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The Many Faces of Botox

Botox, a deadly toxin, is also a powerful drug and a so-called fountain of youth. But could it also become a weapon?

WebMD Feature

Mary Schwallenberg used to wear bangs to cover the wrinkles on her forehead, but since she started getting Botox injections, the 53-year-old has been able to pull her hair back without feeling self-conscious. That's because the muscle-paralyzing drug temporarily prevents her muscles from contracting to form unwanted lines, making her skin look smooth and young again.

"People say I look less tired," she says. "I think [Botox] is a simple, quick way to erase some time off your face without having to undergo anything permanent."

Schwallenberg is one of millions of people who have taken advantage of the FDA's April 2002 approval of Botox to reduce frown lines and furrows between the brows. Although the drug has been around for years -- with the government giving the nod to treat eye disorders in 1989 and painful neck and shoulder contractions (cervical dystonia) in 2000, and with doctors unofficially administering it for various curative and aesthetic purposes -- mainstream awareness of the drug only soared after the thumbs-up for cosmetic use.

In fact, cosmetic (as opposed to therapeutic) treatments made up one-third of the 310 million uses of Botox in 2001, according to Allergan Inc., the drug's manufacturer. After the formal government sanction, cosmetic use rose to 40% of 311 million in the first three quarters of 2002. The company forecasts overall sales for the whole year to reach at least 430 million.

The drug's growing popularity has stirred both excitement and grumblings about the impact on doctors' practices and on America's face. Amid promising new developments for future applications, questions have also arisen about its overall safety. And as with many other hot commodities in today's society, there are fears that terrorists may use it as a biological weapon.

The fears, the queries, and the enthusiasm all apparently coexist, albeit less than harmoniously, effectively making Botox a household name.

Botox parties, which have been reported from Los Angeles to London, are said to be more convenient, comfortable, and economic ways to dip into the so-called fountain of youth.

Schwallenberg says she gets a $25 to $30 discount for getting her Botox injections at the "Happy Hour" held at the office of her doctor, Scott A. Greenberg, MD, FACS. For Greenberg, the event, usually a three-hour affair, is a chance to acquire new patients (established ones are encouraged to bring a friend), and to provide an easy setting for nervous clients.

First, he gives a group lecture on the benefits and risks of Botox, after which all patients get a chance to ask questions and hear each other's. Then each person meets with him individually for further consultation, to sign a consent form, and if agreed upon, to get an injection. After the treatment, clients have the chance to mingle with the group while consuming refreshments.

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