Eye Didn't Know!

Longer, Thicker, Darker Eyelashes With Latisse®

Did you know? Latisse® is the new prescription medicine for growing longer, thicker eyelashes. Patients are already coming to my office and asking for it. The aesthetician in my office has been using it for a number of weeks and already reports a noticeable difference in her eyelashes.

Latisse® was developed because of a side-effect of a commonly used eyedrop for glaucoma. I can always tell if these patients are using their drops because their lashes are thicker and longer! Allergan decided to reformulate this medicine into a liquid which can be applied to the base of the upper eyelashes. In their clinical trial of 278 patients, 79% of patients noted thicker, longer and darker lashes at week 20 compared to 20% using a placebo. The majority noted improvement after two months. 

The eyelashes gradually return to their baseline appearance after discontinuing the medicine.

There is a theoretical side-effect of permanent darkening of the iris (the eye color), though this did not happen in the clinical trial, and is unlikely to occur if the medicine does not enter the eye. There is also the theoretical side-effect of reversible skin darkening, but this did not occur in the trial either.

Did you also know? Allergan, the makers of Latisse®, also make BOTOX® and Juvederm®. I enjoy using all of these products in my practice, and my patients enjoy looking younger, with a natural appearance.

Botox® Competition Soon

Did you know? Botox® has been a mainstay in non-surgical facial enhancement for over a decade, and has proven safe and effective. Every year we find more ways to use it (for example, to raise the corners of a downturned mouth, or soften the lines around the mouth). In the next one to seven years, expect to see up to three Botox®-like compounds approved for use in the United States.

The first compound likely to appear is Reloxin®, available now in Europe under the name Dysport, made by the Medicis Corporation. Also in the pipeline are Purtox®, by the Mentor company, and Xeomin®, by the Merz Corporation. It is expected that differences between the compounds will be relatively small. It will be interesting to note whether or not competition will result in a decrease in price.

Did you also know? Ophthalmologists were the first to use Botox both therapeutically and cosmetically. It was first used to weaken the muscles in certain cross-eyed conditions as well as to weaken the muscles in a condition called blepharospasm, where affected patients involuntarily squeeze their eyes shut.

I first used Botox® 15 years ago for patients with blepharospasm. My staff members would ask me to treat their wrinkles with the leftover medicine. Quickly they told my patients, and now it is a large and rewarding part of my practice!

Botox: No Sweat!

Did you know? There a many people who are incapacitated by excess sweating. Antiperspirants are of little help, and they avoid social or public situations due to embarrassment. Botox can help! Sweat glands are triggered by nervous impulses carried by the chemical acetylcholine. Botox blocks the release of this chemical, so sweating is reduced! It really works! The injections are nearly painless. The effect usually lasts for six months, but some people respond for 12 to 18 months. The cost is approximately $1000.

Did you also know? The list of indications for Botox continues to grow, both cosmetic and medical. I started injecting Botox twelve years ago for patients with blepharospasm, a condition of severe involuntary spasms around the eyes. My staff and patients asked for cosmetic treatments, and now it is a large and very gratifying part of my practice! I am now treating excess sweating as well and look forward to helping more patients.

Dermal Fillers for Facial Sculpting

Did you know? Many patients are familiar with the use of dermal fillers, such as Juvederm, Restylane, and Prevelle, to fill nasolabial folds to give a more youthful appearance. That is just the beginning! Before deciding what treatment is best, it is necessary to use a mirror and evaluate the entire face. Even more common than a prominent nasolabial fold is volume loss of the upper cheek. A youthful face is shaped much like a heart, while an aging face tends to have a hollowed look in the mid and upper cheek. Filling this area with volume can work wonders for restoring a youthful appearance. The lips, as well, flatten with age. Adding a touch of volume and definition to the lips can take years off of a woman's face.

Did you also know? Similarly, Botox is not reserved for the upper face. I frequently use a very small amount of Botox to smooth the skin around the lips and even to raise the corners of a downturned smile!

Prevelle

Did you know? There is a new dermal filler available called Prevelle, made by the Mentor corporation.

Prevelle has a number of advantages. Compared to other dermal fillers, Prevelle is more comfortable, and it is less expensive. It is made of hyaluronic acid, a natural substance found in skin, similar to Juvederm Ultra and Restylane. It is designed, however, to last approximately as long as Botox treatments last, which is approximately three to six months.

So far, my patients love it! They report that it is much more comfortable being injected (it contains an anesthetic in the filler), and it is very smooth. Time will tell how long it lasts.

I see it as the ideal introductory filler. Since the cost is about half of the longer lasting fillers, it is not such a large initial investment. If you like the results, you can continue using it, or perhaps opt for a longer lasting filler, if desired. If you don't like the results (that's never happened in my practice!) it will wear off. Also, for those patients who think other products are uncomfortable being injected, this product causes much less discomfort.

Did you also know? Mentor also makes Puragen, a thicker product (like Juvederm Ultra Plus) but is not yet available in the United States.

BOTOX®: No Sweat!

Did you know? BOTOX® is well-known for its ability to decrease wrinkles and give a more relaxed appearance to the face. Few people know that BOTOX® is used for dozens of medical conditions, as well. BOTOX® works by decreasing the release of a substance called acetylcholine from nerves. This substance causes muscles to contract, which is why treatment with BOTOX® relaxes the muscles which are responsible for some wrinkles.

Acetylcholine is also responsible for sweat gland activity. There are some patients who are disabled by severe underarm sweating. For this condition, called hyperhidrosis, treatment with BOTOX® in the armpit can markedly improve symptoms. There is a society for those with severe sweating, whose website is located here.

Did you also know? Some insurance companies will pay for treatment of hyperhidrosis.

Custom BOTOX®, Not Cookbook BOTOX©

Did you know? As the holiday season gets into full swing, I am performing more and more BOTOX© Cosmetic procedures, as patients wish to look their best. My patients are pleased that I customize their BOTOX© treatments to their individual faces. I give each patient a mirror, and we talk about areas that can be treated. Sometimes I point out areas to avoid or treat only lightly to avoid side effects like a droopy eyebrow. I then customize the treatment to their unique needs. Rarely do two faces receive the same treatment.

Most patients are aware that BOTOX© can treat frown lines, forehead wrinkles and crow's feet. Few are aware, however, that an experienced physician can use BOTOX© to give a non–surgical eyebrow lift, soften "bunny–lines" in the nose, smooth out fine lines around the lips, smooth a dimpled chin, raise a downturned smile, and soften neck bands.

Did you also know? BOTOX© was originally used by ophthalmologists to treat spasms around the eyes and crossed eyes. It was soon noted that it could relax wrinkles, and a new industry was born!

I started using BOTOX© over ten years ago to treat spasms around the eyes. My staff asked me to treat their wrinkles, told my patients of their results, and soon I found myself performing BOTOX© cosmetic treatments. I find it to be very gratifying.

BOTOX®

Did you know? BOTOX®, known by many as a cosmetic wrinkle-reducer, has dozens of medical applications? BOTOX® works by relaxing muscles, decreasing the release of a substance called acetylcholine. It is used therapeutically in virtually every condition which involves overactive muscles, ranging from muscle-spasm in stroke patients, cerebral palsy, neck pain and TMJ (temporo-mandibular joint disorder). It is used for straightening lazy eyes (strabismus), and relaxing the muscles around the eyes in blepharospasm, a disabling condition which causes uncontrolled squeezing-shut of the eyelids. It is also used for excessive sweating, inability to swallow (dysphagia), and writer's cramp.

Did you also know? For ten years, I have diagnosed and treated many patients with blepharospasm, none of whom knew there was any treatment available. Early on, my staff encouraged me to use BOTOX® cosmetically as well. I quickly discovered how gratified patients are to receive its cosmetic benefit. Expect BOTOX® to give a relaxed appearance, not to completely eliminate lines or expression. As well as relaxing the muscles between the brows, it can relax the forehead, crow's feet, fine lines under the eyes, and even fine lines around the lips.