Botox, Restylane and Juvederm filler injections with far less pain.

Before being injected with your chosen dermal filler, you’ll probably receive local anesthesia, for which you’ll have to wait to work before you get the enhancing injection. The waiting is annoying; the pain more so. But doctors are working on new techniques that make getting an injectable treatment less painful and time-consuming.

A team at UT Southwestern has been combining 2% lidocaine with Radiesse, Restylane and other hyaluronic acid fillers. Tissue is immediately numbed and immediately treated—simultaneously—giving the patient a faster and more comfortable wrinkle-filling experience.

“There is significant time savings in not having to wait for traditional dental block anesthesia to take hold,” explains UT Southwestern plastic surgery chairman Dr. Rod Rohrich, “and the procedure is more pain-free with shorter recovery time.” His team’s findings appear in the journal Plastic and Reconstructive Surgery.

Although the aforementioned formulas require manual mixing, manufacturers have begun offering fillers with lidocaine already built in, like Hydrelle and Prevelle.

This couldn’t come soon enough for most of the medical spas and plastic surgery offices I know. And if you’ve ever had Botox or Restylane injections you know what I mean.

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Botox, Restylane, Juvederm and other filler injections with less pain.

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The molecule in Dysport is exactly like Botox Cosmetic but is covered by a different coating, which dissociates (dissolves) at a different rate. That is why the onset of action of Dysport is thought to be faster than Botox Cosmetic since the coating comes off faster. In Botox Cosmetic Treatment the usual onset of action is 3 to 7 days where the Dysport onset of action seems to be a few days faster. The dosing is different with Dysport, so there may be some confusion when translating Botox “units” with Dysport “units.” This is why you need to see an injector who has experience specifically in Dysport injections. Also, there is a learning curve with Dysport injections, so you may not initially achieve the same results as you are used to receiving with Botox Cosmetic.

There is also some confusion about the pricing of Dysport with many reports on the Internet and advertising claiming that it is cheaper than Botox Cosmetic. There is a discrepancy in the potency of units. A “unit” of Botox is not equivalent to a “unit” of Dysport, so unit pricing is not comparable. There is a slight savings with Dysport, but it is about 5% – nothing substantial. So, do not expect to go to your plastic surgeon to achieve the same results as Botox Cosmetic for half the price. However, with competition, hopefully prices will come down. Allergan (Botox Cosmetic) is currently offering a $50 mail-in rebate for Botox Cosmetic customers and Medicis Aesthetics (Dysport) is offering a $75 mail-in rebate. With these rebates and introductory pricing, you may be able to get a better deal than your last injection.

In the end, it is great to have another minimally invasive product approved on the market which can give consistent and noticeable results with virtually no downtime and minimal risks.

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Dysport: The New Botox?

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Medical Spa MD: I came across this article from Australia on Botox and Restylane being injected in womens feet.

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Bootox? Botox & Restylane injections for women’s high heels.

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A pointed nose and taut skin seem to have emerged as the two most important assets for Indians going by the number of people opting for rhinoplasty or “nose jobs” and botox injections in the country.

Among the non-surgical procedures, some of the widely practised procedures include Botox injection, (Some Botox from Canada is being imported to India.) microdermabrasion (a non-invasive procedure that uses a spray of micro crystals to remove the outermost layer of dry, dead skin cells and reveal younger, healthier-looking skin), collagen injection, laser hair removal and chemical peel.

Other popular surgical procedures include abdominoplasty and male breast reduction.

Though there are no official records of plastic surgeries in India, a study of hospital records show that cosmetic medical procedures like rhinoplasty and liposuction have seen an increase of 150 per cent in the last five years.

Skin clinics and laser treatments are gaining traction as well.

Post from: Laser Clinic MD

Botox & Nose Jobs becoming more popular in India

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Although this chapter from the Advanced Medical Aesthetics Training Manual wasn’t actually requested in the training manual I wrote for the academy students, I felt it was extremely important for , especially for medical estheticians, to know the difference amongst the various treatments used to alleviate the appearance of wrinkles and folds, and the difference between dynamic and static lines.

Medical estheticians have the most “face time” with clients, examining it with magnifying lenses, treating it with exfolliants, moisturizers, galvanic current, high frequency, various acids, etc. They understand the realm of fine lines and wrinkles and know what can be alleviated with topical treatments such as facials, peels, microdermabrasion and laser resurfacing, and what cannot.

I cannot tell you how many patients call or come into our office with no knowledge of the difference between paralyzing agents such as Botox and Dysport, and dermal fillers. We take it for granted that we know the difference, but injectable products can be very confusing to the lay person. Because the aesthetician works with the client’s skin, they should be well versed in the differences in the two categories of injectables and the products that lie within. Estheticians become your most powerful education source for your clients which ultimately leads to an upsell for them (with possible commission).

Many people think all fillers products are the same, nor do they care to understand the difference between hyaluronic acid or calcium hydroxylapetite. All they truly care about is “how long will it last” and will the “results look fake”. Only with proper education can the medical esthetician effectively and intelligently discuss the differences in the filler products, educate the patient about the effects and lasting results, and help lead the patient to the right product, or combination of products, for their expected outcome.

This information in this chapter is very important for your front desk/phone people as well!

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Medical Spa MD: Understanding Botox & injectables.

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MedicalSpaRX.com sells Dysport, Ipsen’s newest introduction the the cosmetic corrections market in the USA. Dysport is starting to make an impact on doctors choices to treat your wrinkles in 2009 and going forward, with MedicalSpaRX.com offering some of the lowest pricing on a wholesale basis.

(MedicalSpaRX.com is affiliated with Medical Spa MD, the largest community of plastic surgeons, dermatologists, laser clinics, and skin clinics on the web with more than 4,000 physician members world-wide.)

Traditionally the main selling botulinum toxin product for MedicalSpaRX.com has been the ever so popular Botox that is manufactured by multinational Allergan. Until recently Botox has arguably dominated the market for wrinkle corrections performed by a medical professional, as we at MedicalSpaRX.com have noted through our sales.

Of course there has also been the option to buy and use so called “fillers” such as Restylane or Juvederm since the late ’90s, all of which MedicalSpaRX.com also supplies at discounted pricing to medical professionals.

Since its approval by the FDA this year, Dysport has slowly gained popularity with sales through MedicalSpaRX.com. Contributing to Dysport taking some of our Botox sales are several advantages in price and effects.

We have noted that Dysport can begin showing effects in the patient within one day of injection, whereas patients that have been treated by Botox have regularly commented saying that effects are usually noticed within a week of treatment, or in some cases within 2 weeks according to some doctors.

There is also a small pricing advantage in Dysport’s favor, with pricing being an average of 5-10% cheaper than the same treatment with Botox. Although the price on MedicalSpaRX.com is higher per vial than Botox, the amount of Dysport used per injection differs and the end result is a more cost effective product.

Although gaining popularity we at MedicalSpaRX.com are still seeing strong Botox sales, which tells us that we still have a very loyal following that prefer to use the tried and tested Botox.

We would suggest to medical professionals to at least try out Dysport through MedicalSpaRX.com, who has such great pricing it can’t hurt.

About MedicalSpaRX.com

MedicalSpaRX.com is an international wholesaler of pharmaceuticals and medical products to doctors, clinics and other medical organizations at discounted pricing. Amongst the products that are sold by Medica Depot are Botox, Dysport, Restylane and Juvederm.

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Medical Spa RX: Botox & Dysport

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The company’s third-quarter earnings increased 8 percent to $179 million, or 58 cents per share, compared with $165 million, or 54 cents per share, in the year-earlier period.

Excluding special items, Allergan earned 70 cents per share. Analysts on average expected 69 cents per share, according to Thomson Reuters I/B/E/S.

The company’s shares were up 1.2 percent at $54.20 in early trading on the New York Stock Exchange.

Allergan said global sales rose 4.2 percent to $1.13 billion in the quarter, somewhat higher than analysts’ expectations of $1.08 billion.

Sales of Botox rose about 3 percent to $328 million, following declines in earlier quarters that the company had attributed to waning use of cosmetic procedures during the economic downturn.

For full-year 2009, Allergan forecast earnings of $2.75 to $2.77 per share, excluding special items, compared with Wall Street expectations of $2.75 per share.

The company said it expects full-year sales of $4.35 billion to $4.4 billion, compared with Wall Street forecasts of $4.32 billion. (Reporting by Ransdell Pierson, editing by Dave Zimmerman)

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Medical Spa MD: Allergan’s Botox profits on the rise.

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Is your medical spa using a new vial of Botox for every patient?

If your medical spa is using a new vial of Botox for every patient, yours will be the first medical spa or cosmetic practice of any kind that I’ve ever know to do so.

Here’s a story from the Las Vegas Review Journal that specifically points out Botox as a ‘contributor’ to an outbreak of hepatitis C. Of course, if you read the story you’ll see that some nurses were observerd ‘reusing needles’ that contaminated vials of Botox. A very different cause indeed from just using the Botox on multiple patients.

And of course, there’s the cost, which almost every medical spa meantioned in the story. (You’d have to get all of your Botox from Canada to afford that.)

Skin Clinic MD: Here’s the story on Botox.

Single-use Botox vials used on more than one patient.

That practice at the Endoscopy Center of Southern Nevada, public health officials have repeatedly said, contributed to the hepatitis C outbreak in the Las Vegas Valley.

A phone call to inquire about the cost of a Botox party was greeted with this information: “It will be cheaper if all the partiers use the same vial.”

One business that seems to be going well in Las Vegas is known for throwing Botox parties. That’s an ongoing phenomenon across the country where friends get together and drink champagne while their wrinkles are needled away.

“We just couldn’t handle it financially,” said one medical assistant who asked to remain anonymous. “We would have gone out of business.”

Medical assistants at two different spas said their owners only stopped multipatient use of single-use vials of Botox “until things quieted down” after the hepatitis outbreak was announced.

The Review-Journal had little trouble finding medical providers who said they and their companies knowingly broke state and federal regulations.

“You can’t have doctors worrying about breaking the law or guidelines or whatever,” Niamtu said.

A new company called Dysport is manufacturing a similar product, and the competition could force Allergan to provide smaller dosage vials to physicians who want them, he said.

Now a federal lawsuit filed in California by Las Vegas physician Ivan Goldsmith argues that sales representatives for Allergan Inc., maker of the popular anti-wrinkle drug Botox, promote multipatient use of its 50-unit or 100-unit single-use vials.

Goldsmith’s lawsuit alleges that doctors can only make a profit using Botox if they reuse the single-use vials that the drug comes in.

But the complaint also raises issues that go beyond dollars and cents, ones that the community has been acutely aware of since the hepatitis C outbreak became public in February of last year.

The Botox business model “created an unacceptable and unreasonable risk of serious and debilitating injuries and illnesses, including HIV and Hepatitis B and C,” states the lawsuit, filed Sept. 29 in U.S. District Court for the Central District of California.

Allergan spokeswoman Kellie Reagan said the product’s (Botox) prescribing label has always been clear: single use only.

She wouldn’t comment, however, on how Allergan’s sales representatives promote the drug’s use.

Goldsmith said in the lawsuit that Allergan misrepresented to him “the true and permissible use of the product.”

Most patients need far less Botox than is provided by Allergan in either its 50-unit or 100-unit vials, the lawsuit said.

And, according to the suit, the medication can’t be saved for later use on the same patient because, once a vial is opened, it must be thrown away within four hours of first use.

Physicians and medical spa providers of Botox contacted by the Review-Journal said Allergan’s sales representatives have consistently said vials of Botox could be used for multiple patients.

“No matter what training seminar or continuing medical education course I went to, the Allergan people always said a vial was for multiuse,” said Sandra Bledsoe, who operates Focus Medical Weight Loss & Spa. “Many patients only need 15 or 20 units at a time.”

“Allergan seminars have demonstrated multiple patient use of the product for years,” said Las Vegas plastic surgeon Dr. Julio Garcia, who said he has attended the company’s seminars.

Garcia said doctors felt they could be safe if they used a new syringe and needle for each injection, which, even if against the rules, would result in sterile treatments.

The problem comes when mistakes happen, said Dr. Joseph Niamtu, a Richmond, Va.-based cosmetic facial surgeon long active with the American Academy of Cosmetic Surgeons and the Cosmetic Surgery Foundation.

“Someone inadvertently picks up a contaminated syringe and inoculates the entire vial,” he said.

That may sound familiar.

Last year, health officials revealed that authorities investigating a cluster of hepatitis C cases had observed nurses at the Endoscopy Center’s Shadow Lane clinic reusing syringes in a manner that contaminated single-use vials of medication.

Nine hepatitis cases were linked to the practice, and more than 50,000 people were urged to get tested for blood-borne diseases.

Medical officials say no cases of hepatitis C have been connected to Botox injections.

Still, Dr. Ihsan Azzam, state epidemiologist for the Nevada State Health Division, said concerns about blood-borne diseases in relation to the administration of Botox can’t be dismissed.

He said discussions with some of the state’s medical providers have made it clear to him that multipatient use of single-use Botox vials continues in Nevada.

The Review-Journal also contacted providers who say the practice is ongoing.

“I think we need to include use of Botox as a risk factor when we talk about hepatitis,” Azzam said.

He noted that after he sent a bulletin to physicians and other medical providers about injection safety in the wake of the hepatitis C crisis in Las Vegas, some providers who administered Botox in their practices were not supportive.

In his directive, which echoes the position of the Centers for Disease Control and Prevention, he wrote: “Do not administer medications from single-dose vials to multiple patients or combine leftover contents for later use.”

He said a number of providers called him to say that they wouldn’t follow the regulations because they knew how to safely administer Botox to multiple patients from a single-dose vial.

“I was very surprised,” Azzam said Thursday, adding he hopes state inspectors will catch those who refuse to abide by medical regulations. “Some seemed to be daring me to come after them.”

If caught, physicians’ licenses would be at risk.

Azzam said Botox providers told him it would not be possible to make a profit if the injection practices he supported were followed.

“I followed the rules,” Goldsmith said last week. “And it killed me financially.”

Goldsmith is asking the court that his lawsuit be certified as a class action, arguing that more than 100 doctors who invested in the product are affected nationwide, with their economic losses exceeding more than $5 million.

In his lawsuit, Goldsmith said a 100-unit vial of Botox could cost him $1,000, but a patient treatment might only be $500. Because it is a single-use drug, the rest would then have to be thrown away.

“You were losing money that way, not making it,” Goldsmith said. “The patient didn’t want to eat the cost.”

Goldsmith has had a run-in with the Nevada State Board of Medical Examiners, which last year subpoenaed some of his patient records.

The board said it had received information that Goldsmith illegally dispensed compounded medications, dispensed medications without having a pharmacist on site, allowed clerks to dispense medications, and used human growth hormone on patients without meeting Food and Drug Administration criteria.

Goldsmith has denied the allegations and, more than a year after the board’s subpoena, no action has been taken.

Garcia said he is following the rules regarding Botox injections, but knows that many in the medical community aren’t doing so.

Last year he wrote a letter to the state medical board saying patient safety could be compromised because spa personnel continue to inject Botox “with the doctor not present.”

That issue has been in the news lately, the result of recent attempts by the medical board to keep medical assistants from injecting Botox. That effort failed.

“The possibilities of infection, given what is going on when it comes to injecting Botox by whomever, are terrifying,” Garcia said.

“We’re not talking about 40,000 or 50,000 people. We’re talking about hundreds of thousands of injections” in Southern Nevada.

Tracy Jones, a Las Vegas saleswoman, said while she has been a frequent user of Botox, she generally doesn’t know if she is the only one receiving Botox from a vial.

“It’s not something people ask,” she said.

Most medical providers are well aware that Botox, like any injectable medication, can be contaminated when drawn up into a syringe.

To prevent contamination in his Botox injections, Niamtu, the Virginia facial surgeon, said he and his staff every day will draw up five sterile 20-unit syringes of Botox from a 100-unit vial.

Though he said that may not be in accordance with CDC guidelines that say single-use vials cannot be used for more than one patient, Niamtu said he must walk a tightrope between the “practical and the optimal.”

He said “something will have to be done,” if medical officials in other states become as aggressive in enforcing regulations as he believes they are in Nevada.

“Doctors can’t throw away that much medication, and patients aren’t going to pay for the extra,” Niamtu said. “Allergan will have to step up to the plate and make different quantities of the drug. It may cost them a little more.”

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Laser Clinic MD: Single use Botox?

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Botox & Dysport are now offered at almost any laser clinic, medical spa or skin clinic that offers laser treatments. Why?

Botox Cosmetic is a purified protein produced by the Clostridium Botulinum Bacterium which reduces the activity of the muscles that cause glabellar lines (frown lines) that form between the brows. It’s available from nearly all medical spas and laser clinics. Botox can last up to 6 months but results may vary and you many need treatments sooner.

An initial consultation from the skin clinic physician or medical provider should be done prior to receiving treatment. This will also be the time the patient’s expectations will be set about the outcome of the treatment. Fortunately, Botox, Dysport, and Reloxin are among the most common laser clinic and med spa treatments and complications are very rare. This examination will include a review of allergies, medications and possible contraindications that could temporarily prevent or preclude this treatment.

Before an injection of Botox or Dysport, a cold pack or an anesthetic may be used to minimize discomfort to the client. The medical provider will determine the areas of injection by examining the patient’s ability to move certain muscles in the brow area. Tiny injections will be made into the muscles responsible for creating the lines.

Although there is no recovery time there may be some mild side effects at the injection site. A small amount of pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding or bruising may occur. Other reported side effects include headache, respiratory infection, flu syndrome, temporary eyelid droop and nausea, and infection at the injection site.

Dysport Treatments (Reloxin)

Dysport is a paralyzing agent approved by the FDA that’s similar to Botox in that it’s effects and treatment are the same. It’s a botulinum neurotoxin A complex(abobotulinumtoxinA) and is approved for the temporary improvement in the appearance of moderate to severe glabellar lines in adults younger than 65 years of age.

Reloxin was the previous name of Dysport. Although Botox Cosmetic and Dysport function in the same manner and have the same contraindications and results, it should be known that the dosing units of the two agents differ. Botox and Dysport cannot be combined.

Contraindications for Botox, Dysport, & Reloxin:

• Pregnancy or breast feeding or planning to become pregnant
• Diseases that affect the nerves or muscles
• Antibiotics (Gentamicin, Tobramycin, Clindamycin, Lincomycin)
• Heart medications
• Medications for Myasthenia Gravis and/pr Alzheimer’s disease

Post from: Laser Clinic MD

Laser Clinic Treatments: Botox & Dysport

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So what’s the reason for this influx of discount Botox from Canada? Retail Botox is expensive. Wholesale Botox from Canada is only about 40% of the cost of Botox purchases made through American pharmacies.

So let’s take a look at what Botox is and why it’s a favorite treatment in medical spas, skin clinics, and laser clinics.

What is Botox?

Botox is the brand name of a toxin produced by the bacterium Clostridium botulinum. In large amounts, this toxin can cause botulism, which you probably associate with food poisoning. Despite the fact that one of the most serious complications of botulism is paralysis, scientists have discovered a way to use it to human advantage. Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles.

The US FDA approved such usage in the late 1980s upon the discovery that Botox could treat blepharospasm (uncontrolled blinking) and strabismus (lazy eye). Aesthetic physicians like plastic surgeons and cosmetic dermatologists have been using Botox for years to successfully treat wrinkles and facial creases. In April 2002, Botox gained FDA approval for treatment of moderate-to-severe frown lines between the eyebrows… “glabellar lines”. However, Botox is often used ‘off label’ for other wrinlled areas of the face as well, especially around the eyes.

How Does Botox Work?

Botox blocks nerve signals. Injected muscles can no longer contract, which causes the wrinkles to decrease and effectivly ’smooths’ the skin.

Botox injections are often used on forehead lines, crow’s feet (lines around the eye) and frown lines. Wrinkles caused by sun damage and gravity do not respond to Botox treatments.

How Are “Discount Botox” Treatments Performed?

The procedure takes only a few minutes and no anesthesia is required. Botox is injected with a fine needle into specific muscles with only minor discomfort. It generally takes three to seven days to take full effect and it is best to avoid alcohol at least one week prior to treatment. Aspirin and anti-inflammatory medications should be stopped two weeks before treatment as well in order to reduce bruising.

Does a treatment with Botox from Canada Last as long?

The effects of Botox from Canada will last four to six months, the same as any other Botox treatment. As muscle action gradually returns, the lines and wrinkles begin to re-appear and wrinkles need to be re-treated. The lines and wrinkles often appear less severe with time because the muscles are being trained to relax.

What Are the Side Effects of “Wholesale Botox I need to be aware of?”

All Botox treatments, regardless of where the Botox was purchased, have the same side effects. Temporary bruising is the most common side effect. Headaches, which resolve in 24-48 hours, can occur, but are rare. A tiny percentage of patients may develop eyelid droop that usually resolves in three weeks. This development is usually caused by migration of the Botox and for this reason, you shouldn’t rub the treated area for 12 hours after injection or lay down for three to four hours.

Who Should Not Receive Botox Treatments?

Pregnant women, breastfeeding women, or those have a neurological disease should not use Botox. Since Botox doesn’t work for all wrinkles, a consultation with a physician is always recommended.

Will My Insurance Pay For Botox Treatments With Botox From Canada?

No. Botox is not generally covered by insurance when used for wrinkles.

Is wholesale Botox from Canada different from other Botox?

No. All Botox is made to the same standards in the same production plant (in Ireland). There’s absolutely no difference in the Botox from Canada, and Botox from America. The longer answer is that Botox that is not intended for sale specifically in America is not technicaly ‘approved’ by the Federal Drug Administration.

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Wholesale Botox From Canada At Your Laser Clinic?

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