The Botox Chronicles: #1

This is a reprint of my original posts on April 1st and 14th, 2011 with some mild variations. You can see the original postings here:

http://makeitwork.maconscene.com/2011/04/01/botox-and-juvederm-and-wrinkles-oh-my

http://makeitwork.maconscene.com/2011/04/14/botox-blog-1-beginning

Oh my God. It happened. This past week in fact. I discovered my first wrinkle. How in the sam h*** did this happen?! Oh actually I can explain it- all my work stress causes me to frown a lot. But what do I do about it? Am I too young for Botox? Do I really need to go that extreme? And is Botox an extreme move? It seems to me that it may be but I really don’t know. So of course, it’s time to research.

When I Google wrinkle treatments in Macon it pulls up the local CVS and Walgreens for over the counter products as well as Botox and Juvederm and Restylane and even laser treatments. Yikes!

But this is when fate comes in to play… luckily I mentioned my predicament to my lovely friends at FOJ (aka Fountain of Juice for those not in the know) and they directed me to Stephanie Ollikainen at Dr. Stefan Adair’s office.

I quickly found out that there is a LOT of information out there….

Ok,  so as I said before I have discovered my first wrinkle. Christ I just still can’t quite get over it. So I sat down with Stephanie Ollikainen and Dr. Stefan Adair to pick their brains about Botox and what all is involved with it. This blog will be the first of a few, going over some of my basic questions going in to the Botox process. But before I get to the technical stuff, let me stress this: I never even thought about how important it is to make sure the person you receive Botox from has the proper education. According to this article from the NY Daily Times (http://www.nydailynews.com/lifestyle/health/2010/09/16/2010-09-16_freezy_freaky_one_days_training_is_all_that_is_needed_to_administer_botox.html ) one day’s training is all that is required to dispense Botox, in some cases. “The injectable can be injected by a medical doctor or dentist, or by a physician’s assistant or registered nurse, so long as they’re under a doctor’s supervision. But doctors, PAs and nurses need only to take a weekend course in order to start administering Botox.” Yikes!! How scary is that?! And let’s be honest, how does the average person walking into a doctor’s office know what makes one doctor qualified over another? I will say, knowing that the doctor I am seeing is also trained in plastic surgery makes me feel better. After all, who else is going to know the anatomy of the face better?

However, I do like to also know why a physician chooses a particular field. For instance, if he were to tell me “because I would make the most money” then I am pretty sure I’d run away screaming and flailing in the other direction. So when Dr. Adair told me he chose plastic surgery because of the challenge, because “ plastics to me is the apex of surgery – it requires critical thinking and artistic skills combined; it is unlike any other surgical specialty (we have more surgical training years than any other, including neurosurgery)” well frankly, I am reassured. (It doesn’t hurt that I consider myself to be somewhat of an artist as well, so I can appreciate that aspect.) Now I found that there is a lot to Botox and its application that I did not know, and frankly it’s a little intimidating! For instance, Botox is a vapor which is then mixed with saline for injection, which is why sometime it can be hard to verify if you are getting the correct amount or if you are in fact getting what you paid for. I will list my questions and the answers below, to make it easier to read:

Q. How much training is needed for Botox?
A. Botox can be taught to virtually any specialty, but surgical knowledge of the anatomy and variations in facial features allows a good plastic surgeon to maximize the results and improve upon those in other specialties… our detailed understanding of facial anatomy and anatomic variations guides us in the correct use of Botox where others less trained would not have the eye or knowledge base to make the correct decisions
Q. How often a week do your perform the Botox injections
A. Botox is more or less on demand – any day(M-Th)
Q. What are some of the potential side effects?
A. Asymmetry due to unintentional blocking of local nerves is main side effect, but rare
Q. What other procedures does your office do?
A. I am specially trained in cosmetic surgery (facelift, browlift, rhinoplasty, liposuction, abdominoplasty, breast augmentation and lift, and numerous others) Refer to www.dradair.com – see procedures and gallery.
Q. Do you administer the injection or one of your staff?
A. I administer it
Q. What are some of the problems when using someone who is not properly trained?
A. One can end up with asymmetric paralysis (etc)
Q. Do you allow patients to see before and after pictures?
A. Yes
Q. What is the Difference between Botox and Restylane?
A. Botox causes a reversible paralysis to the muscle, Restylane is a filler (elaborate). Botox can take 3 to 5 days to settle in while Restylane is immediate. There is also Juvederm which is a hyaluronic acid (synthetic) but normally found in human tissue. Collagen is not used anymore (elaborate) One can use fat but it is more invasive and not as predictable. Sculptra is another product, and lasts roughly 2 years. One must be specially trained to administer Sculptra and it is less forgiving.
Q. What other uses does Botox have?
A. Botox can also treat muscle spasms around the eye as well as excessive sweating, Migraine headaches, cervical dystonia, blepharospasm, strabismus (“crossed eyes”), etc.
Q.How long does Botox last?
A. Generally 3 months but in some people it can last as long as 6 months
Q. How can one be sure that one is getting true Botox rather than the generic form?
A. Go to a reputable physician certifed by the American Board of Plastic Surgery
Q. How is it that some places are giving what seem to be extreme discounts on Botox? Is there a danger to going to a less expensive provider? How much should it cost?
A. They simply dilute it more – effectively a shell game. They give you much less Botox and actually charge more per unit, but many patients only look at the absolute price rather than what they are actually paying for. Botox typically ranges $12-16/unit – be careful because cc’s or ml (volume) are used to confuse patients

I will be following up with a few more questions and answers with the next blog… to follow this up I will be going in as if I were having a consult of my own! That way any of yall who are too scared to check it out can take a walk in my shoes. I’m SO looking forward to bringing yall on this journey with me!