Botox for every patient, yours will be the first medical spa or cosmetic practice of any kind that I've ever know to do so.

Here's a story from the Las Vegas Review Journal that specifically points out Botox as a 'contributor' to an outbreak of hepatitis C. Of course, if you read the story you'll see that some nurses were observerd 'reusing needles' that contaminated vials of Botox. A very different cause indeed from just using the Botox on multiple patients.

And of course, there's the cost, which almost every medical spa mentioned in the story. (You'd have to get all of your Botox from Canada to afford that.)

Single-use Botox vials used on more than one patient.

That practice at the Endoscopy Center of Southern Nevada, public health officials have repeatedly said, contributed to the hepatitis C outbreak in the Las Vegas Valley.

A phone call to inquire about the cost of a Botox party was greeted with this information: "It will be cheaper if all the partiers use the same vial."

One business that seems to be going well in Las Vegas is known for throwing Botox parties. That's an ongoing phenomenon across the country where friends get together and drink champagne while their wrinkles are needled away.

"We just couldn't handle it financially," said one medical assistant who asked to remain anonymous. "We would have gone out of business."

Medical assistants at two different spas said their owners only stopped multipatient use of single-use vials of Botox "until things quieted down" after the hepatitis outbreak was announced.

The Review-Journal had little trouble finding medical providers who said they and their companies knowingly broke state and federal regulations.

"You can't have doctors worrying about breaking the law or guidelines or whatever," Niamtu said.

A new company called Dysport is manufacturing a similar product, and the competition could force Allergan to provide smaller dosage vials to physicians who want them, he said.

Now a federal lawsuit filed in California by Las Vegas physician Ivan Goldsmith argues that sales representatives for Allergan Inc., maker of the popular anti-wrinkle drug Botox, promote multipatient use of its 50-unit or 100-unit single-use vials.

Goldsmith's lawsuit alleges that doctors can only make a profit using Botox if they reuse the single-use vials that the drug comes in.

Botox Patient: Posted from Laser Treatment MD

Botox: Single use? is a post from: Botox Patient

Allergan’s Botox profit.

Botox Patient — Sat, 07 Nov 2009 17:24:26 +0000

Allergan Inc (AGN.N) on Thursday said its quarterly profit rose, as sales of anti-wrinkle drug Botox rebounded from an earlier slump and helped offset lower sales of medical devices.

The company’s third-quarter earnings increased 8 percent to $179 million, or 58 cents per share, compared with $165 million, or 54 cents per share, in the year-earlier period.

Excluding special items, Allergan earned 70 cents per share. Analysts on average expected 69 cents per share, according to Thomson Reuters I/B/E/S.

The company’s shares were up 1.2 percent at $54.20 in early trading on the New York Stock Exchange.

Allergan said global sales rose 4.2 percent to $1.13 billion in the quarter, somewhat higher than analysts’ expectations of $1.08 billion.

Sales of Botox rose about 3 percent to $328 million, following declines in earlier quarters that the company had attributed to waning use of cosmetic procedures during the economic downturn.

For full-year 2009, Allergan forecast earnings of $2.75 to $2.77 per share, excluding special items, compared with Wall Street expectations of $2.75 per share.

The company said it expects full-year sales of $4.35 billion to $4.4 billion, compared with Wall Street forecasts of $4.32 billion. (Reporting by Ransdell Pierson, editing by Dave Zimmerman)

Botox Patient: Posted from Laser Treatment MD

Allergan’s Botox profit. is a post from: Botox Patient

Botox + Dysport

Botox Patient — Sat, 07 Nov 2009 17:24:14 +0000

MedicalSpaRX.com sells Dysport, Ipsen's newest introduction the the cosmetic corrections market in the USA. Dysport is starting to make an impact on doctors choices to treat your wrinkles in 2009 and going forward, with MedicalSpaRX.com offering some of the lowest pricing on a wholesale basis.

(MedicalSpaRX.com is affiliated with Medical Spa MD, the largest community of plastic surgeons, dermatologists, laser clinics, and skin clinics on the web with more than 4,000 physician members world-wide.)

Traditionally the main selling botulinum toxin product for MedicalSpaRX.com has been the ever so popular Botox that is manufactured by multinational Allergan. Until recently Botox has arguably dominated the market for wrinkle corrections performed by a medical professional, as we at MedicalSpaRX.com have noted through our sales.

Of course there has also been the option to buy and use so called "fillers" such as Restylane or Juvederm since the late '90s, all of which MedicalSpaRX.com also supplies at discounted pricing to medical professionals.

Since its approval by the FDA this year, Dysport has slowly gained popularity with sales through MedicalSpaRX.com. Contributing to Dysport taking some of our Botox sales are several advantages in price and effects.

We have noted that Dysport can begin showing effects in the patient within one day of injection, whereas patients that have been treated by Botox have regularly commented saying that effects are usually noticed within a week of treatment, or in some cases within 2 weeks according to some doctors.

There is also a small pricing advantage in Dysport's favor, with pricing being an average of 5-10% cheaper than the same treatment with Botox. Although the price on MedicalSpaRX.com is higher per vial than Botox, the amount of Dysport used per injection differs and the end result is a more cost effective product.

Although gaining popularity we at MedicalSpaRX.com are still seeing strong Botox sales, which tells us that we still have a very loyal following that prefer to use the tried and tested Botox.

We would suggest to medical professionals to at least try out Dysport through MedicalSpaRX.com, who has such great pricing it can't hurt.

About MedicalSpaRX.com

MedicalSpaRX.com is an international wholesaler of pharmaceuticals and medical products to doctors, clinics and other medical organizations at discounted pricing. Amongst the products that are sold by Medica Depot are Botox, Dysport, Restylane and Juvederm.

Botox Patient: Posted from Laser Treatment MD

Botox + Dysport is a post from: Botox Patient

Medical Spa Botox

Botox Patient — Sat, 07 Nov 2009 17:23:45 +0000

From Medical Spa MD: Understanding Botox & Injectables. Injectable products are an important contributing factor to your clinic’s financial success. With new products entering the market like Dysport and Evolence, and other exiting like ArteFill, it is important that your staff be knowledgeable of the products used in injectable procedures.

Although this chapter from the Advanced Medical Aesthetics Training Manual wasn’t actually requested in the training manual I wrote for the academy students, I felt it was extremely important for , especially for medical estheticians, to know the difference amongst the various treatments used to alleviate the appearance of wrinkles and folds, and the difference between dynamic and static lines.

Medical estheticians have the most “face time” with clients, examining it with magnifying lenses, treating it with exfolliants, moisturizers, galvanic current, high frequency, various acids, etc. They understand the realm of fine lines and wrinkles and know what can be alleviated with topical treatments such as facials, peels, microdermabrasion and laser resurfacing, and what cannot.

I cannot tell you how many patients call or come into our office with no knowledge of the difference between paralyzing agents such as Botox and Dysport, and dermal fillers. We take it for granted that we know the difference, but injectable products can be very confusing to the lay person. Because the aesthetician works with the client’s skin, they should be well versed in the differences in the two categories of injectables and the products that lie within. Estheticians become your most powerful education source for your clients which ultimately leads to an upsell for them (with possible commission).

Many people think all fillers products are the same, nor do they care to understand the difference between hyaluronic acid or calcium hydroxylapetite. All they truly care about is “how long will it last” and will the “results look fake”. Only with proper education can the medical esthetician effectively and intelligently discuss the differences in the filler products, educate the patient about the effects and lasting results, and help lead the patient to the right product, or combination of products, for their expected outcome.

This information in this chapter is very important for your front desk/phone people as well!

Botox Patient: Posted from Laser Treatment MD

Medical Spa Botox is a post from: Botox Patient

Medical Spa RX: Botox from Canada

Botox Patient — Sat, 07 Nov 2009 17:23:29 +0000

From Medical Spa MD: Medical Spa RX has had it’s first physician who has reordered Botox 5 times. In fact, there are a number of them. Woot!

Oddly enough, I consider 5 reoders of Botox significantly significanly more impressive than only 4. (I don’t know why. Perhaps because Medical Spa RX has only been offering Botox for the last 4 months so 5 orders would be more than monthly.)

Medical Spa RX has been shipping orders for something on the order of 4 months now so 5 orders is telling me that we’ve got a number of physicians who switched to Medical Spa RX very shortly after we launched it and have been using it exclusively. (My clincs usually orded Botox or Restyland monthly so that’s where my logic lies.)

We’ve been extremely diligent in makeing sure that Medical Spa MD Members are being taken care of by Medical Spa RX and as far as I’m aware we’ve never yet had a single complaint about the service or product.

I should note here that Medical Spa RX and Medical Spa MD are completely different. Medical Spa RX is Select Partner who offers exclusive services to our Members. (Any technology provider or service company who can provide meaningfull value to our Members is welcome to apply.)

For those physician or medical spa Members who have not yet ordered your Botox through Medical Spa RX and are in a position to do so, I’d highly recommend giving them a chance by placing a small test order of whatever you use most, Botox, Restylane, Juvederm of Dysport.

Also, if you haven’t heard about the group buy option, there’s nothing like it to harness buying power.

Botox Patient: Posted from Laser Treatment MD

Medical Spa RX: Botox from Canada is a post from: Botox Patient

Botox & Nose Jobs becoming more popular in India

Botox Patient — Sat, 07 Nov 2009 17:22:58 +0000

Botox becomming more popular in India?

A pointed nose and taut skin seem to have emerged as the two most important assets for Indians going by the number of people opting for rhinoplasty or “nose jobs” and botox injections in the country.
Though there are no official records of plastic surgeries in India, a study of hospital records show that cosmetic procedures like rhinoplasty and liposuction have seen an increase of 150 per cent in the last five years.
Other popular surgical procedures include abdominoplasty and male breast reduction.
Among the non-surgical procedures, some of the widely practised procedures include Botox injection, microdermabrasion (a non-invasive procedure that uses a spray of micro crystals to remove the outermost layer of dry, dead skin cells and reveal younger, healthier-looking skin), collagen injection, laser hair removal and chemical peel.

via ptinews.com

Vanity is constant as the norther star… So is Botox. Just the kind of thing you can get at any laser clinic or skin clinic.

Botox Patient: Posted from Laser Treatment MD

Botox & Nose Jobs becoming more popular in India is a post from: Botox Patient

Bootox? Botox & Restylane injections for women’s high heels.

Botox Patient — Sat, 07 Nov 2009 17:22:46 +0000

I came across this article from Australia on Botox and Restylane being injected in womens feet.

IT'S the subject of whispered conversations over cocktails deep within Flemington's Birdcage. The secret weapon a flock of fashionistas rely upon to teeter upon 10cm stilettos all day long at the races.

Botox and filler injections for the feet are the latest crazes in cosmetic surgery to make their way to Flemington – and the solution, according those with cash to splash, to the old racing conundrum of how to wear those towering pumps and not end up carrying them home after the final race has been run.

For about $1500, some doctors, such as Bondi-based cosmetic surgeon Michael Zacharia, will inject hyaluronic acid (Restylane) into the balls of the feet.

The fluid, commonly injected into joints to treat osteoarthritis, numbs the parts of the foot that become strained by wearing sky-high heels.

And judging by the height of the footwear that was racing out the door of Melbourne boutique Miss Louise yesterday, 10cm heels will indeed be spotted around the Birdcage today.

Dr Zacharia, who has been doing the procedure for just over a year, said the foot filling provided "internal padding for the feel at that point of pressure underneath the balls of the feet. Instead of using those silicon pads inside your shoes, this is an internal way of doing it."

The procedure, however, is a lot more expensive than purchasing a pair of silicon inner-soles. At $750 per foot, the fillers will last for about six months.

Dr Zacharia said three or four people this week had told him they wanted the foot fillers for the Spring Racing Carnival, but he warned those considering the treatment that the sensation immediately following the injections could be uncomfortable.

"I've been told that for about 10 minutes afterwards it feels like you are walking with marbles in your feet, or it's like there is something in your shoe," he said.

The other procedure women are turning to is "bootox" – having Botox injected into the balls, arches and soles of the feet to paralyse the sweat glands, which Dr Zacharia said would also set you back about $1500.

Australasian College of Podiatric Surgeons president Mark Gilheany said while women might think the procedures were magic solutions to stiletto-fatigue, foot fillers could be masking symptoms of more serious problems.

He warned that for people experiencing a significant amount of pain standing in heels it could be a sign of partially dislocated bones or torn ligaments.

"If you require something of that (surgical) nature then you could have an underlying problem," he said.

"It's not something that is routinely done and I haven't seen any clinical trials to say whether the injection of a biological cushion into the foot is effective.

"If there was anything that really worked I'm sure I would know about it. It seems like a waste of time when you can stick a cushion in your shoes and take some paracetamol."

Botox Patient: Posted from Laser Treatment MD

Bootox? Botox & Restylane injections for women’s high heels. is a post from: Botox Patient

Bad Botox

Botox Patient — Sat, 07 Nov 2009 17:22:35 +0000

Federal officials in Washington State indicted three beauty salon proprietors this week for administering phony Botox and for trying to bribe an officer to overlook an unauthorized laser device.

In the first instance, Xin “Faith” He of Natural Beauty in Bellvue, WA told clients she was injecting Botox and the hyaluronic acid dermal filler Restylane when in fact she was injecting counterfeit substances. Her actions led to at least two reported negative reactions since 2004 that required a dermatologist’s or plastic surgeon’s care. One victim (pictured above), who wished to remain anonymous, remarked, “My face looked like Frankenstein’s.”

In the second case, the two owners of Crystal Nails in Burien are charged with offering an official an $800 bribe to overlook a dangerous and unapproved radiation-emitting laser treatment they had imported.

Of course, neither of these Botox injectors were running a real medical spa, skin clinic or laser treatment center. They were just injecting Botox on their own.

Botox Patient: Posted from Laser Treatment MD

Bad Botox is a post from: Botox Patient

Botox around the world

Botox Patient — Sat, 07 Nov 2009 17:16:41 +0000

There's a lot of Botox used around the world from sweating to headaches to wrinkles.

Here's a graphic from a Botox story on CNN.

In the hunt to discover the next blockbuster medical use for Botox, doctors have injected it experimentally into muscles and glands all over the body, making it medicine’s answer to duct tape. According to recent medical journals, physicians have used it to treat chewing problems, swallowing problems, pelvic muscle spasms, drooling, hair loss, anal fissures and pain from missing limbs.

“We see it as a molecule that keeps on giving. As we understand it more, it gives us new ideas of how to use it,” says Dr. Mitchell F. Brin, a neurologist who is the chief scientific officer for Botox at Allergan, the drug’s maker.

No other therapeutic agent “has so many demonstrated uses,” he says.

But some health advocates worry that doctors are widely adopting novel uses for Botox before federal guidance and rigorous clinical studies have established safe and effective dosages for the new treatments.

“It’s trial and error with a nerve poison,” says Dr. Sidney M. Wolfe, the director of the health research group at Public Citizen, a consumer advocacy group. Last year, the group petitioned the Food and Drug Administration to require a warning label for injectable toxins.

Botox Patient: Posted from Laser Treatment MD

Botox around the world is a post from: Botox Patient

Botox Patient: Fake Botox or not, Discount Medspa is going to jail!

Botox Patient — Sat, 07 Nov 2009 17:15:25 +0000

Via an almost unbeliveable story on Wired: Fake Botox or not, Discount Medspa is going to jail!

A website that sells a prescription drug similar to Botox without requiring a prescription claims it has more than 2,000 customers. Some have learned how to inject the botulism-derived drug into their own faces from YouTube videos produced for the site.

Discountmedspa sells a variety of other DIY cosmetic treatments, including prescription Renova, and lip-filling gels. The botulinum toxin-derivative for sale on the site is Dysport, produced by the pharmaceutical company Ipsen and is a competitor of Allergan’s Botox. The site simply calls it “the Freeze.”

A Grand Prairie, Texas, woman, Laurie D’Alleva, who appears to be the site’s proprietor, performs treatments on herself in self-made videos posted to the site’s YouTube channel. In one video, D’Alleva pulls out a vial of what is presumably Dysport and a syringe filled with saline.

“It’s important to remember that you are mixing the potency of the botox,” she says, mixing the contents of the vial with the saline solution. She then injects her forehead and the areas around her eyes.

Ipsen received FDA clearance to sell Dysport in the United States a few months ago, but it’s a prescription medication. It’s the first direct competitor for the branded Botox, which is the most popular cosmetic treatment in America. Doctors did more than 2.4 million Botox procedures in 2008, according to the American Society for Aesthetic Plastic Surgery. In recent years, the vast amounts of money spent on the treatment have attracted scams and knockoffs, which the FDA has had to crack down on. In May, the FDA also ruled the drug needed a tougher “black-box” warning label to reflect an increased understanding of the small, but real risks of the treatment.

In the U.S., it is illegal for anyone but a doctor or nurse practitioner to prescribe drugs to patients and only pharmacists can dispense drugs to people. Yet drug sellers on the internet routinely flout the FDA’s regulations. A review published last month in the Annals of Family Medicine found more than 130 websites offering antibiotics without a prescription. The National Association of Boards of Pharmacy tracks thousands of sites that don’t meet its standards for brick-and-mortar shops. LegitScript, a private firm that works with the NABP, has database of 47,633 internet pharmacies; 46,570 of them aren’t up to snuff.

These sites are brazenly circumventing regulations that protect consumers from bad or fake drugs and ensure that the chemicals are used correctly. The laws were designed precisely to prevent Americans with little to no medical training from doing things like buying a form of toxin, mixing it with saline and injecting it into their faces. Yet, precisely that appears to be possible with the help of discountmedspa.com.

Video: The original YouTube video was pulled by DiscountMedSpa on Wednesday, October 28. Wired.com had saved the source and has embedded that video in the story.

In a blog post response to a customer’s skeptical query, Laurie provided the following explanation for the legality of her site and the provenance of her products.

I know there is much information out on the net about fillers and Botox ‘knock-offs’. This is not what I am selling! The products I have are from a company names Ipsen… I have a connection that allows me to get products that are not usually available in the states because I purchase other products in their line. Now the trick is I have to market it and label it under my own brand, to keep them and myself from getting into any legal trouble. It does take a leap of faith, but I assure you I have over 2000 customers now who love the products and are saving literally hundreds of thousands of dollars between us!

“I watched a Doctor on YouTube.com do this to a patient and he warned people not to inject below the eyes however I had to put a smile on my face too,” Lesley commented on a blog post. “The trick to this is to hold a pencil just at the corner of one side of your mouth and inject two units of Freeze at the very bottom of your chin. This will cause your [sic] very end of your mouth to turn up. Then do the other side the same way. If you don’t get it even you may have a crooked smile so be very careful that the injection is placed in exactly the same place as the other side.”

Her recommendation for another user is to “watch YouTube.com and you will learn a lot of some of the Doctors [sic] secrets to recreating your face the way you want to look.”

Other women describe mishaps with over-injecting the drug.

“My Dr. would never inject the crows feet. I did and got GREAT results!” wrote a commenter named Pat. “Unfortunately, I can’t read those little hash marks on the syringe too well and over injected above the brow on one side. A week later I’m now sporting a half closed and swollen eye, and look ready for Halloween!”

the Texas Department of State Health Services released the following statement, but would not comment further.

“The Texas Department of State Health Services is aware of discountmedspa.com through a complaint we received. That complaint status remains open and under review,” the agency wrote.

The complaint was made under the Texas Food, Drug and Cosmetic Act, which regulates the sale of prescription drugs like Dysport in the state.

“Botox is a prescription drug that must be dispensed or sold by a licensee pharmacy and only with a prescription from a licensed practitioner. Any over-the-counter sale of Botox is illegal,” the agency affirmed.

Unbelieveable that people could be so dumb as to inject themselves with Botox… or anything else for that matter. Discount Medspa’s owner is definately headed for the slammer.

Side Note: Medical Spa MDs partner site, Medical Spa RX, is a licensed and regulated phamacy that sells wholesale Botox and other fillers exclusively to licensed medical professionals only.

via medicalspamd.com

This was first posted on Medical Spa MD.com. It’s truly amazing what people will do. Injecting yourself in a mirror with Botox has got to be a precursor for the Darwin Awards.

Botox Patient: Posted from Laser Treatment MD

Botox Patient: Fake Botox or not, Discount Medspa is going to jail! is a post from: Botox Patient

Do it yourself Botox: People are injecting themselves with fake Botox.

Botox Patient — Sat, 07 Nov 2009 17:15:12 +0000

People are risking death or serious injury by using an illegal Botox equivalent without prescription, a CBD cosmetic doctor warns.

Dr Mario Soteriou, of Cosmetic Image Clinics, said self-administering the goods obtained at a new US-based online store was equivalent to playing “Russian roulette”.

He said neither the Botox equivalent nor the dermal filler sold on the website was approved by the Australian Therapeutic Goods Administration, which also decrees the products must only be administered under medical prescription.

The website also sells needles and an instructional DVD to enable buyers to self-administer the do-it-yourself Botox equivalent, with the promise of wrinkle free skin.

The dermal filler is also being marketed with a DIY guide for plump lips.

Dr Soteriou, who has specialised in cosmetic medicine since 2000, said he was “severely shocked” by the shonky website.

He said injectable treatments such as Botox and dermal filler should only be administered by qualified practitioners.

“The big problem with these drugs is that we don’t know what they are made of and they can’t guarantee you safety or results,” Dr Soteriou said. “Self-administering them is essentially like making a life decision without putting any thought into it.

“I wouldn’t even advocate for doctors and nurses to be injecting themselves.

“You are also risking your own death if you have an adverse or severe allergic reaction to the drugs.”

Dr Soteriou believes the website is a “money grab” and fuels people’s desperate desires for quick-fix anti-ageing products.

“I’ve never heard of these products before and I attend a lot of medical conferences to ensure I’m up-to-date with the latest in facial rejuvenation techniques,” he said.

via Medical Spa MD: Fake Botox or not, Discount Medspa is going to jail!

Botox Patient: Posted from Laser Treatment MD

Do it yourself Botox: People are injecting themselves with fake Botox. is a post from: Botox Patient