Happy New Year to all from Shire Facial Plastic Surgery!

Botox before & after Crows' Feet

James Shire, M.D., F.A.C.S. was the first person to preform cosmetic Botox® in the Chattanooga TN area. With over 16 year of experience in treating patients with Botox®, this article will provide the information that all patients should understand about Botox®. This is one of the safest and most effective treatments there is.

Botox® is  botulinum toxin type A and is a product that is made in a laboratory. It was first developed in the 1940′s and has been used for years treating neuro-muscular problems throughout the body.  1988 was the first time it was used to treat a wrinkle. What Botox® is actually doing is preventing the muscles from contracting, thus eliminating the wrinkles. We use Botox® to treat the frown lines, forehead lines and crows’ feet. It is not recommended for the area around the mouth or under the eyes. These muscles are in your face for a reason, and it is not for wrinkle -making; they are brow depressors, pulling the brows down. Therefore, with Botox®, not only do the lines and wrinkles disappear but by knocking out the brow depressor muscles, you can also get a little browlift, which is the reason it looks so good.

Botox before & after, frown lines

Botox® is very predicable and very safe. The variability in results is not from the Botox®, but from who is preparing and giving the Botox®. It must be reconstituted properly. We reconstitute to 2cc for 100 units. Beware of those who over dilute it with 5cc or even up to 10cc per 100 units, this will make the product less effective and will not last as long. That is why you can find it advertized  so cheaply, but in reality, what are you getting?………saline! There are other variables that can also affect Botox®. It should never be shaken, it must be stored at the correct temperature, and alcohol will make it ineffective. There are also different injection techniques that can produce different results such as raising or lowering the brows. The doctor injecting the Botox® must know and be able to control this.

As was mentioned, Botox is extremely safe with little if any complications. The one complication that is talked about the most is an eyelid ptosis,or a drooping eyelid. This can be caused by an improper injection in the wrong location or injecting too large of a volume in an area. But in most cases it is caused by the activity of the patient after the injection. Since we instruct all our patients that they must not rub or massage their face, bend, lift or excerise for about 5-6 hours after the Botox® injections, we have not had this problem.In summary, there is no treatment that can improve and remove wrinkles as well as Botox®.  As a patient and a consumer, please remember that when deciding on treatment, you must consider how the Botox® is made, how it is stored, how it is being injected and who is doing the injections. Botox® is just the tool, it is who is using it and how it is being use that really matters.

Making decisions for medical and surgical cosmetic procedures have gotten more difficult for the patient/consumer. With the decrease in medical reimbursements to doctors and the increase popularity in aesthetics, many physicians and even non-physicians are entering the cosmetic surgery market. This is also promoted by the onslaught of advertising and media hype that surrounds it. The consumer reads about the “newest” product in a magazine, sees “cheap” prices that are too good to believe, and hears about exaggerated or misleading claims. What is a patient to do? How can the patient make a good educated choice?

James R. Shire, MD of Shire Facial Plastic Surgery in Chattanooga, TN explains “As an example, if you are given a paintbrush and paint and asked to create a self portrait, and the same paintbrush and paint were given to Rembrandt to paint a self-portrait, which painting will be better? It is not the tool (or product) but who is using it that really makes the difference in the final outcome”.

In these difficult economic times everyone is cost conscience. But the last thing you want is cheap surgery. It is reasonable to try to get the best deal you can. This works well with TV’s and refrigerators, but you never want to get the cheapest parachute, fire extinguisher, or surgeon. Especially if it is your face!  Always remember, your face goes before the world.

Whether it is cheap Botox, a great deal on fillers or deciding which filler to get, the patient must be an educated consumer. The first step is to find a qualified and well-trained DOCTOR who specializes in the area you are interested.  Beware of spas with nurses, aestheticians, techs performing medical procedures, or out of field doctors (such as family doctors, ER doctors, OB-GYN doctors, dentists, etc.) trying to cash in on the aesthetic wave. One does not see these doctors trying to be pediatricians or cardiologists. A clearer example would be that you would probably not want to take your new Mercedes to the corner gas station for its repairs, you would want a specialist for that type of car. If the person is not able to handle the complications of a procedure, they are not qualified to do the procedure in the first place. These non-invasive procedures may be marketed as simple and easy, but in reality they are real surgical procedures with real complications that can and do occur all to often. We see in our office more and more people with unsatisfactory results coming in for us to correct and repair their bad surgery, filler injections, and/or Botox. Some of these situations can be corrected, but many times they can not be corrected or that the result of fixing the problem may leave the patient worse than before.

In addition, with all the emphasis on rapid or instant recovery time and non-invasive surgical alternatives, there is one thing that should be kept in mind. If there is no recovery required, then there will be no lasting result!