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Don J. Fontana, MD, PA
Botox Parties and Facial Fillers? Maybe Not, Think Again
Don Fontana, MD

Botox Parties and Facial Fillers? Maybe Not, Think Again

With the holiday season over, perhaps one of your New Year's Resolutions is to be more aware of your appearance. One of the quick fixes is to consider Botox and facial fillers. The idea of a quick fix, a simple yet effective enhancement with little or no down time is very alluring. Botox, chemical peels and facial fillers fulfill this type of enhancement, yet the limiting factor in this decision may be cost. Entrepreneurs have devised what appears to be a solution to reducing cost, the so-called Botox or Facial Filler Party. These “parties” are conducted in individual's homes, beauty salons and spas and uncommonly in physician's offices. So what's the problem?

Consider first that Botox and all facial fillers are prescription drugs and can only be purchased by a physician and administered under the guidance of a physician. The standard of medical care would then dictate that a physician establish a physician-patient relationship in which the medical history of the individual receiving the Botox or facial filler be reviewed. While complications due to Botox are very rare when injected by a trained physician, a conscientious physician will review the patient's medical history before treatment. In addition to bruising, rarely headache, and flu-like symptoms may occur.

The most significant risk is a drooping of the eyebrow or eyelid as a result of the Botox migrating to muscles too low on the forehead. Fortunately, in most cases, this dissipates gradually in the first 3-4 weeks after injection, but can persist longer giving the person an abnormal appearance. This complication is more often seen when injections are done by physicians or nurses who do not understand facial anatomy.

The next most common complaint of the so-called “Botox party” is the fact that the Botox “didn't work.” Remember, one of the major attractions to these parties is “bargain basement prices.” How is it possible that one person charges $150 and another $300 for the same area? The answer is that the Botox concentration maybe diluted and the patient does not receive the necessary amount of Botox to affect a result.

Despite the Botox injection, the muscles continued to contract and the wrinkles persisted. This is far more common than patients will admit. Diluted Botox results in a slower and shorter period of effectiveness. The Botox also tends to diffuse and spread somewhat easier, sometimes resulting in unwanted side effects such as drooping eyebrows and eyelids. Should a patient develop a complication as a result of a poorly trained individual injecting Botox or filler at a beauty salon, spa or private home, the patient has no recourse; that is, the treating nurse is gone.

Although Botox injections are the most popular cosmetic procedure, facial fillers are increasingly popular. These substances are also prescription items and can only be purchased by physicians and administered under the guidance of a physician. The most common fillers are Restylane, Juvaderm, Radiesse, and Perlane. There are a number of “permanent” fillers, which in my opinion are to be avoided. Injecting a substance into the folds of the face to lessen the depth is not as simple as one might expect. Knowing facial anatomy and muscle action contributes to the difference between a good result and a lumpy, unnatural appearance.

Prior to use, the physician should review the patient's medical history to diminish the risk of allergic reactions to the particular filler. Skin type, skin color, skin quality and the areas to be treated all contribute to deciding which filler best suits the individual and which will produce the best result. The cost to purchase each of the major fillers are the same for all physicians, although there are occasional large volume discounts. If a patient is offered a dramatically reduced price for facial fillers, then either the patient is not receiving the full volume or the physician is purchasing a “black market” product. If the patient has an unsatisfactory result, an infection or other unfavorable side effects from a filler injected at a Botox and Filler Party, there is no recourse, other than to wait the 3-9 months for the body to absorb the improperly injected chemical.

The best advice to those attending Botox and Filler Parties is “Buyer Beware.” If it sounds too good to be true, be wary. You have been given one face and distorting it with Botox or fillers injected by inexperienced or unlicensed individuals may not be in your best interest no matter what the cost.

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