This is the second article in a series about combating the aging process and turning back the hands of time. The “I’m Just Going to Age Gracefully- Part Two” article will eventually follow. Those that know me are aware of the fact that I can be sidetracked easily. This article is a response to a question posed by several readers.

The Medical Mythbusters articles are designed to be interactive, so if you have a question that falls within my purview, don’t hesitate to email. My particular areas of training are encompassed by the 5 A’s- anesthesia, analgesia (pain medicine), aesthetic medicine, aviation and aviation medicine, and ambulance medicine (pre-hospital care). I do not consider myself an expert on Women’s Health, but I am intimately associated with an OB/Gyn. If your question falls outside those subjects, I’ll either phone a friend or tell you I don’t know!

Back to the myth this article addresses- “All Botox Is Created Equal”- right? Not really… Botox, produced by the Clostridium botulinum bacterium, has been around since the dawn of man (possibly a reason for the extinction of dinosaurs-our wrinkles don’t come close to theirs) but didn’t enter the therapeutic arena until the 60’s and 70’s. It was used initially to treat eye disorders such as blepharospasm and strabismus but gradually worked into other areas of medicine (Gastroenterology, Orthopedics, Pain Medicine) before entering aesthetic medicine. Onabotulinumtoxin A (Allergan trade name Botox) is FDA approved for the treatment of chronic migraines and sweating as well as the commonly known frown-lines or Angry-Elevens between the eyes. It temporarily blocks the signaling pathway between the nerve ending and target muscle, thus providing an average of 3-4 months relief from the target muscle group’s action.

Allergan has marketed Botox in the United States since 1989. Recently, it has become available on the black and grey markets. When patients tell me that they tried Botox and it didn’t work I always ask if they were sure it was the real thing. Allergan has a Botox physician locator (www.BotoxCosmetic.com) that can be used to verify that the Botox is genuine. If your doctor’s name or medical practice isn’t listed when you type in the zip code, the Botox can’t be verified as coming from Allergan.

Why is it important to ensure that the product is real? Allergan stands behind its products and will reimburse the practice and patient if there is a problem. Allergan will not guarantee Botox obtained from second or third parties. Botox that comes directly from Allergan is shipped on dry ice to ensure potency. The potency of black market and grey market “Botox” is often a problem as poor shipping and repackaging affects product longevity.

Botox is an excellent product with a long history of safety in aesthetic medicine. My wife says it has improved our relationship as we both find it difficult to scowl at each other. Confirming the Botox you use comes from Allergan will ensure it achieves the desired effect!

Disclaimer: Dr Stephen Rath is the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He doesn’t offer non-Botox relationship advice but he will be happy to help you with your “aesthetic emergencies”! His email address is DrRath@FusionMedicalSpa.net.

Let’s face the truth; aging isn’t graceful! As we get older our bodies lose the ability to recover from damage. Skin loses the resiliency and elasticity it had in youth. I see patients of all ages in my aesthetic medicine practice, but the majority of patients are in their 50’s and 60’s and their chief complaint is “I looked in the mirror one morning and didn’t recognize the face staring back at me!”

We all know that each additional birthday brings more wisdom and experience (in theory) but we often forget about the negative consequences of aging. Our brain actually helps to protect us from the “trauma” associated with looking in the mirror as we age. A good analogy is the difference between the MP3 audio recording format often used in digital music and a phonograph or high definition CD recording. While an audiophile may be able to distinguish between the two formats, most of us don’t notice that we are only hearing approximately 10% of the information contained in the original recording. Our brains do a wonderful job of filling in the difference.

The brain processes the information obtained from our eyes in a similar fashion. How many times have you driven past a sign or road feature (think speed limit sign) and didn’t notice it until a friend (or friendly officer) pointed it out? The brain takes the image obtained from our eyes and if there isn’t a big change, the difference is averaged out. A birthday, or a new skin lesion or blemish may prompt a closer critical look that removes the averaging filter; in which case the brain will compare images archived from the past with the present. Most of the time this will precipitate an “aesthetic emergency” in an effort to return to a previous baseline image. So, if you happen to take a closer look in the mirror one morning, remember that those changes didn’t occur overnight.

This is the first article in a series. See the next article for more information on combating the aging process and turning back the hands of time!

Disclaimer: Dr Stephen Rath is the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He is not an expert on either the music recording industry or vision, but he will be happy to help you with your “aesthetic emergencies”!