Trading plastic surgery for Botox – is it safe?

But, even though it's a well-researched drug, clinically used since 1989 (and probably before that, frankly) and FDA approved since 2002, there is a confusing morass of myths, misconceptions and facts floating around.

To address some of these, New York City cosmetic surgeon Dr. Scott Blyer, Diplomate of the American Board of Cosmetic Surgery, stepped up to the plate to give us some honest answers about this popular wrinkle treatment.

Top 5 concerns about Botox:

Is Botox is unsafe and possibly even deadly? This statement is the most common and probably the first thing anyone will hear from someone who opposes Botox. There are two parts to their argument: 1) Botox is a poison, 2) Too much of it can kill you.  

Interestingly, both of these statements are actually true. Botox does what it does because it's a mild poison and too much of any poison, no matter how mild, can kill you. What the statement misses is the "mild" part, and the amount required to cause harm. Too much water can kill you too, but you won't hear that announced as fact very often.The truth is, for Botox to become lethal, at least 3,000 units need to be delivered in a relatively short amount of time. Most cosmetic Botox treatments use 100 units or less. That's a pretty sizable safety margin.

Once you use Botox, you can't stop using it because your looks will change forever! This is another common myth, but this one is based on nothing in reality. Botox changes your appearance slightly when it's active, which can be for 4 to 6 months. In that amount of time, many to get used to the "new you" and when it fades, they might notice. So most who use Botox use it regularly (2–3 times a year). Since the cost for treatments is roughly equivalent to a trip to the spa, it's within reach of nearly everyone.* In fact, the most common users are working mothers between ages 40 and 55 with a household income of $100,000 or less.

Why do different doctors charge different prices for the same Botox? Botox varies by provider and by the particular area [on your face]. Typically, the different areas that are treated include the lines in between the brows (glabella), the forehead, and "crow's feet." According to the American Society for Aesthetic Plastic Surgery (ASAPS), the cost per treatment in the United States averages between $300 and $500. Always ensure that your injector is experienced and properly trained; that you are getting FDA-approved Botox Cosmetic from Allergan; and know how many units you receive.

How to do that?

Using good common sense can give you a good idea. If you see the doctor treating you and 4 friends from one bottle, there is likely some over-dilution. Typically 1 bottle treats 2 patients. Allergan from the U.S. has a hologram on it. You can ask to see the bottle

Also remember:  Pricing may also be lower if physicians use an assistant (that is often not a doctor) to provide the injections. You should decide for yourself if you are comfortable with this before going to the office. [In other words, ask ahead of time, when you make the appointment.]

As Botox wears off, does it get into your blood stream and affect other parts of your body?Because of the way that Botox works, it cannot spread beyond the area of the injection site. This is because of the way it interacts with muscle tissue. Botox binds at the site of where the nerve endings meet the muscle, preventing them from sending signals for the muscles to contract, which is what causes wrinkling. When the muscles remain totally relaxed, wrinkles disappear. What Botox is doing is preventing the weakening muscles from contracting. The bind that Botox makes is in specific cells, so it does not spread once bound. As the clinical effect wears off, it's not because Botox has broken free in its binding site, it's because our body is actually making more of the chemical to be released to cause a contraction.  

Botox is a scam because some doctors charge very little for the service and others charge exorbitant amounts. This final point is about economics and marketing, not really about Botox. Cosmetic surgery is almost always a free choice on the part of the patient and the physician. So the costs will be whatever the patient is willing to pay and the doctor is willing to accept. Some physicians may charge large sums of money for Botox treatments, but those doctors are usually targeting a specific clientele who is willing to pay that price for whatever reason. Some doctors offer first treatments at extremely low cost – often lower than their own costs, to allow patients to give Botox a try.

Have you heard these concerns floating around? Or have them yourself? Perhaps there are other issues you'd like to know about. Let me know.

I for one have heard about Botox being diluted more than it should be, so you're not really getting your money's worth, or the full effect. This seems to be ore prevalent when it's not a board-certified doctor providing the treatment. But stay tuned.

More on Botox and other non-surgical cosmetic treatments:
What can I really do about…my Forehead? ( Botox vs. Dysport)

Does Botox Cause Wrinkles?

EyeBrows Instead of Botox

Is the Botox Party Over?