Botox (Botulinum Toxin)

 Botox® injections improve appearance by relaxing muscles that cause wrinkles. These injections also treat medical conditions, including migraines, hyperhidrosis, overactive bladder and eye problems. To maintain results, treatments should be repeated every three to six months.

OVERVIEW

What is Botox®?

Botox® is one of the most widely known brands of botulinum toxin injections. Botulinum toxins are neurotoxins that affect nerves and cause muscle weakening. You might get a botulinum toxin injection for cosmetic or medical reasons. Healthcare providers inject small amounts of Botox into specific muscles to smooth wrinkles, prevent migraine headaches and treat a wide range of other health conditions.

How does Botox work?

Botox blocks nerve signals to muscles. As a result, injected muscles can’t contract (tense up). These effects are always temporary, but can last for several months. The muscle injected depends on the primary area of concern. Several areas can be treated in one session.

What cosmetic conditions can be treated with Botox?

Botox cosmetic injections are used to address signs of aging. This treatment can smooth fine lines and wrinkles in several areas of your face, including your:

• Eyebrows.
• Forehead.
• Nose.
• Eyes (crow’s feet).
• Lips.
• Chin.
• Jawline.
• Neck.

What medical conditions can be treated with Botox?

Botox has been used for decades in the medical industry. These injections may be recommended for the treatment of:

• Crossed eyes (strabismus).
• Excessive muscle contractions (dystonia).
• Excessive sweating (hyperhidrosis).
• Eyelid twitching.
• Chronic migraines.
• Overactive bladder.
• Pediatric upper limb spasticity.
• Adult spasticity.
• Blepharospasm.
• Cervical dystonia.

Can Botox help reduce pain?

Yes. Many healthcare providers recommend Botox for pain management. Botox blocks nerve signals that control muscle activity, resulting in relaxation and pain relief. Botox injections can be successful in treating:

• Back pain.
• Neck pain.
• Jaw pain.
• Nerve pain.
• Sciatica pain.
• Neuropathy (peripheral neuropathy).
• Pelvic pain.
• Chronic myofascial pain (CMP).
• Osteoarthritis.
• Joint pain.
• TMJ pain.

What is Botox made of?

A bacterium called Clostridium botulinum makes the neurotoxins used in Botox. Healthcare providers use a specific type of the bacteria (type A) for medical injections.

Botulinum toxins occur naturally in soil and contaminated foods. If you consume large amounts of botulinum toxins or the bacteria get into a wound, you can develop botulism. This serious nervous system disorder affects breathing. For optimal safety and efficacy, Botox is produced in a lab. Technicians dilute and sterilize the botulinum toxins so they won’t cause botulism.

Is Botox safe?

Botox is generally safe when administered by a licensed healthcare provider. Ask your medical team if Botox injections are right for you.

PROCEDURE DETAILS

How should I prepare for Botox?

Make sure your healthcare provider has a current list of the medications and supplements you take. Certain medications increase the risk of bruising at the injection site. These include anticoagulants or blood thinners (Warfarin®) and nonsteroidal anti-inflammatory drugs (NSAIDs). Alcohol also makes you more prone to redness and bruising. Don’t drink for 24 hours before a procedure.

What should I expect during Botox treatment?

Your healthcare provider uses a fine needle to inject small amounts of Botox into the treatment area. Depending on the issue, you may receive several injections in different spots. Here’s what else you need to know about Botox therapy:

• Botox is an outpatient procedure. You’ll be able to go home the same day.
• Discomfort is usually mild. The injections may sting and feel uncomfortable, but the procedure is over quickly. Your healthcare provider might apply a topical numbing agent to your skin before giving injections.
• You may be given anesthesia. If you’re receiving injections for an overactive bladder, you may receive local or regional anesthesia.

What should I know about Botox aftercare?

Unless your healthcare provider says otherwise, you can return to work and most activities immediately after treatment. To reduce redness, swelling or bruising:

• Don’t rub or put pressure on the treatment area for 12 hours.
• Stay upright (don’t lie down) for three to four hours.
• Avoid physical exertion for 24 hours.

How often should you get Botox?

On average, the effects of Botox last about three to four months. Retreatment is recommended at this time. Eventually, however, your muscles may train themselves to contract less. As a result, treatments can be spaced out over longer periods of time. Your healthcare provider can let you know how often you should get Botox based on your unique needs.

RISKS / BENEFITS

Are there any Botox side effects?

Side effects from botulinum toxin injections vary depending on the area receiving treatment. Most issues are mild and improve in a day or two. Possible Botox side effects include:

• Pain, swelling, redness or bruising at the treatment site.
• Flu-like symptoms.
• Headache.
• Neck pain.
• Upset stomach (indigestion).
• Temporary drooping eyelids (ptosis).
• Eye irritation or redness.

Who should not get Botox injections?

Botox injections are relatively safe. Still, you shouldn’t get this treatment if you’re pregnant, breastfeeding or have:

• Neuromuscular disease.
• Drooping eyelids (ptosis).
• Weak facial muscles.

RECOVERY AND OUTLOOK

How long does it take for Botox to work?

After Botox treatment, most people notice the desired effects around the third or fourth day. Full results will be visible within 10 to 14 days.

How long does Botox last?

Within three to six months after Botox therapy, toxins wear off and muscles regain movement. As a result, wrinkles return and issues like migraines and sweating may resume. To maintain results, you may choose to receive more Botox injections. Your healthcare provider can let you know how often to undergo Botox treatment.

WHEN TO CALL THE DOCTOR

When should I call my healthcare provider?

Botox is a common procedure that’s rarely accompanied by serious side effects. However, you should call your healthcare provider immediately if you experience:

• Vision problems, including blurred vision or drooping eyelids.
• Signs of urinary tract infection, such as blood in your urine (hematuria).
• Shortness of breath (dyspnea).
• Trouble swallowing.
• Slurred speech.
• Numbness or paralysis in an untreated area.
• Severe stomach upset.

FREQUENTLY ASKED QUESTIONS

How does Botox for migraines work?

Botox injections are U.S. Food and Drug Administration (FDA)-approved for the treatment of chronic migraines. This therapy works best for people who have from headaches at least 15 days out of every month.

To ease migraine symptoms, Botox is injected into the treatment area. The medication enters your nerve endings, thereby blocking the chemicals that signal pain transmission.

In general, Botox for migraines works better with every additional treatment. Most people report satisfactory results after the second or third session.

Does Botox hurt?

The needles used for Botox injections are extremely small. As a result, most people experience little to no discomfort during treatment. Some individuals describe a slight pinching or stinging sensation. If you’re worried about pain, your healthcare provider can apply a topical numbing gel.

Can you get Botox while pregnant?

Botox injections aren’t likely to harm your baby. Still, most healthcare providers recommend waiting until after you’ve given birth to undergo treatment.

Can you get Botox while breastfeeding?

Experts aren’t sure whether or not Botox ends up in breast milk. To ensure the safety of your baby, most healthcare providers advise against getting Botox injections while breastfeeding.

Are there other types of botulinum toxins?

There are different brand names for botulinum toxin injections. Not all products treat the same problems. Your healthcare provider can discuss the best option for your unique situation. In addition to Botox, options include:

• Dysport® (AbobotulinumtoxinA).
• Xeomin® (IncobotulinumtoxinA).
• Jeauveau® (PrabotulinumtoxinA).

What should I know about Dysport vs. Botox?

Dysport and Botox are both injections made from botulinum toxins. The main difference is the potency of trace proteins found in these medications. As a result, Dysport may offer faster outcomes, but Botox may last longer. If you’re trying to decide which treatment option is right for you, talk to your healthcare provider.

Does insurance cover Botox?

Health insurance policies vary, so always check with your insurance provider. Most health insurers cover treatments for migraines, urinary incontinence or other medical conditions. Insurers don’t typically cover Botox injections for cosmetic purposes.

What’s the difference between Botox and dermal fillers?

Cosmetically, Botox and dermal fillers offer similar results. Both help reduce the appearance of facial lines and wrinkles. While Botox is made from botulinum toxin, dermal fillers are made from other natural or synthetic materials, including collagen, hyaluronic acid or calcium hydroxylapatite. Botox injections temporarily paralyze muscles to reduce wrinkles, while dermal fillers add volume and help retain moisture. Your healthcare provider can discuss the pros and cons of each treatment and help you determine which option is best for you.

Is it safe to get Botox and the COVID-19 vaccine?

Yes. There are no known cases concerning Botox and COVID-19 vaccine reactions. Healthcare providers strongly recommend that you get the COVID-19 vaccine as soon as you’re eligible, whether or not you’ve had Botox.

There’ve been isolated cases of swelling in people with dermal fillers who received the Moderna and Pfizer vaccines. First, remember that Botox injections and dermal fillers aren’t the same things. Secondly, people who experienced these rare side effects reported that symptoms diminished quickly. Further, the temporary swelling didn’t cause any long-term health complications. For these reasons, the American Academy of Plastic Surgeons states that people who’ve received dermal fillers shouldn’t be discouraged from getting the COVID-19 vaccine.

A note from Cleveland Clinic

If you choose botulinum toxin injections, you’ll need to undergo treatment every three to six months to maintain optimal results. There isn’t a known risk of receiving multiple Botox treatments. Many people find that Botox significantly improves their overall quality of life. Talk to your healthcare provider to determine if this therapy is right for you.

Source Article:  Botox (Botulinum Toxin)

Nonsurgical Facelift

 

A nonsurgical facelift uses noninvasive or minimally invasive techniques to improve the appearance of your facial skin. Treatments such as dermal fillers and fat injections add volume for a smoother, younger look.

OVERVIEW

What is a nonsurgical facelift?

A nonsurgical facelift is a procedure to temporarily refresh, firm or plump the skin on your face. It doesn’t require large incisions (cuts), general anesthesia or an overnight hospital stay. Nonsurgical facelifts typically use a combination of minimally invasive and nonsurgical techniques.

What’s the difference between a nonsurgical and a surgical facelift?

A surgical facelift (rhytidectomy) uses cuts in the face to tighten the skin on your face and neck. A surgical facelift may also transfer fat to your face or adjust facial muscles. For this type of procedure, you’ll need general anesthesia and overnight hospitalization.

Cosmetic surgery is a more dramatic, permanent treatment for aging facial skin. Nonsurgical treatments tend to deliver short-term results.

Who gets nonsurgical facelifts?

People who worry about aging skin or any of the following common facial skin concerns may consider a nonsurgical facelift:

• Sagging skin and loose jowls (around your face and jawline).
• Shadows around your eyes.
• Sunken cheeks.
• Thin lips.
• Wrinkles, including frown lines (on your forehead), crow’s feet (at the corners of your eyes) and marionette lines (on the sides of your mouth).

Who shouldn’t get a nonsurgical facelift?

Some people with pre-existing skin conditions might not be good candidates for a nonsurgical facelift. Talk to your healthcare provider before treatment if you have:

• Active acne.
• Cold sore outbreaks.
• Eczema.
• Moles, freckles, skin tags or other skin growths.
• Psoriasis.
• Skin burns, such as those from radiation therapy.
• Skin rashes (contact dermatitis).

It’s also important to note that nonsurgical facelifts might not be effective for cosmetic concerns such as:

• Deep wrinkles.
• Extremely loose or sagging skin.
• Severe scars.

What are the different types of nonsurgical facelifts?

Nonsurgical facelifts can take many forms and address multiple skin concerns. Your healthcare provider can advise you about which procedures are right for you.

How common are nonsurgical facelifts?

Nonsurgical facelifts are extremely common. In 2020, providers performed more than 13 million minimally invasive cosmetic procedures in the U.S. Most of those procedures — such as botulinum toxin, dermal fillers and laser skin resurfacing — were for the face.

PROCEDURE DETAILS

How is a nonsurgical facelift performed?

Procedures vary depending on the type of nonsurgical facelift you receive. Most procedures take place right in the office. Some are relatively painless, while others may cause discomfort. Your provider can tell you more about what to expect for the following treatments:

• Botulinum toxin injections: These injections, such as Botox® and Dysport®, relax tense muscles that can lead to wrinkles. Most people get botulinum toxin injections between their eyebrows, in their forehead or at the corners of their eyes. Results can last up to three months.
• Chemical peels: Chemicals remove the top layers of your skin. Chemical peels can help reduce large pores, minimize wrinkles and reveal newer, firmer skin. Most people need multiple chemical peels to achieve the results they want.
• Dermal fillers: Also called soft tissue fillers, injections of substances such as hyaluronic acid or gel add volume back to sunken areas of the face. Dermal fillers add fullness back to your cheeks and lips. They can also fill in deep wrinkles. These fillers last anywhere from six months to several years.
• Fat injections: Also called fat grafting, fat injections use fat from elsewhere in your body to fill in sagging areas of your face. Fat injections are more invasive than dermal fillers, as liposuction is necessary to take fat from your body, but they tend to last longer.
• Laser skin resurfacing: Beams of intense light target certain areas of your face. The treatment removes the older, outer layers of your skin. Heat from the light also stimulates collagen growth. Laser skin resurfacing can help your skin appear smoother and firmer.
• Microdermabrasion: This minimally invasive procedure gently sands away layers of your skin with a rough pad. Exfoliation with microdermabrasion can help reduce the appearance of fine lines, mild scars and other skin concerns. You may need multiple treatments, usually a few weeks apart. Results last several months.
• Microneedling: Thin, tiny needles make small wounds in your face. Microneedling stimulates the growth of collagen and elastin in your skin. It can improve the look of loose skin, wrinkles, large pores and sun damage. You may need multiple treatments, usually about three to eight weeks apart. Full results take about three to six months to appear.

RISKS / BENEFITS

What are the risks of a nonsurgical facelift?

The potential risks of a nonsurgical facelift procedure depend on the type you receive. Most nonsurgical facelift treatments are generally safe and have minimal side effects, but risks may include:

• Bleeding.
• Blisters.
• Bruises.
• Dry skin.
• Infection.
• Itchy skin (pruritis).
• Lumps or asymmetry in your face.
• Peeling skin.
• Scars.
• Skin burns.
• Skin redness.
• Swelling.

In rare cases, botulinum toxin injections and dermal fillers can lead to:

• Fever.
• Headache.
• Nausea and vomiting.
• Skin rash.

What are the benefits of a nonsurgical facelift?

A nonsurgical facelift can help you achieve firmer, smoother and younger looking skin without surgery. You don’t need general anesthesia or overnight hospitalization. Recovery is faster and less painful than recovery after a surgical procedure. Nonsurgical facelifts also tend to be much less expensive than surgical cosmetic procedures.

RECOVERY AND OUTLOOK

What can I expect during recovery?

Some people experience mild pain, soreness or discomfort after their treatment. You might notice your skin is red and a little swollen. After a few days, you may have bruising, flaking skin or scabs, depending on the procedure you choose. Most people can return to normal activities right away or shortly after their procedure.

As you recover, your provider may recommend:

• Cold packs for any swelling.
• Ointments to soothe your skin.
• Pain relievers.

How long do the results of a nonsurgical facelift last?

The results of treatment vary. You may need to repeat some procedures, such as chemical peels or botulinum toxin injections, every few months. The results of other treatments may last longer.

How can I maintain the results of a nonsurgical facelift?

Talk to your healthcare provider about the best way to maintain the results of your procedure. Regular treatments can help you achieve longer-lasting skin benefits. You can also maintain a healthy skin care routine by:

• Cleansing and moisturizing your face each day.
• Not smoking.
• Staying out of the sun.
• Using face products that contain antioxidants.

WHEN TO CALL THE DOCTOR

When should I see my healthcare provider?

Contact your healthcare provider if you experience these symptoms after your procedure:

• Flu-like symptoms.
• Infection.
• Numbness or loss of movement in any part of your face.
• Pain that doesn’t go away or gets worse.
• Severe swelling in your face.

A note from Cleveland Clinic

A nonsurgical facelift is a noninvasive or minimally invasive treatment to improve the look of your facial skin. Procedures add volume to your face and reduce the look of wrinkles and sagging skin. These treatments produce temporary results, so talk to your healthcare provider about the number and frequency of treatments necessary to achieve your goals.

Article Source:  Nonsurgical Facelift

Prescription weight-loss drug

 Study the pros and cons of medicines to treat obesity.

Are you an adult who has serious health problems because of your weight? Have you tried diet and exercise but haven't been able to lose enough weight? If you answered yes to these questions, a prescription weight-loss drug may be a choice for you.

Prescription drugs are medicines that a health care provider prescribes for you. You can't buy them off the shelf in a drug store like you can buy nonprescription medicines.

Just know that you need to use prescription weight-loss drugs in addition to — not instead of — a healthy diet and exercise.

Who can take weight-loss drugs?

Your health care provider may suggest a weight-loss drug for you in some cases. These include if you haven't been able to lose weight through diet and exercise and your:

• Body mass index (BMI) is greater than 30. This means you're living with a condition that involves having too much body fat, called obesity.
• BMI is greater than 27. You also have a serious medical problem linked to obesity, such as diabetes or high blood pressure.

Before choosing a medicine for you, your health care provider thinks about your history and health challenges. Then your provider talks with you about the pros and cons of prescription weight-loss drugs.

These drugs aren't for everyone. For example, you shouldn't take prescription weight-loss drugs if you're trying to get pregnant, are pregnant or are breastfeeding.

How well do weight-loss drugs work?

Prescription weight-loss drugs that you can use for more than 12 weeks, called long-term use, lead to major weight loss compared with an inactive treatment that doesn't use medicine, called a placebo. The combination of weight-loss medicine and lifestyle changes leads to greater weight loss than do lifestyle changes alone.

Taking these drugs for a year can mean a loss of total body weight of 3% to 12% more than that lost with lifestyle changes alone. That may not seem like a lot. But losing 5% to 10% of your total weight and keeping it off can have important health benefits. For example, it can lower blood pressure, blood sugar levels and levels of fats in the blood called triglycerides.

What you should know about weight-loss drugs

Mild side effects, such as nausea, constipation and diarrhea, are common. They may lessen over time. Rarely, serious side effects can happen. That's why it's important to ask your health care provider about all treatment choices. And ask about the possible benefits and risks of each drug.

Weight-loss drugs can be expensive and aren't always paid for by insurance. Ask your insurance company about your coverage.

Many people gain back some of the weight they lost when they stop taking weight-loss drugs. But practicing healthy lifestyle habits may help limit weight gain.

How long do I take a weight-loss drug?

How long you take a weight-loss drug depends on whether the drug helps you lose weight. If you've lost enough weight to improve your health and you haven't had serious side effects, your health care provider may suggest that you take the drug long term.

If you haven't lost at least 5% of your body weight after taking the full dose of a drug for 3 to 6 months, your health care provider will probably change your treatment. They may switch you to a different weight-loss drug.

What drugs are approved for weight loss?

Six weight-loss drugs have been approved by the U.S. Food and Drug Administration (FDA) for long-term use:

• Bupropion-naltrexone (Contrave)
• Liraglutide (Saxenda)
• Orlistat (Xenical, Alli)
• Phentermine-topiramate (Qsymia)
• Semaglutide (Wegovy)
• Setmelanotide (Imcivree)

Most prescription weight-loss drugs work by making you feel less hungry or fuller. Some do both. The exception is orlistat. It affects the way your body absorbs fat.

Bupropion-naltrexone

Bupropion-naltrexone is a combination drug. Naltrexone is used to treat alcohol and opioid addiction. Bupropion is a drug to treat depression, called an antidepressant, and a drug to help people stop smoking, called a quit-smoking aid. Like all antidepressants, bupropion carries a warning about suicide risk. Bupropion-naltrexone can raise blood pressure. So your provider will need to check your blood pressure regularly at the start of treatment. Common side effects include nausea, headache and constipation.

Liraglutide

Liraglutide also is used to manage diabetes. It's given as a daily shot. Nausea is a common complaint. Vomiting may limit its use.

Orlistat

You also can get orlistat in a reduced-strength form without a prescription (Alli). Orlistat can cause side effects such as passing gas and having loose stools. You need to follow a low-fat diet when taking this medicine. In rare cases, people have had serious liver injury with orlistat. But researchers haven't found that the drug causes liver injuries.

Phentermine-topiramate

Phentermine-topiramate is a combination of a weight-loss drug called phentermine and an anticonvulsant called topiramate. Phentermine has the potential to be misused because it acts like a stimulant drug called an amphetamine. Other possible side effects include an increase in heart rate and blood pressure, insomnia, constipation, and nervousness. Topiramate increases the risk of birth defects.

Phentermine by itself (Adipex-P, Lomaira) also is used for weight loss. It's one of four similar weight-loss drugs approved for use for less than 12 weeks, called short-term use. The other drugs in this group aren't often prescribed.

Semaglutide

Semaglutide also is used to help control type 2 diabetes. You take it as a weekly shot to manage obesity.

It can cause side effects such as:

• Nausea and vomiting
• Diarrhea
• Belly pain
• Headache
• Tiredness

Setmelanotide

The FDA has approved setmelanotide only for people age 6 and older who have obesity due to one of these rare inherited conditions:

• Pro-opiomelanocortin deficiency
• Proprotein subtilisin-kexin type 1 deficiency
• Leptin receptor deficiency

To take the drug, you'll need to have test results that show you have one of these conditions. Setmelanotide doesn't treat any of the gene problems that cause these conditions. But it can help you lose weight. It can lessen your appetite and make you feel fuller. And it may help you burn calories while your body is at rest.

You take setmelanotide as a daily shot. It can cause side effects such as:

• Swollen or irritated skin where the needle went in
• Patches of darker skin
• Nausea
• Diarrhea
• Belly pain
• Unwanted sexual reactions
• Depression
• Suicidal thoughts

Never give setmelanotide to a child under 6 years old. It can cause newborns and babies to have dangerous reactions.

The bottom line

Weight-loss drugs aren't an easy answer to weight loss. But they may help you make the lifestyle changes that you need to practice to lose weight and improve your health. 

Article source: Prescription weight-loss drug