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New Botox applications grow, broaden surgeon's role

Miami Beach, Fla. – New applications for Botox (Allergan) are demonstrating that not only is it safe, but its effectiveness is continuing to broaden the cosmetic surgeon's abilities.

"Botox's future is bright," says Jean Carruthers, M.D., here at the 2005 South Beach Symposium. "We're constantly finding new ways in which Botox can aid with not only aesthetic aspects, but physical concerns as well."


Dr. Carruthers
Dr. Carruthers is in private cosmetic practice in Vancouver and clinical professor, ophthalmology, University of British Columbia. Straightening the spine In one of the newer applications of Botox, Dr. Carruthers has shown that the injections can actually have the ability to change a person's posture – for the better. The "stoop" on the back that is commonly a result of bad posture, either when sitting or standing, can actually be reversed through Botox injections that lift the breasts.

"The Botox is placed in the inferior aspect of the pectoralis major muscle, situated below the breast," Dr. Carruthers explains. "I usually use 15 units at each injection site and usually three sites per side for a total of 45 units per side, or 90 units. Subjects report a normalization of their posture lasting three to four months. I have only so far selected slender subjects who are physically active for this treatment.

"So far, we have not noted any independent breast elevation, but feel that the breasts move more related to the uncurling upward movement of the thorax," Dr. Carruthers says. "We use 7 millimeter, 31 gauge needles to perform the injections because we are concerned that longer needles could transit the intercostal space and potentially affect the pleura, causing a pneumothorax."

Tipping time A telltale sign of aging in the female face occurs when the nose tip begins to "dip," or become lower. Botox has proven to be effective in reversing this mark of aging as well, Dr. Carruthers says.

"By using three to four units of Botox into the dilator naris muscles, plus the depressor septae muscle at the base of the nasal columella, the tip of the nose will elevate for approximately three to four months. Repeated sequential injections can maintain the effect. The injections can be uncomfortable because the tissues are so tightly organized in this region. It is best to use more concentrated Botox to reduce the volume effect to enhance patient comfort," she adds.

Additional cosmetic uses for Botox are heightened with its increasingly useful ability as an adjunctive treatment to help polish and refine the aesthetic effect of a primary treatment.

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