This article is about Botulinum toxin. The author wishes to clarify at the beginning that he has no monetary disclosures in any respect to make for or in opposition to using any specific trade name under which it is bought i.e.Botox, Dysport, Neuronox, etc. Although Botulinum toxin A is the pharmacological name of the substance, since BOTOX is to Botulinum toxin A what XEROX is to photocopying, for the sake of simplicity, the trade name BOTOXhas been used interchangeably for Botulinum toxin – A.

Botulinum toxin is a substance that has been identified for over a century and used for medical functions for greater than 50 years. It was primarily used for strabismus (otherwise referred to as a squinting eye), blepharospasm (lack of ability to open the eyes), and cervical dystonia (wry neck). In 2002, its use was authorized for enhancing and reducing frown lines within the space between the eyes on the forehead (glabella) and has been used efficiently in more than half a million people since that time. Presently, the Food and Drug Administration (FDA) has permitted botulinum toxin A for blepharospasm, strabismus, cervical dystonia, and the aesthetic enhancement of glabellar (forehead) rhytides (frown lines).

Common Medical Uses:

Presently, botulinum toxin is mostly used in the treatment of hyper functional lines. Earlier, hyper functional lines have been the cause of a lot of consternation for the people affected by them. These lines usually made patients wrongly come across as angry, anxious, fearful, or fatigued. Prior to now, plastic surgeons solely had surgical choices in their armamentarium, along with excision or implantation of fat, collagen, or silicone. These procedures usually offered minimal enhancement and exposed patients to the dangers related to surgery. Injections of botulinum toxin A present a chance to handle these hyper functional lines with minimal morbidity. The three commonest areas for injection are the glabella, peri-orbital crow’s feet, and brow areas.

Pathophysiology:

Hyperfunctional lines and wrinkles are the consequence of the contraction of the underlying facial musculature. The facial musculature is complicated and is accountable for facial expressions. The repeated contraction of these muscle groups over many years nonetheless produces many facial lines, face wrinkles and furrows.

Questions:

Numerous questions may enter your mind, at this stage: What is Botox? Is Botox safe? How much does Botox cost? What does Botox do?

Allergan, a company based in the USA, manufactures Botox. Botox is very safe and Botox prices (Botox cost/ Botox injections cost) are reasonable in India, at approximately 6 USD per unit of Botox (about 1/10th the cost of Botox in the USA). Botox Injection treatment requires specialized Botox training. Botox injection sites involve injections of Botox under eyes, around facial lines, botox around eyes, on glabella and forhead. Botulinum toxin injection treatment procedure (Botox) is the gold standard offacial line and wrinkle treatment globally, at this moment and unfortunately, nothing is better than Botox and there exists no alternative to Botox (Botox alternative), for non-surgical anti-aging therapy.

Pharmacology:

Botulinum toxin A (BOTOX ®) causes muscle relaxation by inhibiting the release of acetylcholine (a neuro-transmitter) at the neuromuscular junction.

The toxin requires 24 to 72 hours to make an impact, reflecting the time required to disrupt the synaptosomal process. In very uncommon circumstances, some people could require as many as 5 to 10 days for the total impact to be observed.

The effect of botulinum toxin lasts 12-24 weeks. The duration of action varies. Usually, the effect lasts longer for muscle tissues that are not used frequently and reduces as the frequency of action increases. For instance, the results last lesser in the area below the eyes, where the skin is thinner and most active (three to four months) and lasts longer on the brow where the skin is comparatively less mobile (lasting 5 to eight months).

Indications:

  • Hyperfunctional face lines, wrinkles and furrows (eg. glabellar, brow, forehead lines, crows feet, undereye lines, platysma, laugh lines, nasolabial folds, melo-mental lines, dimpled chin, etc)
  • Hemifacial spasm
  • Post facial paralysis
  • Blepharospasm (compelled, uncontrolled closure of eyelids)
  • Strabismus (Cross eyes or squinting)
  • Cervical dystonia (Neural problem leading to muscle rigidity)
  • Hyperhidrosis – Increased sweating within the axillae, palms and soles of the feet.
  • Sialorrhea – Excessive salivation
  • Migraines and migraine like headaches

Contra-indications:

  • Being pregnant
  • Lactating
  • Past history of a reaction to toxin or albumin
  • An infection at the injection site
  • Allergy to eggs

There is no any scientific proof to show Botox is unsafe in the pregnant or breast feeding mothers. Furthermore, there’s NO cause to believe that Botox which is injected into the muscular tissues LOCALLY ought to have any systemic impact whatsoever. So, technically there isn’t any cause to believe that Botox is unsafe in the pregnant or breast-feeding! Nevertheless, we choose to not use Botox in the pregnant or breast-feeding, simply to be more than secure in these susceptible situations.

Misconceptions:

  • It is commonly misunderstood that BOTOXactually paralyses the facial muscles which leaves people with mask like faces. Though this can happen with extreme quantities of BOTOX, most physicians inject just the amount that allows patients to preserve normal facial expressions. When used correctly, BOTOX simply prevents facial grimaces.
  • Addition of BOTOXexternally to the face does not have any effect. Hence Botox facials are a sham!
  • The Do-It-Yourself BotoxKits on the internet are a bad idea because it requires not only the skill of a cosmetic surgeon, but also a knowledge of the facial muscles, where it is safe to stick a needle, how to give an injection,  etc.

The Procedure:

The areas to be injected are made aseptic and may be numbed.  Typical injection sites include 6 or 8 areas. After the procedure, the patient is advised to avoid lying down for 2 to 4 hours. Patients are advised to exercise the injected muscles to increase the effectivity of the treatment. Results will be evident within 3 to 10 days. Botox does not actually erase lines, but just irons them out. Thus, deep lines become less deep and superficial ones will almost disappear. Additional procedures like fillers may be required. Also, deeper wrinkles may need 2 or 3 additional sessions.

Risks:

Side effects occur in less than 0.0001% of injections. Main risks are headache, pain and flu like illness.

The Verdict:

Botox is one of the wonders of modern medicine, when used correctly and in the right hands. It is truly almost a painless procedure! Many people in whom a decade ago we would have no alternative but to operate, can now just be Botoxed and these folks can thus avoid the side-effects and the time required for healing associated with surgery.

Video on Botox Therapy:

https://www.youtube.com/watch?v=Ck3u56Ii0_Y

https://www.youtube.com/watch?v=u8TyeruYHvc

Dr. Debraj Shome’s Blog on Botox Therapy:

http://debrajshome.wordpress.com/2012/03/03/best-botox-injections-in-mumbai-india/

All Botox Injections are given by Dr. Debraj Shome, top / best plastic surgeon in India, currently based in Mumbai, India. Dr. Debraj Shome is a top Botox doctor and an expert in Botox Injections for non-surgical facial cosmesis.

A lot of our patients visit us from Hyderabad, New Delhi, Chennai, Bangalore, Kolkata, Pune, Ahmedabad, Chandigarh, Jaipur, Nagpur, Kolhapur, Cochin, Trichy, Bhopal, Indore, Assam, Manipur, Mizoram and many other places in India. Many of our consumers (medical tourism) also come in from the USA, Singapore, Dubai, Qatar, Canada, Nigeria, Kenya, Mauritius, UK, South Africa and many other countries in the world.

Locally, from Mumbai and the surrounding areas, we cater to consumers from Thakur Village, Thakur Complex, Kandivali, Borivali, Goregaon, Jogeshwari, Dahisar, Andheri, Lokhandwala, Dadar, Chembur, Malad, Powai, Khar, South Mumbai, Worli, Bandra, Chembur, Thane, Santacruz, Navi Mumbai, Mira Road, Bhayender, Vashi, Panvel, as we have multiple centers in Mumbai.

BotoxTreatment in India

Botox treatment is one of the most often performed procedures in the medical world today. Botox treatment in India mainly involves the correction of the skin to suit the needs or wishes of the patient.

India is on top of the list for countries preferred for medical tourism for cosmetic surgeries like Botox. This has a lot to do with the justified and affordable surgery and medical costs for Botox treatments in India. It is also a fact that India is medically advanced than most developing countries and few developed countries when it comes to the cost to surgery comparison. Therefore, people flock to India for various medical treatments, and Botox treatment is one of these.

Before you undergo Botox treatment in India you have to have realistic expectations from the results of the treatment. The cost of Botox treatment in India depends on the amount of work you need to done. Before deciding on the areas which need Botox treatment, Dr. Debraj Shome will examine for skin for its quality and elasticity. Dr. Debraj Shome will ask you questions about your lifestyle and will advise you one the changes you have to a make in your lifestyle after the Botox treatment in India. The following conditions might make you unsuitable for Botox treatment in India:

  • Infection of the lips/mouth
  • Diabetes
  • Blood-clotting issues
  • Lupus

If you are smoker and drink heavily then also you should inform Dr. Debraj Shome, before you receive Botox treatment in India. In case you have any allergies or have had any earlier allergic reactions to fillers, make sure your doctor knows of the same before you undergo Botox treatment in India. In addition, inform your doctor as to what medications you currently take.

Indian cosmetic surgeons are known for their precision and ability to do great work. One of the most famous names here is that of Dr. Debraj Shome. Dr. Debraj Shome is famous within India and has a global reputation too. His Botox treatment at The Esthetic Clinics comes with-

  • Immense knowledge
  • Availability of one-to-one consultation
  • Follow-up systems
  • Awareness about current methods in this field
  • Guidance on recovery and care
  • In-depth investigations without bias
  • Tie-ups with specialty hospitals
  • Cost effectiveness

A few other famous hospitals he is linked to are:

  • Saifee Hospital
  • Nova Specialty Hospital
  • Breach Candy Hospital
  • Holy Family Hospital

Dr. Shome’s interest areas are varied. Some domains he excels in are as follows-

  • Facial Reconstructive Surgery post Facial fractures and cancers
  • Rhytidectomy
  • Mid-Face lifts
  • Blepharoplasty
  • Facial & Orbital Fracture Repairs
  • Neck Lifts
  • Eyelash enhancement
  • Non-surgical Facial Rejuvenation
  • Face Lifts
  • Cosmetic Facial Plastic Surgery
  • Oculoplastic Surgery
  • Rhinoplasty
  • Auricular Repositioning
  • Hair Transplants and Hair Restoration Surgery
  • Jaw Contouring
  • Reconstructive Surgery for Facial & Eyelid Cancers
  • Facial implants
  • Lip Augmentation & enhancement
  • Facial Flaps & Grafts for Facial Cancers,
  • Orbicularis Oculi Myectomy for intractable Hemi facial spasm &Blepharospasm
  • Eyelid Surgery viz. Ectropion

The cost of Botox treatment in India depends on many factors such as the doctors’ qualifications, the time of the year, and doctor’s experience. The cost of Botox treatment in India will also depend on the amount of injections that are needed for your face. In some cases Botox treatment cost in India can also be varied in terms of the number of units of Botox fillers used. The cost of Botox treatment in India should be discussed with the doctor in advance before starting the treatment.


About Dr. Debraj Shome

Debraj Shome-2
Debraj Shome, MD, DO, DNB, FRCS (Glasgow), FICO (USA), MNAMS, MBA (Healthcare Management, Vanderbilt University, USA), is Consultant Facial Plastic Surgeon, Oculoplastic Surgeon & Cosmetic Surgeon at Nova Specialty Surgery, Mumbai, India..Read more

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