When it comes to BOTOX®, you'd be hard pressed to find someone more educated on the nonsurgical cosmetic practice. Former president of the New Zealand College of Appearance Medicine and a physician trainer for Allergen - the company that makes BOTOX® - Dr Teresa Cattin has been teaching appearance medicine techniques on using BOTOX® for the past 10 years. bd sat down with Cattin to discover all the ins and outs of BOTOX®.
Skin needling has become a popular anti-ageing treatment recently. How does BOTOX® compare with skin needling?
Skin needling in various forms has been available for many years, with the most recent version being the Dermapen. The principle behind skin needling is exactly the same as the principle behind peels and laser rejuvenation - when an injury is inflicted on the skin (be it with heat, chemical or needles), the healing process involves an increased production of collagen which may subsequently appear to reduce fine lines and improve skin texture.
BOTOX® is completely different to skin needling in that it softens dynamic lines (i.e. lines caused by repetitive muscle movement) by temporarily relaxing the muscle causing the lines, allowing the overlying skin to undergo repair. Apart from softening dynamic lines, BOTOX® can also be used to lift the brow to give a fresher” appearance, shape the eyebrows, lift a sagging jaw line, lift the corners of the mouth, soften neck lines and even reshape the face. BOTOX® really is the cornerstone of nonsurgical cosmetic practice as there is so much we can do with it.
What is BOTOX® derived from?
BOTOX® is a highly purified naturally occurring protein. It is derived from bacteria in a laboratory in much the same way penicillin is derived from mould. It is a prescription medicine and it does not contain the bacteria or spores which can cause the medical condition known as botulism.
Has BOTOX® changed over the years in terms of longevity and formulation?
BOTOX® was initially developed in the 1970‘s to correct eye squints (strabismus) and was first registered in 1989. There has been no significant change in formulation since its first development 24 years ago. In 1997 there was a small change made to the formulation, with some of the unnecessary carrier protein being removed to make a more pure” product but this had no effect on performance or longevity.
Are there going to be any new developments in BOTOX®?
I hope not! BOTOX® is considered the gold standard” of temporary muscle relaxants. Having used it for over 15 years, I’m very happy with it and can’t think of any way I’d like to improve it. While a number of other companies have tried to produce similar products, none have come near BOTOX® in terms of performance, safety or reliability.
What's the most frequently asked place to have BOTOX® injected?
The most frequently requested area is the upper face. In my clinic, the most frequent complaint I hear is about looking tired” and wanting to look fresher” (not younger!). This is achieved with BOTOX® by lifting the brow to open up and frame the eye area. The second most frequent treatment request would be crows feet. I prefer a very natural” look and believe we should have crows feet when we smile, but they should be around the eye not radiating down the cheek or back to the hairline. BOTOX® is outstanding at keeping crows feet under control by stopping them radiating as well as preventing them from getting worse over time.
Is there anyone that BOTOX® shouldn't be used by?
Yes. BOTOX® is a prescription medicine and there are a number of medical conditions in which the use of BOTOX® would be inadvisable. The most common absolute contraindication is pregnancy and breastfeeding. Like any other medical treatment, the doctor must assess the medical history prior to treatment and discuss potential benefits and risks.
What do you think of skincare companies bringing out products that claim to be the natural alternative to BOTOX®?
The BOTOX® protein relaxes a muscle by temporarily blocking the action of a chemical at the neuromuscular junction and has to be injected to effectively reach that junction. It’s really nonsensical to think that any product applied to the skin could possibly find its way to that junction and block the chemical responsible for muscle contraction as effectively as a neuromodulator.
There is a significant difference between a skincare product/cosmetic and a prescription medicine like BOTOX®. By definition, a cosmetic product does not affect the body’s structure or function” whereas BOTOX®, being a medicine, is unequivocally proven to affect muscle function by temporarily relaxing it.
What are the medical uses of BOTOX®?
BOTOX® has been approved for over 26 cosmetic and therapeutic uses by over 85 regulatory authorities around the world. Basically, every field of medicine regularly uses BOTOX® in some way. Therapeutic uses include blepharospasm (excessive eye blinking), cervical dystonia (a painful twisting of the neck) in adults, and foot deformity due to spasticity in juvenile cerebral palsy patients two years of age or older. Today in New Zealand, BOTOX® is also indicated for spasticity in adults (muscle tightness in the limbs), primary hyperhidrosis of the axillae (excessive underarm sweating), prophylaxis of headaches in adults with chronic migraine, and treatment of urinary incontinence resulting from a defined neurological illness (such as spinal cord injury or multiple sclerosis).
How long has BOTOX® been around for?
BOTOX® is one of the oldest and most widely researched drugs we have in medicine today, with 24 years of patient experience. Extensive scientifically-robust clinical trials involving over 15000 patients have confirmed its safety and efficacy. As a doctor I find this extremely reassuring - there are very few drugs available with this kind of safety data and history. To ensure the best results, it should only be administered by a doctor who has had specific training in how to use BOTOX® correctly and who has the qualifications to evaluate and determine the best treatment for each individual.
Dr Teresa Cattin is also behind the skincare range FaceWorks. Click here to visit the brand listing.