Botox®, Collagen & Restylane

BOTOX® (Botulinium A) has been used safely by physicians for 20 years to treat patients with certain medical conditions such as eye spasms, central nervous system disorders and excessive muscle contractions. The more recent use of BoTox to reduce wrinkles was discovered almost by accident.

Vancouver dermatologist, Dr. Alastair Carruthers, began using Botox® to treat signs of aging in 1986 after his wife Jean, an ophthalmologist, observed that her patients who were treated for eye spasm lost their crow's feet. According to Dr. Carruthers, one patient actually commented that she looked "much happier" and "less angry" because the BoTox also improved the wrinkles between her eyebrows.

How does BOTOX® work?
BOTOX® is injected in minute quantities into the contracted muscles that cause wrinkles and the results are impressive. The muscles relax and wrinkles improve. Within five to seven days, lines of facial expression are reduced. The effect does wear off within three to six months and then BOTOX®needs to be injected again. Most patients, however, do request additional sessions. Studies appear to show that with continued treatments, there is a greater length of time between injection procedures.

What is the treatment like?
Because the toxin is injected in such small amounts, the safety profile for this medication is high and side effects are minimal. There may be a slight sting at the injection site in about half of the people undergoing the procedure. There may be a mild bruise at the injection site but this is uncommon. Bruising appears to be more common in those people taking aspirin or blood thinners. There might be a concern about a droopy eyebrow or droopy eyelid. Droopy eyelids occur in about one out of 100 people. It lasts an average of four weeks and then it goes away.

Are BOTOX® treatments safe?
There are really no contraindications to the procedure. In other words, it appears that all people can have the procedure performed. There is even one report of a pregnant Alaskan woman who developed botulism and delivered a normal baby. The same toxin in botulism is used in BOTOX®, except there are higher amounts of the toxin in botulism. This reassures us that BOTOX® is indeed a safe agent.


What is Collagen?
Collagen is an important natural component of our skin's structure. It is also present in our joints, bones and ligaments. In young skin, collagen is abundant and imparts plumpness to the face and other areas of the body, such as our hands. As we age, the amount and quality of collagen in our body decreases, and as a result, wrinkles and creases begin to appear. Our cheeks become hollow and our upper lip thins.

How is collagen used in cosmetic surgery?
Cosmetic surgeons use a form of collagen derived from cows (injectable bovine collagen) to correct imperfections that time has placed on our face. The bovine collagen is purified to create a product that is similar to human collagen. In this form, collagen falls within the category of an "injectable soft tissue filler." When injected beneath the skin, these fillers plump up creased and sunken areas of the face.

Collagen can fill out wrinkles, skin depressions and some scars. It cannot, however, correct severe wrinkles, nor can it treat sagging skin.

Other techniques such as a chemical peel, dermabrasion or a facelift may be needed to treat these other varied cosmetic concerns.

Before receiving collagen treatments, a patient should be tested on two separate occasions, at least two weeks apart, for a possible allergic reaction to the collagen. Doctors perform the second allergy test because most treatment-related allergic reactions occur after the first treatment.

These "intradermal tests" are administered directly into the top layer of skin on the patient's forearm. A small amount of collagen is placed under the skin with a hypodermic needle. One may feel some minor stinging or burning as the injections are administered.

Patients should not exercise or drink alcohol on the day of the allergy test since these activities may produce swelling at the injection site.

Patients must return two days after the first allergy test and again four weeks later for an evaluation. At that time, the second test is given to determine if an allergy has developed as a result of the initial injection. Swelling, redness, tenderness or itching at the test site indicates that the patient should not receive collagen. This is only noted in 1-2% of the population.

What can I expect after my collagen treatments?
Following collagen treatments, normal activities can be resumed immediately. Depending on the area treated, an injection can last from three to six months