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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?

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"They have the benefit of a group setting in terms of a discount financially, and the more relaxed setting of a group, but they also have the benefit of an individual medical treatment that's private and confidential," says Greenberg.

Many health experts, however, have frowned upon Botox parties, fearing that the social atmosphere trivializes the risk associated with the procedure. According to a May 2002 news release issued by the American Society for Aesthetic Plastic Surgery (ASAPS), such affairs "have raised red flags for many medical professionals."

The concern apparently originated from media reports of some parties being held in beauty salons, spas, or people's homes, with the injections sometimes administered by untrained personnel.

"It's inappropriate, obviously, if you're not in a medical environment," says ASAPS spokesman Alan Gold, MD. "You can still have side effects, an allergic reaction, or a fainting episode."

Gold speculates, however, that the occurrence of these inappropriate gatherings may be slightly exaggerated and actually make up only a small percentage of the drug's use.

Nonetheless, the ASAPS recommends that anyone who undergoes Botox treatment makes sure that they can answer "Yes" to the following questions:

  • Have you been asked to provide a complete medical history?
  • Have you been advised on alternative treatments?
  • Have you been advised of the risks and given your informed consent?
  • Is a qualified physician administering the treatment?
  • Is the physical setting appropriate for administering medical treatment, including handling emergency situations?
  • Are you willing and able to follow posttreatment instructions?
  • Will you receive adequate follow-up care?

For more information on these recommendations, call the ASAPS referral line at (888) 272-7711, or visit the web site at www.surgery.org.

In one recent episode of the NBC sitcom Will and Grace, Will decides to get Botox injections to get rid of wrinkles. After the procedure, though, he finds himself unable to move facial muscles to show expression. So when Grace tells him something exciting, she becomes angry when he appears nonchalant, even though he insists he is really happy about her news.

Will's frozen mug may be the stuff of comedy, but it's no laughing matter to health experts who say faces lacking emotion lose the ability to communicate with others.

"Not to be able to show pleasure, interest, or joy is devastating in terms of social relationships," says Doe Lang, PhD, a New York City-based psychotherapist. "People think you're hostile, unfriendly, and they think you don't like them."

Yet stiff faces need not be a consequence of Botox procedures. Lang says reputable plastic surgeons can perform treatments without damage. Also, she says she believes some people may think their face feels paralyzed after an injection because they're not used to paying attention to muscles in the area.

"A lot of people are totally unaware of what their faces usually do. So perhaps when they feel a little stiffness they get frightened," says Lang, who notes that wrinkles are evidence of how people use their face.

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