To B or not to B

This intriguing question has raised not a few eyebrows in America – and perhaps even here at home – as this anti-aging, "miracle" drug called Botox promises perennial beauty seekers a quick, surgery-free fix. So quick you can have it during your lunch break and go back to work as if nothing happened.

Without batting an eyelash, Hollywood celebrities are going for it, no matter what the price – literally and figuratively speaking (for a bit of suspense, more on that later).

Fact is, it’s become quite a rage in the US that Botox parties are now as common as Tupperware parties. Of course, Botox parties not only offer fun. Nobody leaves a Botox party with a frown (line) on his/her face – those who’ve had it swear they feel like a whole new person.

But before you make a dash for the Big B, here are some quick facts – some of them painful – that you must face about this drug (or treatment), which has raked in millions of dollars in sales since the Food and Drug Administration gave its manufacturer, Allergan, the go signal to market is as a wrinkle remover.

Botox is short for botulinum toxin which causes botulism, a form of food poisoning that could be life-threatening. In plain language, it’s poison. Originally, it was used by ophthalmologists to treat nervous twitching of the eyelids, and by neurologists to cure spasm of the neck muscles. But then, doctors were amazed to find that the drug helped smooth out the lines or wrinkles on the face as well. Quite an unexpected but welcome bonus.

A very tiny amount of this poison (not really enough to cause botulism and make you pay for your vanity by killing you) is injected with a tiny needle into the wrinkled area to paralyze or weaken the hyperactive facial muscles that cause all that unwanted wrinkling on your face (like the frown lines from constant frowning, the forehead lines from raising your eyebrows, the crow’s feet from smiling or squinting).

Since the early 1980s, Botox has been successfully used as an anti-wrinkle treatment. The treatment takes only a few minutes. Why, in the blink of an eye, it could be over! No anesthesia is needed.

How soon will the wrinkles disappear?

The treatment starts to work in two to four days. It improves in the next seven to 10 days.

Does it hurt?

Of course, it does – no pain, no gain, remember? It could even be traumatic for those who shrink at the mere sight of needles. Some may experience temporary or minor bruising from the injection, swelling or numbness.

A newly-Botoxed person has to stay upright or refrain from bending his/her head for three to four hours after the injection so the toxin doesn’t spread to other muscles. The patient should also avoid strenuous activities.

A side effect, though rare, especially if done by an experienced doctor, is a temporary drooping of the eyelid.

But what probably hurts even more is the prohibitive cost of the treatment: from $100 to $300 per area. Since we have two eyes, that easily translates to $200 plus per treatment.

One soap star experienced a more dramatic effect: Botox froze her face like a mask that she couldn’t smile or frown when her role called for it. Sadly, she nearly lost face – and her career.

Perhaps she – and her doctor – didn’t know that Botox is not really intended for smile or laugh lines. It can only treat creases in the forehead, root of the nose as well as crow’s feet. It can likewise be used in the neck and upper lip. Botox should not be used on women who are pregnant or breastfeeding, and those who are suffering from a neurologic disease. Botox and drinking alcohol also don’t mix.

Happily, the treatment is reversible. With Botox metabolized by the body, its effects last for four to nine months, and then the wrinkles start coming back like a nightmare. It lasts longer in women (about three to six months) than in men. Usually, it’s back to Botox after six months. But can you imagine injecting yourself with poison every six months for the rest of your life?

Certainly, Botox has become big business and doctors are smiling, nay, laughing all the way to the bank. Doctors in the US usually pay $400 per 100 units of Botox. A jar contains enough drug for three to four patients, but once this jar is opened, its shelf life is only four hours. To save on costs and reduce wastage, Botox doctors prefer scheduling their patients as close to each other as possible.

Smile! Or should we say, "Freeze!"