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What Areas of the Face Are Most Commonly Treated With Botox®?

Botox® has been used clinically since the 1980’s when it was employed by ophthalmologists to treat muscle issues of the eye. Over time, clinical uses of it have expanded considerably. In 2002, the FDA (Federal Drug Administration) approved its use specifically for the temporary cosmetic treatment of moderate to severe frown lines between the eyebrows. Although it is at other sites for the same muscle relaxing effect, these uses are technically considered by the FDA to be off-label.

What are the most common areas in the face that Botox® is requested? These are the areas associated with the most common muscle hyper-animation with expression and include:

1.  frown lines situated between the eyebrows and on the bridge of the nose
2.  crow’s feet creases at the corners of the eyes
3.  creases of the forehead

Far less commonly treated facial areas include the lower eyelid, creases around the mouth and specific neck creases. These are also higher risk areas for significant side effects such as drooping of the lower eyelid or weakness of the muscles of the lip than can affect speech, appearance and ability to purse the lips so you should use considerable caution and prudence before proceeding.

Though the duration of effects do vary from person to person and are even dependent on the specific area, expect around three to four months on average. Some patients can have results that last 6 months or more but this is not very uncommon. In order to maintain the effects, Botox® treatments should be repeated on a regular basis, usually every three to four months.

For more information on Botox®, fillers such as Juvederm™ and Radiesse®, eyelid surgery or any other cosmetic surgery procedure or to schedule a complimentary consultation, you can contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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Dysport™: An Alternative to Botox Cosmetic® That Will Soon be Available

In April, the FDA approved the usage of another cosmetic wrinkle remover, which like Botox Cosmetic®, is derived from botulinum toxin. To be marketed as Dysport™ by Medicis Pharmaceutical Corp., it will be a direct competitor to Botox Cosmetic® which is sold by Allergan Inc. It has been used with great success since 1991 in Europe where Botox Cosmetic® is also very popular.

Though derived from botulinum toxin, these two products are not identical and do have several differences which will be sorted out in the future with greater experience. Dysport™ has a more rapid onset of action, typically one to two days versus the three to five days seen with Botox Cosmetic®. It also has a greater spread for a more diffuse effect, requires fewer injection points and may last slightly longer than Botox Cosmetic®. However, it does have significantly more adverse side-effects. Botox Cosmetic®, though requiring more injection points, is far more precise, predictable and has a lower risk of adverse problems.

Dysport™ should be available for clinical use here within the next month or two. Pricing is not yet established but will likely undercut the cost of Botox Cosmetic® in order to acquire patients and market share. Its presence will be a win-win situation for patients, allowing for more than one treatment option as well as providing competition which may lead to more favorable pricing and incentives.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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