Posts Tagged ‘Allergan’

Not all Sydney Botox is Created Equal

Saturday, November 7th, 2009
Michele Ellingsen recently asked:

Unfortunately, Botox received from one cosmetic procedure provider may not be exactly what you get at another. Even though Botox (botulinum toxin type A) is supplied to all doctors and facilities in a manufacturer’s vial containing 100 units of vacuum-dried neurotoxin complex, in order to be able to inject these active units of Botox, a physician must add a saline solution to get it in “liquid form.”

There are 100 units of Botox in every vial, and the more saline that is added to the vial, the less active units that will be present in each syringe. You should be aware that some may refer to this as the dilution process, but it is actually called “reconstitution.” So while each healthcare professional gets the same Botox product from the manufacturer, when it’s reconstituted for injection, strength and efficacy will differ depending on the amount of saline added. This brings to mind a number of questions for you to ask yourself before deciding on Botox injections.

With this in mind, you should be cautious when you see Botox offered at bargain prices. Everyone pays the same price to the vendor (Allergan) - so how can prices to patients vary so much? It doesn’t seem reasonable, does it? That’s because it isn’t, if manufacturer’s recommended reconstitution guidelines are followed. Botox at a “bargain” price almost always means it has been diluted far beyond what’s recommended (or effective).

A patient may assume that he or she is getting a “good dose” of Botox because the physician is injecting a large amount - but don’t confuse units of saline with units of actual Botox. Physicians who add more saline to the Botox vial than is suggested by the manufacturer, or by the American Society of Plastic Surgeons (ASPS), are administering a less effective injection of Botox - so you should always ask, “What is your reconstitution ratio?”

Also, some facilities quote a price based on the area of injection. You need to look further into this vague statement. As well as asking about the reconstitution ratio, you also need to ask a second important question, “how many units do you inject in that area?”

And, that begs the next question — what is their definition of an “area”. For instance, a provider may advertise “$99 per area”, but if the crow’s feet area is broken up into two areas, when in most practices it is considered one area, you’re not getting any bargain. Look, instead, for a dermatologist or plastic surgeon that charges for Botox “by the unit” so you only pay for the exact number of units you receive. Be sure that he or she follows ASPS guidelines on reconstitution, as well.

If you’re considering Botox, you want to be as educated as possible and do plenty of research before going ahead with the injections. Being the well-informed consumer of these products means being aware of exactly what is being used in your cosmetic treatment, whether the person administering your cosmetic treatment is qualified, and last, but not least, if you are even a candidate for Botox injectables.

Insights Into Botox and Its Cosmetic Applications

Wednesday, October 14th, 2009
Dr Barry Eppley recently asked:


le in America have now heard of Botox and if they haven’t, they surely will in the immediate future with its TV advertising campaign. The commonality of Botox has not only generated lots of interest but with that level of curiousity comes misconceptions and wife’s tales. Let me cover some basic concepts of this miracle drug….some of which you may know and others of which you may find surprising.

Allergan, the manufacturer of BOTOX” or botulinum toxin, was an original dermatology/opthalmology product company. It began developmemt of Botox as an experimental drug over three decades ago in the 1970s. It’s opthalmological researchers tried it on monkeys with strabismus (eye muscle disorder known as cross-eyed or wall-eyed) with surprising curative results. Since then, they have sought and expanded its uses to include cosmetic ****** applications which was granted in 2002. It is this cosmetic application that has exploded Botox unto the American and worldwide scene.

The manufacturing of Botox is an interesting story. In the beginning, it was made under the strict supervision of the U.S. Military as it was a poisonous drug. Since then it is manufactured in a secret location in the U.S. and then shipped for bottling in Ireland. Whether this story is actually true, I do not know but it certainly adds to the drug’s mystique. It certainly is the most expensive drug in the world if you break down its price structure . At 5 nanograms of volume placed in each bottle which sells for nearly $500 per bottle to providers, that makes its value over 1 trillion dollars per pound!

Botulinum Toxin or BOTOX”, is produced from anaerobic (lacking oxygen) bacterial cultures creating a toxin. The toxin is composed of seven strands named A, B, C, D, E, F, G. Each strand can block the release of the neurotransmitter, acetylcholine, from the nerve synapse resulting in temporary muscle paralysis. (no power to the muscle so to speak) The different serotypes have different durations of action before it wears off. Serotype A lasts around three to four months while Serotype F lasts just a few weeks. This is why you see on the Botox bottle and in its advertisements, botulinum toxin A, as this one serotype lasts the longest.

The actual Botox toxin is put into small vials of 100 units as a desiccated (dry) powder. But what does the 100 units mean? It means how many units are required to kill 100 mice. Each vial then contains one hundred mice units or 100 units for short. Initially, Allergan used 25 nanograms of the toxin to kill 100 mice. But it has been learned with improved technology and manufacturing that less is needed to do the same job and the amount per bottle is now reduced to 5 nanograms. This has great relevance since Botox is a drug that requires repeated injections over time to maintain its effects. Using repeated lower doses will reduce the likelihood that patients may develop resistance or immunity. And despite what is often touted, some few select people do have a natural immunity to Botox and others do develop some resistance to its effects over time.

As a cosmetic treatment, Botox is what I call a ‘northern’ treatment’. It is superb at controlling undesired expressions around the eyes and forehead. This northern area of the face probably accounts for the vast majority of its cosmetic use as it creates results that sometimes actual surgery can not rival. It can also be used on the southern part of the face around the mouth. But its effectiveness in this area is diminished as surgical treatments are usually more effective and Botox plays more of an ancillary role to complement other types of treatments.






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