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Improving the Effectiveness of Neurotoxins Use for Aesthetic Enhancement

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Austin, TX Cosmetic Dermatologist | Improving Botox® , Dysport, XeominNew opportunities in anti-aging injectable treatments are arising with a number of advanced neurotoxins approved for cosmetic use by the FDA. Skin care experts are now able to achieve subtle effects with these treatments that help a patient appear naturally younger and rejuvenated, rather than present a ‘frozen’ face. According to Seth L. Matarasso, MD, clinical professor of dermatology at the University of California, School of Medicine in San Francisco, with three FDA approved injectable toxins, the opportunities in aesthetic enhancement have multiplied.

For people who wish to achieve a more youthful looking face without surgery, this is the most exciting time. A growing number of patients are seeking new skin care treatments, with inspiration coming from positive testimonials of other patients. A recent survey by the American Society for Dermatologic Surgery showed that dermatologic surgeons performed 1.49 million neuro-modulation procedures in 2012, which is nearly a 25 percent jump over the previous year.

Choosing the Right Treatment Provider

The most popular injectable neurotoxins in use today are Botox® , Dysport, and Xeomin. Leading experts in dermatology say that each of these treatment options can be equally effective. In most cases, it comes down to the personal preference of the patient and the treatment provider. Many patients choose Botox® over other options simply because they have used it in the past, and they are happy to continue with the same treatment.

Experts suggest that the key to successful outcomes with neurotoxins lies with the treatment provider. Amazing results can be achieved with Botox® , Dysport, or Xeomin alike, and things can go wrong either any of them if the provider makes a mistake. Therefore, it is crucial to choose a qualified and experienced skin care expert with a proven track record of success with these injectable treatments.

Expansion of Off-label Treatments

The advantage of opting for an experienced treatment provider or dermatologist is that it may be possible to receive effective treatment even in off-label areas. Skilled providers are able to address the aesthetic concerns of patients with regard to various areas of the face and body with injectable neurotoxins. The versatile usage of these toxins is a game-changer in aesthetic medicine.

Experienced providers are not just confined to treatments to reduce the effect of facial lines and wrinkles. They are able to enhance the overall appearance and shape of the face to minimize the impact of aging. Apart from off-label areas on the face, these toxins are also used for improving the appearance of the neck and chest.

Topical Anti-aging Solutions

While the injectable toxins continue to remain a most widely used non-surgical anti-aging treatment, skin care experts are looking forward to the development of topical anti-aging agents. These topical gels or creams may be used in combination with the injections to achieve more effective outcomes.

Development of Botulinum toxin Type A topical gel and other topical anti-aging agents is currently underway. Another innovative treatment called “cryomodulation” is under development, which will not involve chemicals and yet deliver the same cosmetic results as the injectable neurotoxins.

As minimally invasive procedures such as Botox® and Dysport are becoming more widespread, clinics are popping up everywhere that advertise quick, cheap cosmetic procedures. However, not all medical practices are created equal, and some patients are finding that out the hard way. Some discount clinics are providing turning out low-quality procedures with a focus on maximizing the number of patients they see.

The consequences of these “in-and-out” cosmetic facilities range from a longer healing time to excessive scarring or worse. Patients may find inadequate consultations, with a focus on being “sold” a procedure, and less than ideal procedures for post-treatment recovery issues. Because doctors in such clinics see patients at such a high volume, it’s difficult to discuss pre-existing health problems or make accurate recommendations for post-surgical care.

If you are considering a cosmetic procedure, we recommend that you treat it like any other medical service and do your research. Verify that the clinic and physician you are going to are well-qualified to deliver high quality care. At Zimmet Vein & Dermatology, we are happy to meet with you to discuss concerns, pre- and post-procedure care, and Dr. Zimmet’s experience and background.

Are you interested in softening your wrinkles but can’t stand the thought of needles? Revance Therapeutics is currently developing a topically applied botulinum toxin type A, which may provide a painless alternative to Botox® ® and Dysport®

The new product, if approved by the FDA, works by “pulling” the large neurotoxin molecules through the skin by attracting them to a lysine chain. As the molecules are pulled through, they act the same way Botox® does: by disabling the nerve impulses that cause muscles to contract in a way that creates wrinkles. So far, the gel has been successful in reducing the appearance of crow’s feet in the trial’s subjects.

As always, Dr. Zimmet recommends not using a product until it is approved for use by the FDA. Until the topical gel is authorized, Botox® or Dysport administered through a needle are peer-reviewed and FDA-approved methods of rejuvenating skin.

A new alternative to Botox® and Dysport will be showing up in dermatologists’ offices soon, as the FDA recently approved the use of Xeomin. Xeomin is an injection that, like Botox® , consists of the botulinum toxin. After two separate trials testing the drug or a placebo on over 500 participants, the FDA decided that Xeomin was a safe, effective temporary treatment for forehead wrinkles.

Though Xeomin injections are new to the US, they have been approved and used in several European countries. There are only minor distinctions between the new product and Botox® : for example, Xeomin doesn’t require refrigeration. Also, Xeomin lacks a protein coating that Botox® has. A small number of patients develop antibodies to the protein, so for those individuals, Xeomin will be a more effective treatment.

The effect that Xeomin will have on Botox® and Dysport remains to be seen. Since Botox® is a more trusted name in cosmetic dermatology, Xeomin will have to prove itself as an inexpensive, effective, and long-lasting treatment. To discuss cosmetic dermatology options, contact Dr. Zimmet today.

Botox® has been used off-label to treat several non-cosmetic medical issues, migraines being the most popular. And now, evidence is piling up that it could be used to treat another type of chronic pain: vulvodynia, or sexual pain in women.

Vulvodynia affects about 16 percent of women. It is characterized by chronic pain in the genital region brought on by sex or tampon insertion. Because so little is known about vulvodynia, it is generally diagnosed by exclusion; that is, it is usually the diagnosis made for specific genital pain that isn’t otherwise diagnosed by a blood test, biopsy, or STI screening.

Though Botox® hasn’t been proven to work for every woman suffering from vulvodynia, several patients of renowned dermatologists have found that it eases–and in some cases, eliminates–the pain. The cause is unknown, but experts guess that the Botox® injection blocks the nerve endings from transmitting pain signals, in the same way Botox® typically blocks neurotransmitters from traveling across nerves to facial muscles.

Though Botox® is not an FDA-approved treatment for vulvodynia yet, it is clear that it relieves genital pain in some women. If you’re interested in using Botox® to relieve non-cosmetic pain, contact Dr. Zimmet to schedule an appointment.

When most people think of being wrinkle-free, their main concern is aesthetics. However, new research show that more wrinkles can be an indication of poor bone density. The study, part of the Kronos Early Estrogen Prevention Study, measured the amount and depth of wrinkles in certain areas of the body, and compared them with the bone density of the patients studied. The result was a noticeable association between fewer wrinkles and healthier bones. A lower bone density puts individuals at a higher risk for fractures and osteoporosis. The researchers did not identify the cause of the relationship between wrinkles and bone density, though they suspect it has to do with levels of collagen proteins in the body. While the utility of the results is disputed, perhaps the results of the study will encourage more patients to get their bone densities checked.

Recently released data shows that a slow economy isn’t dragging down cosmetic procedures anymore, according to the American Society for Aesthetic Plastic Surgery, or ASAPS. In 2010, cosmetic surgeries jumped by 9% compared to 2009, with about 9.5 million procedures overall for the year. And the momentum shows no signs of stopping—in fact, since 1997, surgical and non-surgical cosmetic procedures combined have witnessed a 155% increase.

ASAPS’s report, which is released yearly, consisted of statistics regarding plastic surgery, dermatology, and ENT medicine. The most popular non-surgical procedures included Botox® (over 2.5 million procedures), cosmetic fillers, and laser hair removal.

Here are some other interesting statistics from the ASAPS report:

  • Abdominoplasty, or “tummy tucks,” have increased in popularity by 300% since 1997.
  • Adults ages 35-50 were the most likely to have undergone a cosmetic procedure.
  • Men’s cosmetic surgery is becoming increasingly popular; in 2010, men accounted for 8% of cosmetic procedures.

Perhaps the growth in cosmetic procedures is related to the results of a recent survey, which revealed that more than half of Americans approve of plastic surgery for cosmetic ends. About 70% of the individuals surveyed reported that they would not be embarrassed about having a procedure for cosmetic reasons.

Photo Credit: Vanz

If you’re looking for a cheap alternative to standard cosmetic dermatology, or even just a fun night out with the girls, you might be considering a “Botox® party”: a get-together during which people mingle and socialize, then receive Botox® injections. However, what may seem like a fun way to save some money it could be, at best, a waste of money, and at worst, risky.

Botox® parties have gained popularity in the last few years, causing some health professionals to become alarmed at the possible risks. Although Botox® is normally a very safe and effective procedure, some Botox® party “practitioners” have no qualifications and use watered-down product or even substitutes for actual Botox® . Furthermore, Botox® parties are more likely to take place in a home rather than a doctor’s office, boosting the likelihood that the procedure will be unsanitary, and totally unprepared for dealing with emergency situations that may arise.

Does the “host” know how to deal with a vasovagal event? Have they ever heard of a vasovagal event? Do they have the know-how and supplies to manage an allergic reaction? Other questions that come to mind are how do they dispose of contaminated needles, and where are they getting their syringes and needles? Is there good lighting? Does the host use any magnification? Is the set-up, including the exam table/chair, conducive to administration of a good treatment, or do the ergonomics make this difficult? These are simple but important questions.

With Botox® parties and any cosmetic dermatology procedure, Dr. Zimmet recommends the right questions about the person who is going to perform the procedure. Make sure he or she is a doctor or a nurse under a physician’s supervision who has the proper knowledge, skill and experience for the procedure to be done.

The pop-culture vampire craze has spread from horror movies to fantasy romance novels like Twilight to TV shows like True Blood and The Vampire Diaries. Who would have guessed that its next victim would be cosmetic dermatology?

Several dermatologists and cosmetic surgeons have begun offering “Vampire face lifts,” or Selphyl. During the procedure, the dermatologist takes some of the patient’s blood, and then uses a propriety process to concentrate the fibrin and platelets. The patient is then injected with this mixture for “soft tissue regeneration.” Selphyl is being marketed as a more natural, less painful alternative to chemical fillers, Botox® , and surgical face lifts.

This procedure is not FDA-approved for facial rejuvenation, but rather cleared with permission to market by the FDA 510(k) in the United States for the safe and rapid of collection of a patient’s own platelet-rich plasma.

Since there are no peer-reviewed scientific studies on Selphyl, it is hard to say what the side effects could be or how effective it really is. With any injection there is always the possibility of bleeding, infection, and inflammatory reactions. Because of this uncertainty and the lack of data, Dr. Zimmet asks patients to be cautious.

Source: Something of the Wolf

Soon, eliminating expression lines/wrinkles may require no more than a drop in temperature. A new alternative to Botox® and Dysport based on chilling nerves to promote relaxation was recently presented at a meeting for the American Society for Laser Medicine and Surgery in Grapevine, Texas. The technology, called “cryoneuromodulation,” has not yet been approved by the FDA, but some believe it may be as safe and effective as Botox® .

The technique, introduced in a study by Myoscience, Inc., may have similarities to Botox® : the results last about three to four months, the procedure is quick and involves a few needle pricks, and the patient’s wrinkles and lines diminish. However, rather than injecting Botulinum toxin, the new technology uses probes to freeze nerves in the forehead area. After the procedure, the patient’s forehead returns to normal temperature, but the affected nerves are temporarily “injured.” The cold disrupts the nerve signals and causes the muscles to relax, which makes wrinkles substantially less visible. After the three to four months the cryoneuromodulation is in effect, the nerves should return to their former state.

Some believe that the technology will eventually become as popular as Botox® . The researchers claim that cryoneuromodulation has immediate results, whereas Botox® results become visible after a few days. However, the real selling point of the technology is that, unlike Botox® and Dysport, cryoneuromodulation doesn’t use the Botulinum toxin. Though Botulinum toxin was approved in 2002 by the FDA for cosmetic procedure usage, some people are bothered by the idea of injecting a neurotoxin into their body. Cryoneuromodulation could be a viable alternative for people who want to smooth lines and wrinkles without the injection of chemicals.

Though many dermatologists have expressed excitement over the new technology, the FDA will have the final say regarding approval of cryomodulation. The possibility that the procedure could cause permanent nerve damage is still up for debate, but some researchers and dermatologists are calling the new procedure “promising.”  Before long, a wrinkle-free forehead could be only a freeze away.

Cryoneuromodulation vs. Botox®

  • More natural for the body – no botulism toxin
  • Cold disrupts the nerve signals and causes the muscle to relax
  • Results may last the same timeframe as Botox®

Potential advantages of Botox®

  • Proven track record of safety and efficacy when properly used
  • Very quick and easy to undergo with virtually no recovery
  • Very versatile- used for forehead lines, frown lines, crows feet, mouth frown, and other areas

Cautions about Cryoneuromodulation

  • New technologies are often received with a very positive bias by physicians conducting the research, companies marketing a product, and patients looking for the latest.
  • Complications of a new treatment may not be fully recognized until a large number of patients are treated
  • Cryoneuromodulation may be more painful than Botox®
  • Thermal-based nerve injury may have a higher risk of injury to surrounding tissue than Botox®

Photo: stevendepolo

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