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Last year, 4,329,180 aesthetic BOTOX® treatments were administered to women in the United States to relax their forehead frown lines. The side effects to these treatments have been minimal to non-existent. Slight bruising or swelling at the injection site, if any, has been found to resolve within twenty-four to forty-eight hours. Occasionally, an eye has temporarily drooped after forehead injections, but also resolves within a period of a week or two. But there have been no reports of any effects on the central nervous system. And as far as risk of death from Botox Cosmetic, the FDA confirmed that: "There has never been a reported death where a causal link to BOTOX® (Botox Cosmetic) was established." But new fears about BOTOX® surfaced recently after an Italian study reported in  the April 2 issue of the Journal of Neuroscience revealed that when botulinum toxin, type A (the active ingredient in Botox), was injected into one side of adult rats' brains, minute particles of protein in the toxin were found in the other side of the brain. The media went wild with headlines such as:  Botox Causes Brain Damage.

Although the injections the rats received consisted of purified botulinum toxin, NOT BOTOX®, it is not surprising that many BOTOX® users panicked, fearful that they were now at risk for brain damage. But the study did not suggest that at all and was not designed to test the safety of these aesthetic treatments. “I don’t think fear is warranted,” said Matteo Caleo, a coauthor of the study and a neuroscientist at the Neuroscience Institute of the National Research Council in Pisa. “I would not recommend that someone stop treatment.”  

American doctors with long experience treating patients with BOTOX® are not alarmed by the study. “There is nothing in this paper that says these injections will damage neurons or that there are long-term side effects,” says Gary Borodic, a Boston ophthalmologist and senior surgeon at Harvard, who has no association with Allergan, the manufacturer of Botox and Botox Cosmetic. The safety of Botox Cosmetic (BOTOX  is supported by large-scale clinical studies and hundreds of scientific articles. And one small study in rodents cannot discount decades of safe use. “The drug has a proven safety record for cosmetic injections,” says Borodic. In all the time it has been in use, we have seen no chronic negative effects.  

In Part 1 of my article, Botox and Brain Damage - Hogwash or Science? I explained that botulinum toxin, type A, (the active ingredient in Botox), when administered for the treatment of medical conditions, is over 20 times the strength of that administered to soften facial wrinkles. Critics claim that BOTOX is a cash cow for doctors, so they don't reveal the possible dangers or side effects. After speaking with some highly qualified practitioners whom I deeply respect, I have washed those concerns from my mind, and you can too! Trust me, qualified practitioners are not looking for trouble. Their reputations and ultimately the vitality of their practices depend on ethical behavior and sound professional judgment, based on scientific evidence: carefully structured relevant studies, historical data, statistics, and peer review.
So if you are thinking about BOTOX and have passed the little self-quiz found in Part 1, let's talk about what to do next.  

Here is my best advice:
First, put your safety worries to rest and then concentrate on finding a competent practitioner. Doctors in many fields of medicine have suffered severe financial repercussions from the dual impacts of managed care and skyrocketing insurance rates, while those practicing aesthetic medicine continue to reap financial rewards. As a result, a number of doctors of diverse disciplines (and even some without any MD credential) are taking weekend courses and suddenly transforming themselves into practitioners of the aesthetic arts. Although BOTOX is not surgery, it is still a medical procedure that requires skill and experience. Forget the BOTOX parties and shop-at-the-mall BOTOX.  

My philosophy for whatever it's worth: Spend your time doing research to locate one of the best qualified practitioners in your area. Get referrals from friends and physicians, just as you would for any other medical treatment. Learn who is admisistering Botox on a regular basis. Both training and experience count. It's great to hunt for bargains at Marshall's, but look for expertise for your BOTOX treatments.

We want to learn about your Botox experiences. You can send your private message to us at [Link Removed]  

Lois is the author of the award winning book, SEX, LIES AND COSMETIC SURGERY, the author of the feature article for the LI Beauty Guide Annual Edition (three years running) and the creator of her own Health and Beauty Newsletter.
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