BOTOX® was approved by the US Food and Drug Administration (FDA) in December 1998 for the treatment of strabismus, blepharospasm, and hemifacial spasm in patients aged younger than 12 years. It was being used for different medical conditions where relaxing the muscles was therapeutic. 10 years later it was approved for cosmetic use. 2018 saw over 7 million injections of Botulinum toxin A. Orion Aesthetics is the best cosmetic Dermatology practice in Rocklin where the doctor administers the injections rather than Nurses and Nurse Practitioners at other offices.
The toxin has a heavy and light chain, its 150 kilodaltons in weight. After the injection into the muscle, the Botulinum Toxin is taken up by the nerve terminals ending on the muscles. Once inside the cytoplasm of the nerve terminals, the light chain cleaves the SNARE complex present in the membrane of the vesicles which contain acetylcholine. The SNARE complex helps these vesicles bind to the cytoplasmic side of the cell membrane before they can release acetylcholine in the intercellular space for the muscle fibers to pick it up for their contraction. This cleavage of the SNARE complex is permanent and irreversible.
There are 7 serotypes of Botulinum toxin, A, B C D E F G. Clinically, only toxins A & B are being used. Toxin A has the longest activity, therefore it’s used in medical, cosmetic and aesthetic fields.
There are 4 different types of commercially available preparations of Botulinum Toxin A, OnabotulinumtoxinA (Botox), AbobotulinumtoxinA (Dysport), IncobotulinumtoxinA (Xeomin), andPrabotulinumtoxin (Jeuveau). Three serotypes A products have a 150 kDa core botulinum toxin protein and differ in whether they have complexing proteins surrounding the core neurotoxin. OnabotulinumtoxinA and AbobotulinumtoxinA have hemagglutinincomplexing proteins, whereas IncobotulinumtoxinA is free from complexing proteins. Prabotulinumtoxin is a much larger protein of 900 kDa in a 0.5 mg human serum albumin and 0.9 mg NaCl per 100U vial.
Botulinum toxin products are not interchangeable because they vary in their formulation, dosing, and clinical response.
All the preparations have to be reconstituted in bacteriostatic Saline 0.9% Reconstituted botulinum toxin can be refrigerated or refrozen for at least 4 weeks before injection without significant risk for contamination or decreased effectiveness
At Orion Aesthetics, we offer Jeaveau at $8 per unit and it’s the same potency as Botox or Xeomin. Botulinum toxin A injections of 20 Units are usually required for the Glabellar lines and about 20 units for the crow’s feet, 10 units for the forehead. This helps with the wrinkles for up to 4 months. Using less number of units leads to an earlier return of wrinkles.
Patients are advised to avoid lying supine following treatment for four hours. They are also advised to avoid massaging or applying heat to the treatment area and to avoid activities that cause flushing such as exercising heavily, consuming alcohol, and hot tub use) on the day of treatment.
At Orion Aesthetics, we are in the business of making beautiful faces and spreading self-confidence among those whose attractiveness has been diminished by age. We treat Glabellar lines, Horizontal fore- headlines, Lateral canthal lines, Brow elevation, Infraorbitalrhytides, Eye-opening (lowering of inferior ciliary margin), Nasal flare Nasal tip elevation, Nasal oblique lines (bunny lines), Excessive gingival show (gummy line),Depressor anguliorisoveractivity, Mentalisoveractivity, Masseter overactivity, Perioral rhytides, Platysmal bands with Prabotulinumtoxin A (Jeuveau).
HartejUppal, MD is a cosmetic dermatologist practicing in Rocklin, Roseville, Lincoln CA. He has been awarded America’s Best Cosmetic Dermatologist award in 2013 and 2017. Dr.Uppalspends his day at a Skin Clinic in Rocklin where state of the art technology is used to objectively measure human attractiveness. His office draws clients from surrounding cities Roseville, Lincoln, Granite Bay, Sacramento, etc. He likes to make women look more beautiful and men look more handsome. This has led him to a philosophical question about what is beauty? He is very curious if beauty is subjective, objective or both. What is Beauty? Is there a universal beauty? What is a beautiful face?