SATURDAY, July 27, 2002 (HealthDayNews) -- Remember when Tupperware was all the rage for themed get-togethers at home?
Oh, how times have changed.
Hip hostesses today are inviting their closest friends over for Botox injections.
Ever since the U.S. Food and Drug Administration approved the toxin's use for certain cosmetic procedures this spring, Botox parties have become a big hit in many parts of the nation. Doctors offer their services in homes for groups of mainly women, who make the occasion festive with hors d'oeuvres and chardonnay.
However, the trend is causing some physicians to furrow their own brows with worry. They warn the procedure should be taken more seriously. Not only can there be unwanted side effects from poorly done Botox injections, doctors are walking a fine line of medical ethics, critics contend.
"It heralds a real degeneration of ethics in medicine," says Dr. Lisa Donofrio, an assistant clinical professor of dermatology at Yale University School of Medicine. "What's next? At-home liposuction? If we don't draw the line, this could become more and more pervasive until patients are really being put at risk."
Botox is no mere anti-wrinkle cream. Botulinum Toxin Type A -- popularly known as Botox -- is derived from the bacterium that causes the illness botulism. For the cosmetic procedure, small doses of Botox are injected into a facial muscle, blocking the nerve impulses that cause the muscle to contract.
By essentially paralyzing the muscle, Botox can decrease the appearance of wrinkles around the eyes and forehead. The American Society of Plastic Surgeons estimates 1.6 million Botox procedures were done last year, making it the No. 1 non-surgical cosmetic procedure performed in the United States.
To solicit clients, some physicians are sending out invitations advertising the Botox party concept. A Botox treatment on one area of the face typically involves four to 15 injections and costs from $300 to $600, although some doctors offer group rates for women at parties. The effect lasts about three months.
While Botox injections at home are becoming more common, many plastic surgeons and dermatologists refuse to do them anywhere than their medical office.
"When you take something out of the office setting, you're setting yourself up to be more casual and less safe," says Dr. Melanie Grossman, a clinical assistant professor of dermatology at Columbia University in New York City. "And I would never mix alcohol with any medical procedure."
In rare cases, people can faint at the sight of a needle or have a dangerous allergic reaction to the procedure, she says.
Only a physician can legally buy Botox. However, Donofrio says she knows of cases in which physicians buy it, and then permit nurse practitioners and even medical assistants to do the injections.
"They're using their office as a money-making factory," Donofrio says.
For example, she says, spas often have a medical director. However, the doctor may rarely be there and, instead, medical assistants do the injections.
Improperly done, Botox injections can cause partial facial paralysis and drooping eyelids.
Some plastic surgeons have different reasons for objecting to the Botox-and-brie trend.
Botox is being over-hyped as a cure for facial wrinkles, says Dr. Gustavo Colon, chief of the division of plastic surgery at Ochsner Clinic Foundation in New Orleans.
"Botox is not the end all be all," Colon says. "It's just one more arrow in the quiver of rejuvenation. The ultimate thing to remove facial lines and wrinkles is surgical procedures such as face-lifts. It's the only thing that will correct sagging skin and take away lines."
"For facial wrinkles around the mouth, Botox won't work," Colon adds. "It only works in certain areas of the face, and is only good for some people. A woman who comes in with a lot of wrinkles and a lot of sagging skin, she may not be a good candidate for Botox."
Donofrio says patients should carefully check the credentials of the physician doing the injections, and receive an individual evaluation before the procedure. People with certain neurological disorders should not receive Botox injections, she adds.
What To Do
To read more about Botox and to see before-and-after pictures, visit Dermnet. Or read this American Academy of Dermatology Patient Alert that includes questions to ask before you have the procedure.
