Injecting botulinum toxin A (BTA), or Botox, into the stomach had been believed to delay emptying of the stomach, increase feelings of fullness and reduce body weight. Researchers enrolled 60 obese patients in a 24-week, double-blind, randomized, placebo-controlled, concealed allocation trial to compare the effects of BTA to placebo. They found that the injection slowed movement of food through the stomach but it did not cause weight loss.

“On the basis of our findings, I would not recommend gastric Botox injections to people who want to lose weight. There are some risks with this treatment and we found that there was no benefit in terms of body weight loss,” said Mark Topazian, lead author of the study and professor of medicine in the Department of Gastroenterology and Hepatology at the Mayo Clinic, Rochester, MN.

A previous study had indicated that Botox was a promising weight loss option. This study invalidates those findings because it is larger, used ultrasound to ensure injections were properly placed, and limited bias by ensuring that neither physicians nor patients knew who received Botox and who received placebo injections.

“Unless future studies show different results I’d advise patients to seek other means of achieving weight loss,” said Dr. Topazian.

The popularity of neurotoxin and soft tissue filler injection procedures rose nearly 400% during the past decade, according to the American Society of Plastic Surgeons. The Ouchless® Needle eliminates waiting time, works to instantly reduce the pain associated with an injection, minimizes post-injection numbness, swelling and bruising, and provides patients a far superior injectable treatment experience. While numbing creams can take up to 40 minutes to work and may cause face discoloration, the Ouchless® Needle delivers a short spray of FDA-compliant blend of vapocoolant onto the skin before the skin is pierced. The vapocoolant spray immediately refrigerates the skin, reducing the feeling of needle penetration and making the injection more comfortable. The Ouchless® Needle Collection is available in models to work with most commonly used cosmetic injection syringes.

Increasing uses of injectables for cosmetic advantages – both dermal fillers and neurotoxins – translate to increasing potential for mishaps. Properly and safely injecting filler materials or muscle-paralyzing toxins takes skill and knowledge of the anatomical tissue components beneath.

Although physicians in plastic surgery and dermatology have the most specific training with facial skin and underlying structures, exact behavior of injectable materials and how they integrate with and around those structural components has increased the need for a more complete understanding of exactly where these new placements would be the safest and the most effective in producing the desired effect.

The danger zone nerves and critical arteries present potential unacceptable outcomes for patients if these fragile structures are damaged. Avoiding these areas while delivering desirable cosmetic outcomes is a marriage of skill, knowledge and conservative decisions…and an intimate knowledge of skin and muscle anatomy, such as this workshop provides.

Dr. Pilest noted, after completing the workshop, “As a physician, this was an enormously educational opportunity. But, the real beneficiaries of these activities are the patients who place their trust in the physician who wields the needle.

“It is nothing more than our duty as doctors to seek as much precision training as exists to make sure our patients’ safety remains paramount. This workshop has exceeded my anticipation and I am grateful to my respected peers who made this possible. I wish it were mandatory for every injector in the country.”

As an injection trainer, Dr. Pilest sees emerging techniques with existing and forthcoming dermal fillers which can not only fill lines and stop frowns, but actually recontour the shape of the face to achieve a more balanced and ultimately more vibrant appearance.

Sponsored by the Postgraduate Institute for Medicine and Docent, LLC, the workshop is described: ” New Paradigm in Surgical Anatomy Instruction….the first of its kind Human Cadaver Facial Dissection Workshop is a unique, full face surgical anatomy and injection course designed to improve the safety of botulinum neurotoxin and dermal filler injection procedures.

“Human Cadaver Facial Dissection Workshop incorporates both cadaver dissections and patient injection demonstrations to provide clinicians with comprehensive practical instruction on the complex anatomic structures of the face. Meticulous head dissections will be utilized to examine anatomic planes, fascia, muscles, nerves, arteries and veins.

“Human Cadaver Facial Dissection Workshop will allow viewers to actually see and understand the relationships among anatomic structures that are quite small, inaccessible, often poorly taught and frequently misunderstood. Armed with this practical knowledge, clinicians will be in a better position to avoid anatomic neurovascular danger zones during botulinum neurotoxin and dermal filler injections.”

The workshop was two-part. A presentation to the attendees as a group was first; then small 4-5 physician groups were assigned to a specific instructor for precise close up view and interaction.

Injection demonstrations on cadavers allowed attending physicians to see “into” the skin and where and how injectables might compromise delicate arteries or nerves; as well as how to prevent compromise and steps to take when it’s recognized a problem occurred.

Follow-up live patient injections then reinforced the open-cadaver injection techniques, demonstrating needle angles, palpable “danger zone” nerves and arteries and how to achieve the best results for correctable patient concerns.

As a professional speaker and injection trainer himself, Dr. Pilest applauded the Institute for developing such a critically valuable program. “Every single aspect of this type of education deserves the serious attention of all doctors and other providers who deliver dermal fillers and toxins. “

The approval of Xeomin is based on the results of two pivotal U.S. clinical trials involving 16 investigational sites and included 547 healthy adult patients. In both studies, Xeomin significantly improved the appearance of glabellar lines 30 days following the first injection, when compared to placebo. Xeomin is the only botulinum toxin currently approved in the U.S. that does not require refrigeration prior to reconstitution.

Xeomin works by softening lines and wrinkles, by blocking the signals from the nerves to the muscles, and as a result, the targeted muscle cannot contract. The effects of Xeomin occur within one week, and the results last from three to six months, making it comparable to Botox in terms of both onset and duration of actions.  Xeomin should not be used interchangeably with other botulinum products.

Botox, Dysport and Xeomin have a lot in common, but they also have some important differences. Unlike its predecessors, Xeomin does not need to be refrigerated. This may be an advantage when it comes to distribution. What’s more, Xeomin is “naked.” There are no additives — just botulinum toxin type A. This may lessen a patient’s likelihood of developing antibodies to Xeomin. When your body senses a foreign invader, it responds by creating antibodies and launching an attack. If this were to occur with a neurotoxin such as botulinum toxin type A, it may not have its desired effects.

When looking for a place to get Xeomin, look for a place who uses a wide variety of injectables such as Xeomin, Botox, Juvaderm, Radiesse, and Restylane.  At FACE, our Injection Specialist has worked under Top Docs and trainers, and focuses on liquid face-lifts to restore a synergistic and youthful appearance to the skin.

The IAPAM’s Symposium is the only program which gives physicians an opportunity to learn from two board-certified dermatologists, who are true experts of the skin and cosmetic injectables. In order to ensure doctors learn the best injection techniques, the botox ® training is done in a medical practice, not in a hotel room chair. In addition, the Symposium does not allow exhibitors, giving physicians more time for education.

Physicians who attend the IAPAM’s Aesthetic Medicine Symposium can revisit their educational experience by using the IAPAM’s NEW 3 comprehensive clinical training DVDs. This DVD set offers focused instruction and demonstrations on Botulinum Toxin Botox ® Injection Techniques, Dermal Filler Injection Techniques, Chemical Peel Techniques, and Microdermabrasion Techniques.

The three DVD’s cover three key anti-aging treatment areas:1. Botulinum Toxin for Cosmetic Patients lecture.2. Botulinum Toxin and Dermal Fillers for Cosmetic Patients – live demonstration.3. Chemical Peel and Microdermabrasion live demonstration of techniques.Equally, Symposium attendees receive 16 Cosmetic Practice training DVDs. These resources allow physicians and their staff to re-immerse themselves in the IAPAM’s training at their convenience.

The popularity of the IAPAM’s Aesthetic Medicine Symposium is consistent with the demand by physicians for expert and accredited cosmetic injectable training. Jeff Russell, Executive Director of the IAPAM has witnessed the tremendous growth of minimally-invasive modalities.“We are hearing from our members that minimally invasive procedures like botox ®, dermal fillers as well as microdermabrasion have exploded in demand, and we are seeing a correlating increase in the demand for our botox ® training. Moreover, physicians are realizing they not only need to offer botox ® treatments to their patients, but also laser hair removal, IPL skin rejuvenation, chemical peels, and microdermabrasion, and organizations like the IAPAM educate doctors on how to package treatments for the most appealing and profitable outcomes.”

“Besides creating beautiful smiles, we like to create harmony between the dento-facial complex by addressing the deep lines and wrinkles in the face that can prevent our patients from looking their best,” said Singh.  ”Soft tissues that ring the mouth are as important as perfectly restored teeth for an attractive and confident smile,” said Singh.

Botox is a natural and purified protein that relaxes facial muscles by blocking nerve impulses.  Once the muscles are at rest, the skin becomes smoother, creating a more natural and relaxed appearance.  The effects last about three to four months and patients feel little, if any, discomfort after the procedure.

For older dental implant patients with facial aging, the corners the mouth begin to turn down and wrinkles appear around the lips.  ”Botox can be used by dentists to relax affected muscles to raise mouth corners and smooth wrinkles to assure successful and satisfying outcomes,” said Singh.

Dermal filler agents, such as Restylane, treat fat and collagen volume loss due to the aging process that causes static lines to develop.  ”As we age, our body’s production of Hyaluronic Acid (HA), the body’s natural filler decreases, which causes facial lines to appear,” Singh explained.  He added that it takes about two weeks for dermal filler agents to show results and some patients experience side effects, such as localized pain, infection, bleeding, swelling, redness, bruising and tenderness in and near the injection site.  Results are not permanent and injections will need to be repeated periodically to maintain the cosmetic improvement.

An estimated 8 percent of dentists in North America now provide Botox and dermal filer cosmetic treatments for patients and the number is growing, as state dental boards lobby to allow dentists to use the agents for cosmetic dentistry.

“Facial volume restoration is the future for the achieving optimal aesthetic outcomes in the delivery of cosmetic and restorative dental care,” said Singh.  ”Dentists have as much training and knowledge in the oral and maxillofacial area as dermatologists and other providers, so they, with proper training, can be as proficient in administering these agents,” said Singh.

IAPAM trained physicians are comprehensively educated in all cosmetic injectable outcomes.

Physicians should complete a comprehensive, clinical training program like the IAPAM’s Aesthetic Medicine Symposium or Advanced Botox/Dermal Filler Bootcamp, to ensure they are expertly trained in botox and other minimally invasive treatments. This translates into ensuring that they are trained in the latest injection techniques, how to safely source Botox, dermal fillers and other injectables, and are comfortable with dealing with any possible adverse event due to these procedure. Also, by becoming a member (http://www.iapam.com/aboutiapam/membership) of the IAPAM, physicians are recognized as a member of an internationally accredited aesthetic association.

The IAPAM’s Aesthetic Medicine Symposium training includes:

• dedicated instruction from board-certified dermatologists, who are true experts of the skin and cosmetic injectables;
• hands-on practice in the best injection techniques;
• botox ® training at a multi-million dollar medical practice, not in a hotel room; and
• an environment that does not allow exhibitors, giving doctors more time for education.

For additional information or to register for the next Aesthetic Medicine Symposium with Botox ® training session, please contact the IAPAM, at 1-800-219-5108 ext. 704, email info@theiapam.com or visit http://www.aestheticmedicinesymposium.com/registration.

Botox, Botox Cosmetic and Juvederm are trademarks of Allergan, Inc. Dysport, Restylane, Perlane are trademarks of Medicis, Inc.

Xeomin®, a Merz Aesthetics product, is being referred to as the “naked injectable” by physicians because it does not contain any additives or complex proteins. The benefit of this, according to Dr. Bruce Katz, Clinical Professor of Dermatology at The Mount Sinai School of Medicine and Director of the JUVA Skin & Laser Center in New York, is that the body is less likely to have an adverse reaction to the treatment than with Botox®. Side effects and efficacy are expected to be similar to other botulinum toxin products.

“We are thrilled to have another highly effective botulinum toxin available to treat frown lines – which is still one of the most commonly treated areas here at JUVA,” said Dr. Bruce Katz. “By being selected to offer this cutting edge product to our clients as early as possible the JUVA Skin & Laser Center is once again at the forefront of the latest advancements in skin treatment.  We expect that the availability of Xeomin® will offer even more safety assurance to patients opting for this type of an injectable treatment and ultimately create some friendly price competition among its competitors.”

Xeomin® was approved by the United States Food and Drug Administration (FDA) in July for the temporary improvement in the appearance of moderate to severe glabellar lines, more commonly known as frown lines between the eyebrows, in adult patients.   This approval was based on two clinical trials that found that Xeomin® significantly improved the appearance of glabellar lines 30 days following the first injection.

Xeomin® will be available in dermatology offices around the United States in the spring of 2012; however, JUVA Skin & Laser Center will be offering the treatment as early as November 2011.  It is also approved for the improvement of glabellar lines in 14 countries in Europe under the brand name Bocouture.

Juvederm derma fillers are derived from the hyaluronic acid which is naturally produced in human body and helps to hydrate your skin. The derma fillers are injected directly into the skin, filling up the wrinkle areas, making your skin appear a lot smoother and younger. The changes can be noticed visibly within few hours after injection.

The treatment procedure is quite popular across the globe since it takes less time and shows results almost immediately. At present, there are 2 kinds of Juvederm- Ultra Plus and Ultra. The Ultra functions to add volume to the facial folds and to minimize wrinkles. On the other hand, the Ultra Plus comes with a powerful formulation which is especially designed to remove the deeper wrinkles, folds and to add volume.

The whole process of treatment takes just 15 minutes of time and you can notice the changes immediately. As the results are noticed immediately and you do not have to require getting a surgery done are considered the two major reasons why this skin treatment is so much popular. The effects are found to be long lasting when compared to the other similar treatments available in current marketplace. The best thing is that you don’t require revisiting your skin clinic for touch up.

According to reports, the effects of the injection usually last for more than a year, offering you more time to enjoy effects on your own appearance. The formulation includes lidocaine which makes the procedure less painful. The injection should be administered by skilled professionals also to make the whole experience free of pain. Even the treatment takes 15 minutes of time and it doesn’t interfere with the normal schedules of a person.

As far as the current anti-wrinkle treatments are concerned, Juvederm turns out to be one of the most useful non surgical options. It has been successfully used for eliminating the wrinkles, fine lines and the naso labial folds. This treatment is completely safe for all types of skin and leaves your skin glowing without any side effects.

In that time, women’s perceptions of BOTOX® Cosmetic have changed, and Allergan, Inc. NYSE: AGN, maker of BOTOX® Cosmetic, is sharing key data on these changes:

• The number of women considering talking to their doctors about BOTOX^® Cosmetic treatment more than quadrupled from 1.3 million in 2002 to 5.8 million¹ in 2010.
• The number of women who think that BOTOX^® Cosmetic is an effective means for treating frown lines between the eyebrows has increased from 21 percent when the product was approved to 79 percent in 2010².

Moreover, the BOTOX^® Cosmetic patient profile has evolved and today’s “typical” patient is a highly educated, working woman in her 40s. Sixty-four percent of BOTOX^®Cosmetic patients hold a four-year college degree or a post-graduate degree, and 74 percent work a full- or part-time job. Women have also become more open about treatment; in fact, 90 percent of women who have been treated with BOTOX^® Cosmetic say they would recommend treatment to a friend.

“Women’s understanding and appreciation of BOTOX^® Cosmetic has significantly evolved over the past decade, and as the market leader, we continually invest in educational initiatives that provide women with relevant information they need to make well-informed decisions about treatment,” said Colleen McKenna, Senior Marketing Director, Allergan Medical. “Our partnership with actress Courtney Thorne-Smith and the non-profit organization HealthyWomen is our latest initiative to address pressing questions women have about medical aesthetic injectable treatments like BOTOX^®Cosmetic.”

Allergan and HealthyWomen, the nation’s leading independent health information source for women, conducted a Harris Interactive^® nationwide survey to identify the most common questions women have about medical aesthetic injectable treatments. Courtney Thorne-Smith validates she had many of the same questions before she was first treated with BOTOX^® Cosmetic.

“I’ve been treated with BOTOX^® Cosmetic for nearly 10 years, and while I think it’s become more mainstream, many women have the same questions I initially had,” said Courtney Thorne-Smith. “It’s important for women to understand there is nothing wrong with considering BOTOX^® Cosmetic treatment. There may still be a taboo about this, yet women need to know about resources that address their questions,” added the 43-year-old actress who received a Screen Actors Guild Award for her outstanding performance on Ally McBeal and appears on Two and a Half Men this season.

“With other injectable treatment options now available, it is more important than ever that women not confuse other products with BOTOX^® Cosmetic, or assume they are the same, because each has a unique safety and efficacy profile,” added McKenna. “Allergan understands what is important to physicians and consumers who want aesthetic treatments, like BOTOX^® Cosmetic, rooted in science.”

“For me, I like that BOTOX^® Cosmetic is not a new treatment. My physician has a lot of experience with BOTOX^® Cosmetic and has treated me for many years, so I am consistently satisfied with my results,” said Thorne-Smith. “Through this initiative I am able to help provide women with accurate answers to their own questions, and underscore the importance of going to a trained and qualified doctor for treatment.”

“Many women have questions about medical aesthetic treatments and want to be better informed,” said Elizabeth Battaglino Cahill, R.N., executive director of HealthyWomen. “Our website, HealthyWomen.org, can help women find answers to the most common questions about these treatments, and also provides important considerations for visiting a trained, aesthetic-specialty physician.”

According to the survey of 826 U.S. women ages 35 to 65 conducted by Allergan and HealthyWomen, the most common questions about medical aesthetic injectable treatments, like BOTOX^® Cosmetic, include:

1. Are these products safe? Each aesthetic injectable treatment has a unique safety and efficacy profile and treatments are not interchangeable. For every injectable treatment, including BOTOX^® Cosmetic, it’s important to review the Important Safety Information and Medication Guide with your physician as serious side effects can occur. The most common side effects include pain or temporary bruising at the injection site, temporary tiredness, headache and nausea.
2. How much do these treatments cost? Cost varies across the country based on a number of factors. According to an American Society of Plastic Surgeons survey, the average cost of BOTOX^® Cosmetic is approximately $400 for treatment of the glabellar lines between the brows.
3. Will my face still have expression? Injectable treatments such as BOTOX^®Cosmetic should not radically change one’s appearance. When BOTOX^® Cosmetic is administered by an experienced physician, a person can still frown and look surprised without those moderate to severe lines – also known as the “11” – between the brows.
4. How long does treatment last? Minimally invasive treatments are temporary.BOTOX^® Cosmetic treatment effects can last up to four months.
5. Is treatment painful? Discomfort associated with the injection is usually minimal and brief, and your physician may apply an ice pack or anesthetic cream.