Patient Resources – Injectables

RealSelf.com Answers from Dr. Verebelyi

• Can I get imported Botox Cosmetic for a lower cost?
  Unfortunately, the answer is very much no. Your friend’s doctor is doing something both unethical and illegal. The DEA makes it illegal to import Botox or any other injectable from another country because they cannot monitor the product. The other issue is that of counterfeiting, which has become big business around the globe. This is especially true of Botox coming from Canada, Mexico and France. The only way to assure yourself that you are getting the real thing is to copy down the lot number and call Allergan (the manufacturer of Botox) to double check that that particular lot number was delivered to the doctor who injected it. Another tip, make sure that your provider is willing to mix the Botox in front of you (it comes as a dry powder) that way you are assured they are not over-diluting their product.
• Can Botox treat hyperhidrosis?
  Botox is extremely effective for Hyperhidrosis. According to a study published in The Journal of Drugs and Dermatology this year that compared Aluminum Chloride deodorants (Drysol) to Botox, patients had 92% satisfaction with Botox vs. only 29% with the Aluminum Chloride deodorant after four weeks. Injections done by a qualified practictioner cause minimal discomfort and effects normally last about six months.
• Does Botox treat migraines and wrinkles at the same time?
  When treating chronic daily headache or migraines with Botox, most doctors will use a modified “Follow the Pain” approach. Simply stated, if your migraines start out as tension in the middle of your forehead and between the eyes, then these are the areas that will receive some Botox. Treating these areas will also help upper face wrinkles. However, if your headaches normally start in the occipital area (back of the head) or temporal area (side of the head), then there may not be any clinical justification for putting Botox in those muscles of the upper face. Due to the fact that these specific muscles (which cause the wrinkles in the upper face) are not being treated, you should not expect to see any improvement in those wrinkles.
• What’s the best treatment for eye wrinkles?
  Aging, environmental exposure, and muscles that fold the skin around the eyes hundreds of times a day, provide a triple threat to the tissue around the eyes. The results are wrinkles, textural changes, laxity and discoloration. In order to get the best results in this area you need to treat both the skin and the underlying muscle. I start my patients with Botox. This quick, effective and safe procedure treats the muscle under the skin and keeps it from folding the overlying skin. This prevents further damage, gives an immediate decrease in the lines, and provides a slight raise in the lateral height of the eyebrow all without making the face look altered or frozen. Next, I turn to resurfacing in order to address the wrinkles, pigmentation, texture and laxity of the skin around the eyes. We have used Titan, Laser Genesis, IPL, chemical peels, Fraxel and many other modalities all with modest results. The combination of the Active FX with Deep FX (i.e. Total FX) is the only procedure outside of full CO2 resurfacing that I have seen consistently excellent results for fine, moderate and even deep lines. Downtime should range from about five days to two weeks depending on how aggressively your provider performs the treatment.
• Juvederm – what are these white bumps around my lips?
  Juvederm normally shows up as just bumps or slightly bluish bumps. If the bumps are less than 1 mm and white, they are likely sebaceous glands. These are normally present on the vermillion (pink part of the lip) border especially on the upper lip. Usually they are 1 mm or less in size and white to yellow in color. Sebaceous glands make the oil for our skin and occasionally get blocked. It is unlikely that these blocked glands were caused by the Juvederm. They can be removed with aggressive microderm, TCA acid peels, or very minor surgery.