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It’s become a favourite within the world of aesthetic tweakments and even used to treat such concerns such as migraines and jaw grinding. How safe is Botox, how long does it actually last for, whats the best age for Botox and can you become immune to Botox? We answer all in the following blog.

How Can it Be Safe?

Practitioners inject the popular treatment for reducing wrinkles, Botox, that contains botulinum toxin, directly into the facial area of their patients. You may wonder how this can possibly be safe. The secret is that manufacturers of Botox use purified, extremely small quantities of the toxin.
How Does it Smooth Wrinkles?

Botox works beneath the skin, targeting the muscles that underlie wrinkled facial areas. While it cannot erase existing lines or eliminate sagging, it temporarily immobilizes the muscles of the face where injected by blocking communication between nerve endings and the brain. By forestalling the normal contractions that take place during facial expressions, Botox makes wrinkled skin appear smoother and immobilizes its tendency to sag.

Botox is especially effective in the upper facial area, around the eyes and forehead where it can reduce crows’ feet, creases, and other wrinkles. Depending on the patient, the effects of a Botox injection last three to six months.

History of Botox Use

First utilized for facial applications by medical professionals in the 1970s to treat squinting in young children, British dermatologist Nick Lowe studied and developed Botox in the 1980s for treating frown lines.

The product received its licensing for general use in 1994, and since that time nearly 500,000 British citizens have undergone injection treatments.

While the best administrator for treatments is unquestionably a qualified professional, the rapid spread of Botox use has occasioned a similar growth in the sphere of application choices. After being approved for cosmetic use in the UK in the mid 2000s, beauticians, dentists, or the barber down the street may offer Botox treatments. If you are the practical sort, you can even purchase a do it yourself kit online.

How long does Botox last for?

The Allergan product Botox used in the suggested dose range is usually thought to last about twelve before having no clinical effect.

The action of Botox means that it is possible to see some return of movement from the six week stage as the therapeutic effect of the product starts to diminish and the nerve end plates start to reconnect with the muscles.

If you are finding that your patients are not seeing this duration of treatment there may be a few things to consider:

  • Is your patients expectation of treatment realistic?
  • Have you considered the appropriate dose for muscle mass, surface area, gender and ethnicity?
  • Does your patient have a swift metabolism
  • Are they taking any medicines including vitamins and herbal preparations that could speed metabolism?
  • Has your patient had any illnesses or events to cause a steep change in their recent aging process?
  • Is your patient a smoker?
  • Have you compromised your product by using alcohol to clean the skin or swab the vial top?
  • Have you denatured the product by inconsistent storage, excessive movement or too speedy a reconstitution?
  • Has your placement site and depth of injection been appropriate for the area being treated?
  • Did you advise your patient on aftercare?

The results are generally predictable but each treatment with toxin will produce a slightly different result. Any of the above factors could influence the outcome.

What is the best age for Botox?

Is there really an “Optimum Age” for Botox treatment? Or is this some kind of myth

Similarly…what is “too young” or “past the point of help”?

Up to a point, “Too Young” is obvious. We’ve all heard the recent controversy over the San Francisco Mom who gave Botox treatments to her Pageant-queen 8 year old daughter. There has been a media frenzy of similarly ridiculous stories. And any medically qualified Aesthetic Practitioner worth their weight in botulinum toxin knows that there is simply no question about the right or wrong in these cases. But over the age of about 18? 20? 25? Where does it begin… And where does it, or should it end?

Perhaps the debate can be split into two: the perspective of the Practitioner, and the Perspective of the Patient (note we say Patient, not Client: at Cosmetic Courses, we feel it is so important to remember that Botox is still a medically prescribed drug not just a beauty treatment…ethical decisions need to be made around this topic as with other medical procedures).

The Patient’s Perspective:

Botox provides a safe and effective means of looking more youthful and banishing wrinkles like no other treatment, for up to 4-6 months at a time. Robert Kotler (Md, FACS) makes the valuable point that, to the Patient, the best age at which to begin Botox treatment is largely based on their personal interpretation – on “what you see when you look in the mirror”.

In other words: no matter how many hundreds of times friends, family and surgeons try to persuade a 20-something patient that they have beautiful skin, if all they see when they look in the mirror is one huge wrinkle, they will fixate on it. It can make them genuinely very unhappy, however silly this may seem to other, possibly older, patients. But does this make them any less “eligible” for treatment?

Of course, the highly image-conscious environment of the Western world plays a large part in this. Women and men alike are bombarded by airbrushed images of silk-skinned celebrities. Many feel retaining youthful looks is integral to keeping ahead in their careers.

As a Practitioner, when judging the need of the Patient, it is therefore hugely important to be able to empathise: to think, why is this important to this Patient, is there some way that I can work with the area concerning them to improve it (even if it is not as pronnounced as in other Patients) and not merely to dismiss them as “not needing it” until you have tried to get inside their shoes and seen their reflection in the mirror through their eyes.

In some cases it may be a lot easier…patients who have had a lot of sun exposure, for example, often do have genuine significant forehead wrinkling, squint and glabellar lines even at a very early age.

The attitude towards patients of 65+ wanting Botox tends to be much more liberal, i.e. “Well, if they want to pay for it!” . Many people are going on working to a much older age nowadays so increasingly defending this choice through preserving their youthful looks is important. Plus the generations of highly glamorous older celebrities are making the trend for much older Botox requests just as likely as unusually young Botox patients.

The Practitioner’s Perspective:

Of course, regardless of ability to Empathise and weigh up the emotional implications for your patients (i.e. do they really need this treatment to make them feel better about themselves?) there are still practical implications for the Aesthetic Practitioner, such as the health considerations caused by age.

“Too Young” and a patient is still developing – both physically and emotionally. With the 18’s – early 20’s age group, if you strongly believe that your Patient does not have any lines to treat and is simply feeling the pressure to live up to celebrity airbrushed distortions of  reality, then perhaps it is your ethical duty to explain this. At Cosmetic Courses we believe you should never, ever perform an Aesthetic Procedure purely for the money if the patient does not need it: this will not build up trust and is abusing your medical position.

On the opposite scale, whilst there is technically no reason why Botox treatment is unsafe for patients aged 65+, such treatment is considered “off label” i.e. not the norm. You may need to check out the patient’s skin elasticity, check extra carefully that they are in good medical health with no contraindications (watch out for blood thinning medications or neurological diseases). If all this is fine, then they are as good to go as any other patient!

With all patients who fall outside the “typical” age bracket for Botox treatments (i.e. those who could obviously and easily benefit from it), it is best for both the Patient and the Practitioner if the Consultation process involves a clear explanation of the results that may be achieved and the Patient’s expectations. This will ensure that the patient is not disappointed, and the Practitioner is not expected to perform impossible miracles!

Can you become immune to Botox?

The answer to this is yes you can become immune to Botox! But it is extremely uncommon.

There are a number of different types of botulinum toxins available currently in the United Kingdom.

These include Botox, Xeomin and Azzalure.

If your patient becomes allergic/immune to one of these types of toxin it is likely one of the others will work satisfactorily for them.

Botox is normally associated with botulinum toxin as hoover is to vacuum cleaners. However not all vacuum cleaners are hoovers and not all botulinum toxins are botox.

If your patient does feel their botox treatment is becoming less effective, you need to offer them a full consultation during which you may suggest using an alternative type of botulinum toxin.

Botox Training

If you would like to advance your Botox training options we have a variety of routes for you:

September 11 witnessed new legislation for the use of Botox in the US – it is now legal to administer it to the fine lines around the eyes.

Up to now the Food and Drug Administration had only approved the cosmetic use of Botox for lines across the forehead and between the brows, however doctors have been using Botox in the treatment of lines around the eyes for a number of years.

The approval came after a study led by Allergan, the manufacturer of Botox, into its efficacy as an anti-ageing injectable. In a controlled group of 833 adults one half received Botox injections to the eye area and the other half received placebo injections to the same area. The group that received Botox displayed the most sign of a reduction of wrinkles.

Although Botox was being used by doctors ‘off-record’ in this way, the approval will mean better safeguards and guidelines. Dr Marco Harmaty, Plastic and Reconstructive Surgeon at Mount Sinai Medical Center in New York, told CBSnews.com that Botox has been used not only for crow’s feet for a number of years but also other unapproved parts of the face including creases by the side of the nose. However he also added:

“(It) does give you an added benefit and safety of saying that I’m not doing anything illegal or potentially harmful.”

The FDA approved Botox use for lines on the forehead in 2002.

Kim Kardashian’s latest media circus involves speculation that she is still undergoing regular Botox treatments despite being 7 months into her pregnancy. Though the American socialite has neither confirmed or denied the reports that are circulating throughout US and now global tabloids, the question on many people’s lips is – if true, will this do harm to her unborn baby?

Whilst we can’t comment on the validity of the claims and therefore offer no opinion on this specific case, it is worth visiting the subject on a general basis. There is no evidence that Botox travels beyond the area in which it is injected, and in theory this would extend to meaning it would not reach an unborn baby via the placenta. That said, there is no conclusive evidence that it does not, given that it would be impossible to test this on pregnant mothers and their unborn babies.

Corroborative evidence would suggest that it is safe and indeed prescription Botox is sometimes carried out on expectant mothers suffering from other conditions that require it, such as chronic migraines or cervical dystonia (problems with posture and movement, usually in the neck and shoulders). Currently doctors are allowed to continue with Botox treatment in these cases.

There are also no regulations that prevent practitioners from offering Botox for cosmetic reasons to pregnant women. That said, most who administer it will not offer it to pregnant women for cosmetic reasons alone. This is because the reason for the Botox is seen as non-essential, and therefore the safety of the unborn foetus is given greater precedence.

Cosmetic Courses are one of the UK’s most established medical aesthetic training providers. For information on our Botox training, or any of our other aesthetic courses, contact the team on 01844 390110 or email [email protected] for more information on any of our training courses.

One London clinic is now offering a Californian-produced alternative to Botox which promises the same results minus the toxins, which may come as welcome news to those who are interested in the results of the treatment but uncomfortable with the thought of what is in it.

iovera has been dubbed ‘Frotox’ due to its use of cryotherapy, effectively freezing, to produce the same results as Botox. Its results are said to be instantaneous as opposed to the few days that it can take for Botox to take effect. However its lifespan is slighter shorter lasting a maximum duration of four months.

Developed by medical technology group myoscience, it currently tackles forehead lines (running vertically or horizontally) through administering the treatment to either temple. A device filled with liquid nitrogen is placed next to the nerves which freezes the muscles used to control particular wrinkles. Advocates suggest that the accuracy of the nerve targeting is such that it still allows movement in the muscle.

The treatment lasts for 15 minutes and is so far retailing at £300 at a Harley Street Clinic. Some detractors insist that it poses no viable alternative to Botox, which has been used for several years, until its long-term safety and capability has been demonstrated.

Cosmetic Courses are the UK’s first surgeon led Botox course provider. Contact the team on 01844 390110 or email [email protected] for more information on any of our training courses.

A relatively common condition for athletes can often be misdiagnosed as asthma, but if detected can be treated easily enough through a combination of treatments including Botox for the vocal chords. Although it can be brought about by stress or anxiety it is also commonly linked to increased physical exertion, hence why athletes can be at increased risk of suffering from it.

It’s believed an estimated 5% of professional athletes suffer from Paradoxical Vocal Fold Motion Disorder (PVFMD) which constricts the vocal chords and can impact the ability to breathe. It also causes coughing whilst exercising and because of these symptoms, which are very similar to those caused by asthma, it can often be missed therefore remain untreated.

The two conditions are in fact often linked – 40% of asthma sufferers will also have PVFMD. What will quite regularly happen is the asthma will be detected and treated but the PVFMD won’t be, in which case the athlete will still suffer from its symptoms.

When it is diagnosed correctly treatment will usually consist of multiple solutions. These will likely include vocal chord retraining therapy and also Botox, carried out by various professionals. An ENT specialist with Botox training would be required, as well as a vocal chord therapist and possibly also a sports psychologist who would deal with the impact it has mentally.

Non-athletes who suddenly take up an increased exercise programme can also suffer from the condition.

We’ve collated the results of the feedback for our latest training course – and the results are very encouraging.

On Saturday 7th July, we ran another successful Foundation course in Botulinum Toxin and Dermal Fillers.

Though the course was fairly small, the feedback we received showed that satisfaction levels are going from strength to strength.

In fact, it was among the best feedback we have received since we began. We’re very proud to share the results with you here.

The Verdict

Here’s how our delegates rated us:

  • 100% would recommend the course and return for further training
  • 100% thought the speakers communicated effectively
  • 100% thought the venue was suitable for the training
  • 100% thought the demonstrations were well presented and informative
  • 100% thought the hands-on experience was valuable
  • 98% thought there was sufficient time for discussion

A fantastic set of feedback, and we hope that many of our Foundation course delegates choose to continue their study with Cosmetic Courses – either by moving up to the next level on our Intermediate and Advanced courses, or broadening their expertise into other areas like Dermaroller and Skin Peels.

If you would like to attend our next Foundation Botulinum Toxin and Dermal Fillers course, it will be held on Saturday 11th August. Click here to book your place. Alternatively, we are always happy to arrange bespoke one-to-one training sessions at a time that’s convenient for you. Contact us for more information on 0845 230 4110 or email [email protected].

In a secret recording by the BBC at a Harley Street skin clinic, the clinic’s director was filmed describing how prescriptions for Botulinum Toxin could be obtained in the names of friends and family. The drug would then be stored, ready to be used by nurses to treat walk-in patients without needing to obtain a prescription first.

The nurses would instead telephone the doctor for a remote prescription before injecting patients with the ‘stored’ Botox.

If, for any reason, the doctor could not be reached before treatment, the nurses would administer the Botox injections anyway – with the doctor phoning patients afterwards.

Though remote prescription is not illegal at present, administering Botox without a prescription is against the law. It also raises concerns about patient safety.

In the light of the investigation, the General Medical Council (GMC) has said that new rules will soon be published, making it illegal for doctors to remotely prescribe injectable cosmetic medicines, including Botox.

Nurses who do not hold the V300 prescribing qualification will be required to work directly with a doctor or dentist in order to issue prescriptions.

If you would like any information on our Botox training courses, or any of our other fully accredited courses, contact us on 0845 230 4110 or email [email protected].

The results of our latest training course are in…..and they’re better than ever!

Last Saturday, 12th May, Cosmetic Courses ran another fully subscribed Foundation course in Botulinum Toxin and Dermal Fillers.

We routinely ask all our delegates to fill out feedback forms to let us know what we’re doing right, as well as highlighting any areas we can improve on.

We’ve now collated the feedback from Saturday’s course, and are very proud to be able to share the results with you here.

The Verdict

Here’s how our delegates rated us:

  • Accommodation and travel were given a score of 96%
  • Structure of the course and discussion time scored 97%
  • Course  presentation, lecture, demonstration, venue and effectiveness of communication were all rated 99%
  • Value of the course and amount learned were given a perfect 100%!

Our Foundation courses are designed for delegates just starting out in their aesthetic careers, and mark the very first step in their journey, so it’s particularly satisfying to hear that they found our latest course so useful.

We hope that many of these happy delegates will decide to join the ranks of our previous Foundation course delegates who have progressed to further study on our Intermediate and Advanced courses, or broaden their training into other areas such as Skin Peels and Dermaroller.

If you missed out on our last training course and would like to attend the next one, it will be held on Saturday 23rd June. Alternatively, we are always happy to arrange bespoke one-to-one sessions at a time that suits you. Contact us for more information on 0845 230 4110 or email [email protected].

Question :

Last week my mum had what she was told was Botox.

She has since found out it was a product called “Fabtox” (which I have never heard of): a bespoke product made up of Vistabel.

Within minutes her eye was swollen up and had started to go purple, now her cheek is swollen down to her chin. She has been to A&E and her GP who can’t do anything.

She had it done down at a dental/cosmetic studio in Shoreham near Brighton.

Have you ever seen anything like it?

Thanks so much

 

Answer :

It sounds as if the injection has hit one of the blood vessels which surrounds your mother’s eye.

The blood then moves inside the orbit and produces the bruise you see.

This bruising will settle over the next couple of weeks but it might be worthwhile asking her to massage Arnica cream into the bruised area daily.

Let us know how she gets on.

It is really very important that you research carefully into where you are going for your Botox treatments and the products which they use.

We hope that your mother gets better soon!

If she would prefer to enrol as a model with us in future, we can promise that we do not use any “Fabtox” products here and all our delegates are medical professionals, closely supervised by expert Aesthetic Practitioners. She can enrol by calling our team on 0845 230 4110 or find comfort in our other models’ testimonials at http://www.facebook.com/CCModels.

The Cosmetic Courses Team

The use of the anti-wrinkle product Botox is said to help those feel better about themselves because they do not frown even when they are sad. This then feeds the idea back into their brains, and can help reduce the feeling of sadness. Theoretically, scientists claim that if a person can’t physically frown, the brain then feels as if there is nothing to be sad about- the equivalent of acting happy even if you are not, therefore tricking your brain into thinking you really are.

According to the study performed by the US Association for Psychological Science, it applies even for those who have received the Botox injection to stop wrinkles. These injections are a temporary solution that causes the paralysis of the muscles. It is done by tiny amounts of the toxin being injected into the muscles that are mainly responsible for frowning.

Research performed at the University of Wisconsin used 40 volunteers who allowed small doses of Botox to be injected into their foreheads. Afterward, the volunteers were asked to read from statements that ranged from happy, sad and angry, which they had already done before the treatment began. Those who received the treatment took more time to read off the more negative statements than before they had received their injections. David Havas, a researcher involved in the project, explained that while the time delay was small, it was significant, suggesting that a person’s brain can take longer processing the emotion found in the statement.

According to Mr. Havas, “There is an idea in psychology called the facial feedback hypothesis. Essentially, it says, when you’re smiling, the whole world smiles with you. It’s an old song, but it’s right. Actually, this study suggests the opposite: When you’re not frowning, the world seems less angry and less sad.”

Another Research professor, Mr. Arthur Glenberg, also discussed the study. “Normally, the brain would be sending signals to the periphery to frown, and the extent of the frown would be sent back to the brain”, he stated. “But here, that loop is disrupted, and the intensity of the emotion and of our ability to understand it when embodied in language is disrupted.”

It is important to be careful when you have Botox injections, because you may get the opposite effect. Botox injections in the bottom part of the face may prevent smiling, making a person feel sad, according to research done by Barnard College in New York