Smoothing the Fault Lines
When it comes to cosmetic botox treatment, the devil is in the details
Since the federal investigation, Allergan has made it easy for patients to make sure they're getting the genuine thing. Every Botox vial now has a hologram that says "Allergan" on it and a flip-top cap emblazoned with the company's name. If you decide to go under the needle, do your own quality check. "Ask to see the bottle," says Richard Glogau, a clinical professor of dermatology at the University of California-San Francisco, "then watch the doctor draw the medicine in front of you."
In addition to using authentic Botox, picking the right practitioner to administer the injections is critical to achieving a safe and aesthetically pleasing result. You can't trust someone just because he or she has a medical degree, though there are plenty to choose from these days. Doctors of all types, from dermatologists to gynecologists, are hanging out a shingle and offering cosmetic procedures from chemical peels to laser resurfacing to Botox. In general, doctors aren't required to undergo any special training before performing these procedures. What's more, in many offices, nurse practitioners, registered nurses, physician assistants, and other non-M.D. staffers may be giving treatments.
The good news is that even if you are treated by an inept technician, you'll almost certainly suffer no permanent harm, though you may have to deal with a droopy eyelid or frozen forehead for a couple of months until the Botox wears off. But why spend an average of $300 to $500 a treatment to look like a Stepford wife? Achieving a natural look that allows expressiveness while smoothing away wrinkles is your goal, and the more familiarity your practitioner has with how faces work, the better your chances of attaining it.
Those with the most extensive training in the musculature of the face are M.D.'s in the specialties of dermatology, ophthalmology, and facial and general plastic surgery. Ask your doctor what training he or she has had in the specific procedure you're considering, how many years the doctor has been performing it, and how many patients he or she has treated with it in the past year. Ideally, you want someone with extensive training (more than a weekend course) who has been performing the procedure routinely for at least a couple of years, say experts.
Nurse practitioners, registered nurses, and physician assistants who've taken courses in cosmetic procedures and trained extensively with a doctor may be competent practitioners as well. Ask the same questions about experience, and make sure a doctor will be on the premises when you're having a treatment, says Glogau. Although side effects are rare, people sometimes get lightheaded or faint during the procedure, have an allergic reaction, or bruise or bleed.
If Dysport is approved in the United States as expected in the next couple of years, patients will be able to pick their poison, and the price will probably come down. But for now, choosing an experienced professional and making sure the real thing is being used are your best bets for ensuring that your Botox treatment succeeds without a wrinkle.
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