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Michael J. Will, MD, DDS, FACS
Maryland (301) 874-1707

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A FACE LIFT IN TIME FOR THE HOLIDAYS

A Face Lift In Time For The Holidays With Dr. Will

There are just a couple months until Thanksgiving kicks off the holiday season, so you probably don’t want to spend this time recovering from a more invasive surgery to achieve a youthful, holiday look. No, leave the knives behind and learn how you can rejuvenate your appearance with a liquid face lift.

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HOW BOTOX IS BEING USED AS A TEMPORARY ALTERNATIVE TO FACIAL SURGERY

Botox Temporary Alternative To Facial Surgery Maryland

Facial surgery has been extremely popular for men and women between the ages of 40 and 65 as a way to address the various signs of aging. A nonsurgical alternative, Botox procedure, has been popular with those who are not yet ready to pursue a surgical solution. Botox can now address more of these signs of aging with its new FDA approved use: treating crow’s feet.

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New Supplement May Prolong Botox Results

Zytaze
Do you love the effects of Botox, but wish they would last a little longer? Well you’re in luck. A brand new pill called Zytaze promises to do just that.

Botox injections typically last for about 3 months, but the makers of Zytaze claim the new pill can make the anti-aging effects last up to 30 percent longer. Zytaze may also help the injections take effect faster.

Zytaze, which has been manufactured by Eden Aesthetics, contains zinc and an enzyme called phytase which helps the body to properly absorb zinc. In clinical trials, Zytaze was shown to prolong the effects of Botox for 92 percent of patients.

According to zytaze.com, a pack of 10 Zytaze pills costs around $80, which is significantly more expensive than standard zinc supplements. However, Eden Aesthetics claims that Zytaze supplements are specially formulated to complement Botox injections.

The manufacturer recommends that patients take two 25mg pills a day for four days prior to their Botox injections. And because the pill is a supplement rather than a drug, no prescription is necessary.

Dr. Kevin Hancock, a consultant cosmetic surgeon for the British Association of Aesthetic Plastic Surgery Council believes that Zytaze works by speeding up the healing process.

“We do know that zinc is crucial in helping injured patients to recover, for example burns victims, so it’s fundamental in repairing tissue.”

Taking Zytaze may also just be good for your health in general.

“That may well be influencing the action of the Botox. But the pill is just a vitamin supplement and it may be that lots of people are just slightly zinc-deficient anyway,” Hancock told the Daily Mail.

Maryland’s New Rules for Botox Injections, Wrinkle Fillers

New regulations that took effect August 23 in Maryland will help ensure that anyone looking to have Botox or wrinkle filler injections or have laser hair removal in the state can be sure that the person performing the procedure is a physician or medical professional.

Before this regulation, Maryland did not classify these non-surgical cosmetic services as medical procedures, so they were unregulated, according to the Maryland Daily Record.

“The concern was that medicine was changing and there was very little regulation,” said Dr. Lawrence J. Green. “There was no such thing as some of these procedures 10 to 15 years ago.”

The Maryland Board of Physicians spent four years working with doctors from different specialties and the Maryland State Medical Society (MedChi) to come up with the new regulations to protect the public from any possible unsafe procedures.

With the new regulations, these cosmetic procedures are now defined as the practice of medicine and therefore require that they be performed in most cases by a physician trained in those practices. If non-physicians violate these regulations, they can be found guilty of practicing medicine without a license and fined up to $50,000.

“With these procedures, you can be injecting chemicals into your body, and the people doing it should have medical training,” MedChi CEO Gene M. Ransom III said. “It might sound like a simple thing, but it’s not. These regulations clarify who can do them, and who is qualified.”

Also, a physician now has to be on-site in most cases (unless the board of physicians has approved a plan of delegation). Before the first procedure, a doctor must also examine the patient and maintain a medical record.

Dr. Michael Will is a board certified oral surgeon, cosmetic surgeon, and dental anesthesiologist in Frederick County, Maryland, who offers Botox and wrinkle fillers, such as Juvederm and Restylane.

Can Botox be Used to Prevent Wrinkles?

At age 24, Tiffany Rose Goodyear got her first Botox injections to treat forehead wrinkles she says she got by frequently raising her eyebrows. Five years later, she says she is still getting injections to smooth her existing lines and prevent future wrinkling.

While there is no definitive evidence that using Botox to prevent wrinkles is effective, experts say that over the last few years there has been an increase in the number of 20-something patients who are getting Botox or other injectables to try and ward off future wrinkles.

American Society for Plastic Surgeons’ statistics show that in 2010 almost 78,500 people in their 20s received Botox in this country, an 11 percent increase from 2009.

So what do the doctors think? Plastic surgeon Arthur Perry thinks the concept of trying to prevent future wrinkles is “nutty.”

“You don’t want to use a drug unless you need the drug, and Botox is a drug,” he said.

Brian Glatt, a plastic surgeon, finds that regular use of Botox seems to make the muscle-relaxing effect last longer so patients don’t need to come in as often for treatments. This may occur because the muscle undergoes atrophy, or wasting, after prolonged periods of not being used, Glatt said, which could mean that wrinkles wouldn’t form as easily on a young person who has had treatments for years.

In addition, if Botox is used regularly, the wrinkles that return when it wears off may not be as severe, said Glatt.

However, Perry feels that even if Botox was proven to prevent future wrinkles, it should not be used for that purpose. “It makes no sense whatsoever to do that,” he said.

Plastic surgeon Steven Pearlman goes by what you could call the “rest test.” He said to wait until lines show up before getting Botox. The wrinkles must be there when your face is at rest, not contorted through smiling or grimacing, he said. “Unless someone has lines at rest, they’re not a candidate for Botox.”

So what are some of the best ways to prevent wrinkles? Wear sunscreen and avoid smoking, say the experts.

Consumers Choose Hyaluronic Acid Fillers; Collagen Fillers Discontinued

The trend toward hyaluronic acid injectables may be part of the reason that collagen fillers will be gone from the U.S. market at year’s end, reports the latest issue of Dermatology Times.

In late 2009, Johnson & Johnson announced that it was discontinuing its collagen filler Evolence, and in January 2010 Allergan announced it would be discontinuing its collagen line of fillers at the end of the year. Allergan actually halted production of its collagen products in 2009, but manufactured sufficient inventory to meet estimated market demand through the end of 2010, according to Kelly Lao, manager of corporate communications.

“The discontinuation of the sale of our collagen products … is in response to declined market interest … since the introduction of hyaluronic acid dermal fillers like Juvéderm have become more popular,” Ms. Lao says.

“There is an overwhelming popularity of the new kid on the block: the hyaluronic acids. They have been embraced universally, and suddenly collagens aren’t as popular,” concurs Dr. Seth L. Matarasso, a clinical professor of dermatology at the University of California School of Medicine, San Francisco

The popularity of hyaluronic acid products is due to several factors:

  • Longer-lasting results
  • Appear to give a better fill
  • Some contain lidocaine for less painful injections
  • Upcoming improvements will provide more volume and contour-changing ability and the ability to fill deeper lines

Hyaluronic acids products include Restylane, Juvéderm, Radiesse, which are all available at Will Surgical Arts in the Frederick County area in Maryland.

Dermatologists prepare for departure of collagen from U.S. market” is online at Modern Medicine.

XEOMIN Could Bring Competition, Lower Prices

Last year, the FDA gave clearance for XEOMIN, a drug that can treat abnormal neck pain (cervical dystonia) and spasms of the eye.  Made with botulinum toxin type a, XEOMIN has the same active ingredient as the popular Botox® Cosmetic.

At some point, XEOMIN is expected to receive FDA approval for cosmetic use. When this occurs, it could create enough competition in the market to drive down prices on all botulinum toxin injections.

Current treatment prices for Botox® injection range from $9 to $15 per unit, with most patients requiring about 20 units per treatment area.  These prices could drop when XEOMIN receives cosmetic approval from the FDA. Although XEOMIN isn’t believed to be superior, doctors say it could create more options, more competition and thus, lower prices.

Dermatologists on Modernmedicine.com report:

“Current off-label use hasn’t shown any particular clinical advantage for Xeomin over Botox (onabotulinumtoxinA, Allergan) or Dysport, but the new toxin will broaden clinicians’ aesthetic options and may spur price competition in the U.S. “

With another contender in this already competitive market, consumers may see more rebates and more price breaks from the pharmaceutical companies.

XEOMIN is the 3rd botulinum toxin to receive FDA approval in the U.S. The fourth could be PurTox, a drug by Mentor (popular breast implant manufacturer) that is still being studied.

You can read all the facts on the new website XEOMIN.com, including “How XEOMIN works.”

“XEOMIN is injected into muscles to decrease their activity. XEOMIN blocks the release of a chemical messenger—acetylcholine—that conveys the signal from nerve terminals and causes muscle fibers to contract. Not all terminals are affected by botulinum toxin, so the muscles can still contract, just less forcefully. This allows the muscles to contract more normally.”

New Study Examines How Often to Get Botox

After a period of two years undergoing Botox treatments, patients may reduce the frequency of treatments to every six months and achieve the same benefits, according to a study by the Oregon Health & Science University’s Casey Eye Institute that looked at how often to get Botox.

When looking at a group of 50 women, aged 30 to 50 who were being treated for glabellar lines, the study found a decrease in treatments did not yield a decrease in results. The study discovered that after a patient has undergone regular Botox treatments every four months for two years, the frequency can be lowered. The frequency of how often to get Botox may not dramatically effect its effectiveness.

In fact, the study found that patients who had completed the initial two-year treatment and then received Botox injections only every six months achieved similar results. This is when compared to those who continued receiving Botox treatments every three months.

Though Allergan, the maker of Botox, may still recommend continued treatment every three months, those looking for a cost-effective alternative could reduce the number of yearly treatments.

As an added benefit, the study found that the patients in the age group also experienced a reduction in the formation of wrinkles when Botox use was continued past two years.

Does Botox Affect Emotions?

Do people who undergo Botox treatments experience weaker emotions? A new study published in Emotion, a journal of the American Psychological Association, examined if Botox injections have an effect on emotional experience.

In order to test if feedback from facial expressions influence emotional experience, Barnard College Professors Joshua Davis and Ann Senghas, who led the research, compared the impact on self-reported emotional experience of those with Botox injections, which paralyze muscles of facial expression, and a control group with Restylane injections—a cosmetic filler that does not affect facial muscles.

According to the abstract, “When examined alone, Botox participants showed no pre- to post-treatment changes in emotional responses to our most positive and negative video clips.”

However, between-groups comparisons showed Botox participants exhibited an overall significant decrease in the strength of emotional experience.

“With the advent of Botox, it is now possible to work with people who have a temporary, reversible paralysis in muscles that are involved in facial expressions,” said Davis. “With Botox, a person can respond otherwise normally to an emotional event, e.g. a sad movie scene, but will have less movement in the facial muscles that have been injected, and therefore less feedback to the brain about such facial expressivity. It thus allows for a test of whether facial expressions and the sensory feedback from them to the brain can influence our emotions.”

The findings suggest to the researchers that feedback from facial expressions is not necessary for emotional experience, but may influence emotional experience in some circumstances.

Read the “The effects of BOTOX injections on emotional experience” abstract to learn more. Dr. Will offers both Botox and Restylane injections at his Ijamsville, Maryland office.

“Patient care was incredible! We are so very happy our child was referred to Dr. Will. We appreciate the attentiveness given to his medical condition. Will highly recommend to others.”

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