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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

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

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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

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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.

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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

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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

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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

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Botox from Canada

Botox Patient — Sat, 07 Nov 2009 17:25:00 +0000

Botox from Canada 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.

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.

Botox Patient: Posted from Laser Treatment MD

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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

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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

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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

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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