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Botox and Beyond

By: Lauren McCullough



The New Craze


Cosmetic surgery had become widespread within the last decade. Viewed as a subspecialty of medicine and surgery, its primary goal is to enhance appearance rather than a procedure specifically designed to reconstruct body defects. Most familiar within our own society, cosmetic surgery had become almost as widespread as routine outpatient treatments. The number of individuals undergoing cosmetic surgery is at a record high of 870,000 in 2003 – an increase of almost 7% from 2002. Moreover, the range of individuals receiving these treatments covers a broad spectrum of teenagers whom receive breast augmentations upon commencement form high school to individual’s society considers senior citizens – engaging in hair transplants and botox. The largest dimorphisms shift towards the extremes with the new craze being youth rejuvenation. 


What is it & How it Works  


Botox injections are the most rapidly growing cosmetic procedures with well over 1.6 million people receiving injections as posted through the FDA in 2001. Botox was initially approved in 1989 to treat eye muscle disorders, and soon after in 2000 to treat neurological movement disorders. It was noted during these treatments that botox alleviated frown lines and provided a more refreshed and youthful look. It was not until 2002, however, that the FDA was satisfied with botox as a cosmetic rather that therapeutic procedure and thus granted approval of use for this purpose.

            Botox (Botulinum Toxin Type A) is a protein produced from a culture of the strain Clostridium botulinum, including the same toxin causing food poisoning. With medical use botox is a sterile form of purified botulinum toxin achieved through a series of acid precipitations. Its function is to block nerve impulses releasing the neurotransmitter acetylcholine (Ach) at nerve synapses. It thus paralyzes the muscles that cause wrinkles yielding a smoother and more refreshed appearance of the skin. link to long description


The Cost and Procedure


The average cost of Botox Cosmetic Treatment varies regionally across the United States. Costs range from approximately $370.00 in western U.S to $500.00 along the eastern region of the U.S. 

            Upon receiving treatment the patient will make an initial visit for the physician to resolve the dosage of inoculation and area to be injected. Once treated one may detect results within a few days lasting 3-4 months and requiring periodic touchups.



Does it Really Work?


Among all the claims regarding the effectiveness of Botox, the only valid claims are those made by medical and health care professionals through clinical studies and meta-analysis.

Moreover, they claim botox as “the universally accepted gold standard treatment for upper facial rejuvenation,” however the application of botox to the mid and lower regions of the face is a more invasive procedure requiring more exhaustive knowledge of facial muscular anatomy and function.



Side Effects or Harmfulness of Procedure


Although proven to be effective botox (like most drugs) comes with its share of warnings and possible side effects. Statistics through a randomized double blind study of 535 provided by have shown minor changes upon the admistraion of botulinum toxin. The most drastically varying symptoms between the treatment and control groups were headaches, pain in the face, flu syndrome & pain at injection site. Among these statistics a host of other possible side effects also occur, including dysphasia, upper respiratory tract infection, neck pain, ptosis, and nausea. Other risks, though rare, include bruising, numbness, swelling, twitching of muscles, droopy eyebrow and, most frequently, a droopy eyelid. One physician explained, "Rarely, if the botox drifts too close to the eye muscles, a person can find it impossible to open their eyelid completely."   

Some people shouldn't use botox, such as women who are pregnant or breast-feeding and people with certain kinds of musculoskeletal and neurological conditions. Moreover, recent concerns of the FDA include the current rise of Botox parties. Gatherings, once thought to be a convenient means of providing botox treatments more economically, have been deemed to be dangerous if not in a medical setting equipped to handle emergency situations or adverse reactions.

The Reality

Personal appearance can be very significant to some people. So much, that they will go to great lengths to preserve their youthful look. However, many find it illogical to spend such a large sum of money masking the very thing that should be worth celebrating. Aging has been treated as an illness or disorder that needs some sort of treatment – and botox is that treatment. If successful botox will erase the lines of love, wisdom, and life. It will obliterate the history so eloquently displayed by our face… like ripping the pages of your autobiography. It is suggested that we learn to value our history more than the facade.   



-     U.S. Food and Drug Administration has provided the chemical makeup of botox and how it works (

-        Rx List on Botulinum Toxin provides information on the chemical makeup of botox (

-        Smart Plastic Surgery gives statistics regarding symptom post botox as well as approximate cost of procedure (

-     Physician’s responses and feelings regarding botox can be located through (   

Literature was collected for Pub med at the following links…

Carruthers, J., Carruthers, A. (2001). Botulinum toxin (botox) chemodenervation for facial rejuvenation: Facial Plastic Surgery, viii, 197-204.


Carruthers, J., Carruthers, A. (2001). BOTOX use in the mid and lower face and neck: Semin Cutan Med Surg, 85-92.


Fagien, S. (2003) Botulinum toxin type A for facial aesthetic enhancement: role in facial shaping: Plast Reconstr Surg (5 Suppl):6S-18S; discussion 19S-20S.



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