Friday, September 08, 2006

Botox or Restylane? Don’t get worry lines choosing between them

by Theresa Shadrix
LongLeaf Style
September 2006

If crow’s feet and laugh lines are mocking you in the mirror, it might be time to consider the secret weapons of the cosmetic elite — Botox and Restylane.

Not new to controversy, Botox has been a hot topic among spa gossipers since its debut 15 years ago because its active ingredient is the toxic food bacterium that causes botulism. But the chatter erupted in July when The Islamist National Fatwa Council advised the Malaysian government to ban Botox for cosmetic use because it contains prohibited substances from pigs, which Islam considers unclean.

Cathy DiRamio, public relations manager for Botox manufacturer Allergan Inc., dismissed the concern, saying the final Botox product does not contain any porcine elements. The manufacturing process uses an enzyme derived from pig’s milk to grow the Clostridium botulinum bacteria which give Botox its activity, but the enzyme is removed during the purification process.

Botox has been approved in more than 40 other countries worldwide “for aesthetic use for temporary improvement in the appearance of moderate to severe glabellar lines (the vertical ‘frown lines’ between the brows),” DiRamio said.

Dr. Shelley Ray, an Anniston dermatologist, said she has injected men and women, ages 18 to 65, purely for cosmetic purposes, and her patients are willing to spend at least $150 per treatment every three months. Repeated treatments are necessary, she said, “because Botox weakens muscles by preventing transmission to the nerve, and since it is a protein, the body tears it down.”

Ray insists Botox injection is a safe and painless procedure. “It is a very small needle, more like a pressure discomfort. It is very low on the pain scale,” she said.

While Botox is a muscle relaxer, Restylane is an entirely different cosmetic approach to wrinkles, serving as a filler in the furrows of the skin. Botox is best suited for the upper face, whereas Restylane is injected into the lower facial extremities.

“It plumps up the folds and corrects facial wrinkles, such as laugh lines around the mouth. The cost of Restylane is $450 per syringe. A syringe usually contains more than one treatment and a single injection typically lasts six months, Ray said. When you buy a syringe the doctor will keep it for you, and subsequent treatments will come from that same syringe until it is empty, Ray said. The number of treatments in a syringe depends on the individual patient.

Before injecting Restylane, Ray cautions patients that they may feel some pain. “It is a thick product, so [injection can be] painful,” she said. However, she administers a topical anesthetic about 30 minutes before the procedure to numb the area. “You don’t feel anything,” she said.

Since Restylane is the new kid on the cosmetic block, with FDA approval in 2003 and its first shipment to physicians in January 2004, procedure numbers were not available.

Ray warns that while the injections are non-surgical, both Botox and Restyland are to be administered by qualified professionals, which include ear, nose and throat (ENT) specialists, plastic surgeons, ophthalmologists and dermatologists.

Those seeking a youthful appearance may be confused about which product is best suited for them, but Ray said she injects Botox and Restylane at the same time, and it doesn’t have to be an either/or situation.

“We do consultations all the time where a patient simply comes in and asks what I can do to help them.” If in doubt about your laugh lines, crow’s feet and facial wrinkles, she said, all you have to do is ask.

Longleaf Style managing editor Theresa Shadrix is not yet a candidate for Botox or Restylane — which means she can spend more on shoes.