It's safe to say that the mouth is the clearest giveaway of work done too early. Youthful lips tend to have substantial volume and turn up naturally at the corners, meaning the best strategy for flattering them often comes down to a good signature lip color. For women who remain self conscious about the size or symmetry of their lips—think a slightly lopsided appearance, for instance—Botox can be injected into the orbicularis oris muscle along the lip line as an alternative to lip fillers. "When certain individuals smile, the lip flips in and they lose that upper volume," says Dara Liotta, a New York City-based plastic and cosmetic surgeon. "This relaxes the outer layers of the circular muscle around the lips and looks much more natural than filler." Additionally, injections along the jawline—or more specifically, the masseter muscle—have risen in popularity to relieve stress-induced jaw clenching and have also been known to refine the area. "A lot of people hold tension in the jaw area and when you relax that muscle, the chin comes out of the shadow of your lower lip,” explains Liotta. But the best advice of all? Forget about those self-perceived imperfections and smile. You're only in your '20s once.

A migraine requires only two of the following headache features: a unilateral distribution (one-sided), pulsatile quality (throbbing), moderate or severe pain (more than 5 out of 10), and aggravation by physical activity (such as bending over). In addition, to diagnose migraine, only one of the following is required: nausea or vomiting or sensitivity to light and noise.
"The cost for a procedure depends on two main factors," explains Joshua Zeichner, MD, a board-certified dermatologist. "First, different products cost different amounts because of the technology that goes into their manufacturing. In addition, the cost depends on the fee of the injector. If you are seeing a sought-after, skilled injector, you may be paying a premium for that treatment. Especially when getting injectable fillers, your treatment is dependent on the skill and aesthetic of your injector. I do not recommend compromising here or purchasing a deal on websites like Groupon."
One glaring example took place over the weekend, when someone on Twitter (TWTR) posted a photograph of an injured police officer, with a caption that he’d been “brutalized” by the migrant caravan on its way to the United States. “These pictures do not capture police officers who were brutalized by members of the immigrant caravan making its way toward the U.S. in October 2018,” Snopes explained.
Intradetrusor injection of BOTOX is contraindicated in patients with overactive bladder or detrusor overactivity associated with a neurologic condition who have a urinary tract infection. Intradetrusor injection of BOTOX is also contraindicated in patients with urinary retention and in patients with post-void residual (PVR) urine volume >200 mL, who are not routinely performing clean intermittent self-catheterization (CIC).
There is no cure for migraine currently. Don’t expect to walk into a doctor’s office, get a pill and feel better immediately. Having a variety of treatments can help you live a healthier life. Taking walks with my kids seems nearly impossible some days, and others it clears my mind and boosts my adrenaline. I receive both massage and acupuncture treatments for migraine pain and the general aches and pains that come with caring for and taking care of children. Mental health, as well as physical health, should be addressed. Time for rest and recovery needs to be a priority, to keep from overdoing it.
Some doctors, however, say their experience with their own patients indicates Botox — which was approved by the FDA in 2010 to treat migraines — is quite effective for this purpose. Lawrence Newman, MD, a neurologist and director of the headache division at NYU Langone Medical Center in New York City, says many of his patients have experienced a significant decline in the number of headaches per month after receiving Botox. In many cases, he says, it has cut down that number by 50% and frequently more than that.
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Sometimes, because of these policies, patients are put on meds that are not approved by the FDA for the treatment of migraines, like the antidepressant amitriptyline and the high blood pressure drug verapamil. “In my experience, [verapamil is] not very effective,” says Elizabeth Loder, chief of the headache division at Brigham and Women’s Hospital in Boston and the former president of the American Headache Society. For the insurance companies, that doesn’t seem to matter. “It’s frustrating to patients, especially when it seems like some of the treatments that they’re required to try have a lot of side effects and haven’t really been tested that carefully for migraines.”
Botox often gets a bad rep for leaving patients looking a little frozen, but that's the fault of bad technique, not necessarily the procedure itself, explains Day. "In many places where it's not a trained aesthetic physician doing the injection, it's really just inject by number," she says. The problem with this is that no two faces, or even two sides of a face, are the same. "That cookie cutter, one-size-fits-all approach is what often gives these treatments a bad name," says Day.
With the outbreak of World War II, weaponization of botulinum toxin was investigated at Fort Detrick in Maryland. Carl Lamanna and James Duff[42] developed the concentration and crystallization techniques that Edward J. Schantz used to create the first clinical product. When the Army’s Chemical Corps was disbanded, Schantz moved to the Food Research Institute in Wisconsin, where he manufactured toxin for experimental use and generously provided it to the academic community.
Botox, or onabotulinumtoxinA, is used for three main purposes: muscle spasm control, severe underarm sweating and cosmetic improvement. In this article we concentrate on the third use, achieved with the product called Botox Cosmetic, which contains botulinum toxin type A (the active ingredient), human albumin (a protein found in human blood plasma) and sodium chloride.
Ophthalmologists specializing in eye muscle disorders (strabismus) had developed the method of EMG-guided injection (using the electromyogram, the electrical signal from an activated muscle, to guide injection) of local anesthetics as a diagnostic technique for evaluating an individual muscle’s contribution to an eye movement.[44] Because strabismus surgery frequently needed repeating, a search was undertaken for non-surgical, injection treatments using various anesthetics, alcohols, enzymes, enzyme blockers, and snake neurotoxins. Finally, inspired by Daniel Drachman’s work with chicks at Johns Hopkins,[45] Alan B Scott and colleagues injected botulinum toxin into monkey extraocular muscles.[46] The result was remarkable: a few picograms induced paralysis that was confined to the target muscle, long in duration, and without side-effects.
Each vial of BOTOX contains either 50 Units of Clostridium botulinum type A neurotoxin complex, 0.25 mg of Albumin Human, and 0.45 mg of sodium chloride; 100 Units of Clostridium botulinum type A neurotoxin complex, 0.5 mg of Albumin Human, and 0.9 mg of sodium chloride; or 200 Units of Clostridium botulinum type A neurotoxin complex, 1 mg of Albumin Human, and 1.8 mg of sodium chloride in a sterile, vacuum-dried form without a preservative.
Botox® neurotoxin treatment helps control the symptoms of severe underarm sweating when topical medicines do not work well enough by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don’t receive chemical signals, the severe sweating stops. Botox® injections are expected to temporarily stop the production of excessive sweat in the treated areas only. Sweat continues to be produced elsewhere.
Botox (also known as Vistabel outside the U.S. and the U.K.) is an injection that temporarily relaxes facial muscles to reduce the appearance of fine lines and wrinkles, as well as prevent new lines from forming. Common injection sites include the forehead, the area between the eyebrows, the corners of the eyes, and the sides of the chin. Botox can also be used for a wide variety of other conditions, including migraines, excessive sweating, and psoriasis. LEARN MORE ›

Since then, several randomized control trials have shown botulinum toxin type A to improve headache symptoms and quality of life when used prophylactically for patients with chronic migraine[88] who exhibit headache characteristics consistent with: pressure perceived from outside source, shorter total duration of chronic migraines (<30 years), "detoxification" of patients with coexisting chronic daily headache due to medication overuse, and no current history of other preventive headache medications.[89]
Dr. Schwedt believes ARMR offers hope for patients living with migraine. “ARMR data could lead to breakthroughs in the field,” he says. One hope for ARMR is that it will contribute to the ability for health care providers to use precision medicine to treat their patients. Clinical trials show which migraine therapies are overall effective for groups of people with migraine; however, health care providers are still working to understand which specific therapy is ideal for a particular patient. “One of the challenges we have in this field right now is being able to determine which exact therapy is going to be best for which patient,” Dr. Schwedt says. “For example, we might know that about 50% of patients will benefit from a specific migraine preventive therapy, but we don’t know in advance which 50% that is. I believe the data we’re collecting in ARMR is going to help us get to the stage where we can practice precision medicine, knowing which therapy is most likely to help an individual patient prior to the patient starting that therapy.”
Ratings on RealSelf.com (www.RealSelf.com) show a satisfaction rate of 65% for Botox, which is on par with other treatments such as Restylane, Juvederm, and Perlane and slightly higher than Xeomin and Dysport. Longer-term treatments, such as Ultherapy facial tightening and Liposuction/SmartLipo achieve ratings in the 80% and above area, while others such as CoolSculpting (Zeltiq) achieve ratings in the 70% area. This may reflect upon the short-term nature of all botulinum toxins versus the longer-term nature of these other procedures.
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Prior to injection, reconstitute each vacuum-dried vial of BOTOX with only sterile, preservative-free 0.9% Sodium Chloride Injection USP. Draw up the proper amount of diluent in the appropriate size syringe (see Table 1, or for specific instructions for detr usor overactivity associated with a neurologic condition see Section 2.3), and slowly inject the diluent into the vial. Discard the vial if a vacuum does not pull the diluent into the vial. Gently mix BOTOX with the saline by rotating the vial. Record the date and time of reconstitution on the space on the label. BOTOX should be administered within 24 hours after reconstitution. During this time period, reconstituted BOTOX should be stored in a refrigerator (2° to 8°C).


According to Ravitz, it's very effective among a large sampling of her patients and is usually very well tolerated. She says some of her patients find that it even eliminates the need for medication, which is a huge deal. However, she also says, "About 7 to 10 percent of my patients find that it’s not effective and they actually feel worse during that time." As with any medical procedure, everybody (and everyone's actual body) is different and will respond to treatment differently, and it's best to do a healthy amount of research and thoroughly talk to your doctor about your body and medical history before making a decision.
BOTOX® can be used on the forehead lines, frown lines, crow’s feet, bunny lines (lines in the nose), chin (for dimpling), skin bands on the neck, and around the mouth (for smoker’s lines and down-turned corners of the mouth). Wrinkles caused by sun damage and gravity often will not respond to BOTOX®. It is important to re-emphasize that BOTOX® is NOT a facial filler (that is, it does not fill existing wrinkles) – it merely relaxes the muscles that are creating those wrinkles.
According to the PREEMPT injection paradigm, a total of 5 units of onabotulinumtoxinA is injected into each corrugator muscle. To confirm the location of the muscle, the patient is asked to furrow the brow in order to activate the corrugator. Once the muscle has been located, the muscle should be palpated and pinched by holding it between the thumb and index finger. Five units of onabotulinumtoxinA is injected at an approximate 90° angle with the bevel of the needle pointing upward into the medial belly of the muscle. As the needle is inserted, there is skin resistance, which lessens when the muscle is penetrated. This decrease in resistance is termed a muscle pop. Once the muscle pop occurs, inject into the superficial muscle. If the injection is too far superior or above the corrugator muscle, brow ptosis can occur due to depression of the medial brow as the frontalis elevating function is lost and the corrugator depressing function remains unopposed. Whereas weakening the corrugator muscle will cause elevation of the medial eyebrow, alternatively, if the corrugator injection is done too low, then diffusion to the levator palpebral muscle could lead to lid ptosis.

If you experience migraine symptoms on 15 or more days each month, you have chronic migraines. Over-the-counter or prescription medications may help ease some of your symptoms, but some patients don’t respond well to pain relievers. In some cases, your doctor may prescribe preventive medicines, which are designed to reduce the frequency and severity of your symptoms. According to research published in the journal Neurology, only about one-third of patients with chronic migraines take preventive medicines.
The overall cost of  the injection is charged either at a flat rate or per unit. In terms of per unit, the overall cost of the treatment will depend on the total volume or a total number of units used in the procedure. But service charged at a flat rate depends on the area to be treated. The most expensive area is around the underarm for treating hyperhidrosis.
The other method of calculating the cost of Botox is to pay by the area being treated. Doctors will specify the total cost for a designated region of the face -- for example, in the United States it should cost between $250 and $500 to treat horizontal forehead lines. However, it’s important to note that the forehead is treated as two seperate areas--the forehead lines that run horizontally across the forehead, and the frown lines that appear at the glabella. If you were to pay per area treated you would need to pay for two different areas. This method of pricing can sometimes mean you pay for more than what you need, especially if you don’t have deeply-etched wrinkles. At the same time, there’s an advantage to knowing how much the treatment will cost before you undergo the procedure, leaving no room for any unwelcome surprises.
Botox is said to decrease the frequency of migraine days by an average of 50 percent for those who suffer chronically (people who experience 15 or more headache days per month). After going through hell with my insurance to get approval, I scheduled an appointment with New York City neurologist and pain-management specialist Risa Ravitz. She was kind enough to speak with me about the wonders of Botox while we did my first procedure in June 2017.
Side effects from therapeutic use can be much more varied depending on the location of injection and the dose of toxin injected. In general, side effects from therapeutic use can be more serious than those that arise during cosmetic use. These can arise from paralysis of critical muscle groups and can include arrhythmia, heart attack, and in some cases seizures, respiratory arrest, and death.[27] Additionally, side effects which are common in cosmetic use are also common in therapeutic use, including trouble swallowing, muscle weakness, allergic reactions, and flu-like syndromes.[27]
On average, each BOTOX treatment requires 32 injections, though individual patients may require fewer or more. You’ll receive injections every twelve weeks, and each session only takes a few minutes. BOTOX begins to work as soon as it’s injected, and you should see full results within a week of your first injections. Most patients who benefit from BOTOX treatments receive five rounds of injections over 15 months. BOTOX is injected using a very fine needle. Most patients describe it as feeling like a tiny pinprick.
Study 2 compared 3 doses of BOTOX with placebo and included 91 patients [BOTOX 360 Units (N=21), BOTOX 180 Units (N=23), BOTOX 90 Units (N=21), and placebo (N=26)] with upper limb spasticity (expanded Ashworth score of at least 2 for elbow flexor tone and at least 3 for wrist flexor tone) who were at least 6 weeks post-stroke. BOTOX and placebo were injected with EMG guidance into the flexor digitorum profundus, flexor digitorum sublimis, flexor carpi radialis, flexor carpi ulnaris, and bic eps brachii (see Table 27).
The safety and effectiveness of BOTOX® for hyperhidrosis in other body areas have not been established. Weakness of hand muscles and blepharoptosis may occur in patients who receive BOTOX® for palmar hyperhidrosis and facial hyperhidrosis, respectively. Patients should be evaluated for potential causes of secondary hyperhidrosis (eg, hyperthyroidism) to avoid symptomatic treatment of hyperhidrosis without the diagnosis and/or treatment of the underlying disease.
"As we get older, we lose volume in our face and hyaluronic acid filler can be used as a replacement,” explains Wexler. "For younger women, injections can be used to treat areas with acne scarring or hollowness under the eyes." During your ‘20s, when the face is at its fullest and healthiest, it has been argued that a shadowy gaze can even be quite charming. But in other cases, hereditary dark circles can result in a persistently tired look, which is where a few drops of filler under the eyes may be useful. As top dermatologist David Colbert, M.D. is quick to note, however, too much Botox and filler distorts the face and as a result will make you appear older. “When the line is crossed everyone starts looking like they are related," he also cautions of a uniform cookie-cutter appearance that lacks character or individuality. Or worse. “It’s a snowball effect of people liking something, coming back too soon [for even more], and then it gets too heavy,” adds Wexler.
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Remember that the skill of the injector is extremely important when considering Botox injections. Because Botox can have some very obvious and embarrassing side effects like drooping eyelids, blurry vision, and excessive bruising around the injection site, it's important to consult with an experienced injector. Unlike dermal fillers which can be melted away with a follow-up injection of hyaluronidase, there's not much you can do about a bad Botox experience other than wait it out.

Botox is so commonplace these days that you can get it done at some gyms and spas, but in these cases, you never know what you’re getting, how old the product is, with what it's mixed, and whether the injector knows what he or she is doing. Dr. Matarasso suggests only getting it done by what he calls the “core four”: a board-certified physician who is either a dermatologist, a plastic surgeon, an ear-nose-and-throat doctor, or an ophthalmologist.
Step therapy is largely unregulated both at the state and federal level, though individual states have started to pass legislation to limit step therapy and protect patients: 19 US states, including California, Mississippi, and Illinois, have laws that require insurance companies to grant certain exemptions or to review appeals from doctors within 72 hours so patients can get a waiver. But even then, getting a waiver isn’t always easy.
Marrying ophthalmology to dermatology, Jean and Alistair Carruthers observed that blepharospasm patients who received injections around the eyes and upper face also enjoyed diminished facial glabellar lines (“frown lines” between the eyebrows), thereby initiating the highly-popular cosmetic use of the toxin.[52] Brin, and a group at Columbia University under Monte Keen made similar reports.[53] In 2002, following clinical trials, the FDA approved Botox Cosmetic, botulinum A toxin to temporarily improve the appearance of moderate-to-severe glabellar lines.[54] The FDA approved a fully in vitro assay for use in the stability and potency testing of Botox in response to increasing public concern that LD50 testing was required for each batch sold in the market.[55][56]

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Much like other fillers, Botox is slowly metabolized in the system, so for it to remain effective, patients have to get the procedure every three months or so (however, as Ravitz told me during a recent visit, you can't get it done too frequently or your body will develop antibodies). I've now had four additional rounds of Botox since my initial procedure and have learned a lot about how my body reacts to it. Read on for both Ravitz's insight and information about my experience with five rounds of Botox.
The FDA now requires black box labeling on Botox and similar products such as Dysport and Xeomin to warn of rare but potentially life-threatening swallowing and breathing complications if the toxin spreads beyond the injection site. None of these complications have occurred in people using Botox for cosmetic reasons and the FDA states that cosmetic use of Botox appears to be safe.
Not a Botox patient? Listen anyway. This is good practice for asking the price for other medical procedures like an MRI or a colonoscopy, where the information can be much harder to get. The common replies you could get: “What’s your insurance?” “We can’t tell you because it depends on your deductible.” “We don’t know.” “You’ll have to call billing.”
"In the majority of these cases, it's the doctors at the front line who start using Botox off-label, and then we see the treatment of things we never expected the toxin to work for," says Min Dong, a researcher at Harvard Medical School who studies botulinum toxins in the lab and has no financial ties to Allergan. "I meet with physicians who are using the toxin everywhere--for diseases you would never know about."
Still, Botox's use for depression raises a question that confounds some researchers. In some cases, how Botox works is evident: the toxin can block the signals between nerves and muscles, which is why it can help calm an overactive bladder, say, or a twitching eye, or the facial muscles that make wrinkles more apparent. In other cases, however (with migraines as well as with depression), scientists are flummoxed. They may have noticed that the drug works for a given condition, but they aren't always sure why--in sciencespeak, they don't know what the mechanism is.
In May, hedge fund Appaloosa Management, run by David Tepper, received antitrust clearance from the Federal Trade Commission to potentially increase its stake in the Botox-maker. This means that Appaloosa now has more flexibility to push for further changes at Allergan. It remains to be seen if that happens, but if so, it could mean more changes are ahead for the drugmaker.
Botox is an injectable drug made from a toxic bacterium called Clostridium botulinum. When you eat the toxin produced by this bacterium, it causes a life-threatening form of food poisoning, known as botulism. But when you inject it into your body, it causes different symptoms. It blocks certain chemical signals from your nerves, causing temporary paralysis of your muscles.

The number of Botox varies from one area to another which has a direct effect on how much does Botox cost. For example, to remove crow’s feet, it requires at least 5 to 15 units per side while 10 to 30 units for the forehead lines. Therefore, each of the areas has a different volume of Botox necessary to correct the appearance which factors in the overall cost.
Unopened vials of BOTOX should be stored in a refrigerator (2° to 8°C) for up to 36 months. Do not use after the expiration d ate on the vial. Administer BOTOX within 24 hours of reconstitution; during this period reconstituted BOTOX should be stored in a refrigerator (2° to 8°C). Reconstituted BOTOX should be clear, colorless, and free of particulate matter.
Severe side effects are very rare but can happen if the botulinum toxin unexpectedly spreads throughout the body from the site of the shots. This can cause muscle weakness, hoarseness or trouble talking, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing, double vision, blurred vision and drooping eyelids. The breathing and swallowing problems can be life-threatening. If this happens, seek medical attention right away.
How Long Do Botox Treatments Last?  Before you begin you should know that effects of Botox last about three to four months. That’s all – when practitioners make claim that it lasts longer don’t believe them because it doesn’t. So when you factor in the cost of Botox or Dysport you should know that in order to maintain the beneficial effects of these injections you will probably repeat the treatment three to four times a year.
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So what exactly are you putting into your face? John Paul Tutela, MD, a board certified plastic surgeon, explains, “Botox is a cosmetic injectable neurotoxin that is a very diluted form of Botulinum Toxin, which is found in the bacteria Clostridium botulinum. In this diluted format, it is used to relax your muscles—typically in your forehead, in between your eyebrows, and around your eyes.” The idea is that if you temporarily block local nerve impulses to specific muscles within your face, you won’t make certain facial expressions, so you won’t form the wrinkles that come with them, explains dermatologist Tsippora Shainhouse, MD, FAAD. These are the 7 signs you’re ready for Botox? (And 6 signs you aren’t.)
The most common side effect of the BOTOX procedure for migraines is neck pain. In clinical trials, 9 percent of patients reported this side effect. Other side effects can include headaches or muscle pain, but these side effects are far less common. If you do experience neck pain, an ice pack can help you manage the discomfort until it dissipates. At Allure Esthetic, we will perform the BOTOX for migraines procedure carefully and correctly.
Prevention of contractures begins with finding out what is limiting a child from either actively (moving oneself) or passively (being moved by someone else) moving the joints through a full range of motion. In some cases, this can be due to destruction or abnormality of the bones around a joint. It can also be due to problems with the ligaments and tissue around that joint.

Botox should only be injected with sterile instruments in a doctor's office or a medical spa — not at Botox parties at your local nail salon or neighbor's living room. Botox injection is usually performed with some local anesthesia or a numbing cream. You may feel some minimal discomfort from the shot, but today's needles are so thin and fine that the procedure is often painless. Depending on the extent of treatment, the procedure can take anywhere from a few minutes to 20 minutes.
Postmarketing safety data from BOTOX and other approved botulinum toxins suggest that botulinum toxin effects may, in some cases, be observed beyond the site of local injection. The symptoms are consistent with the mechanism of action of botulinum toxin and may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulti es can be life threatening and there have been reports of death related to spread of toxin effects. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity and other conditions, and partic ularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses, including spasticity in children, and in approved indications, symptoms consistent with spread of toxin effect have been reported at do ses comparable to or lower than doses used to treat cervical dystonia and spasticity. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech or respiratory disorders occur.
Botox costs can vary anywhere from $200 to $400 or more depending on the physician, location, units purchased, desired profit margin, ongoing promotions, etc. Many doctor's offices price Botox based on cost per unit, but others price Botox injections based on the area of the injection. Whether Botox is charged by the unit or by the area might not matter that much if the Botox treatment is effective, but if you want to know exactly how much you are paying for your treatment, you need to know the number of units of Botox per treatment and the cost per unit. (An honest practice will not hesitate to give you this information if you ask.)
Since then, several randomized control trials have shown botulinum toxin type A to improve headache symptoms and quality of life when used prophylactically for patients with chronic migraine[88] who exhibit headache characteristics consistent with: pressure perceived from outside source, shorter total duration of chronic migraines (<30 years), "detoxification" of patients with coexisting chronic daily headache due to medication overuse, and no current history of other preventive headache medications.[89]
One of the most beneficial uses of BOTOX\for migraines is that it can serve as an indicator of how effective migraine surgery might be for you. BOTOX stops contracting muscles from irritating triggering nerves. If that gives you relief, you may benefit from surgery to “free up” pressure on those nerves. Using BOTOX may also help identify which nerves could be triggering your migraines, making surgical intervention more targeted.
Two double-blind, placebo-controlled, randomized, multi-center, 24-week clinical studies were conducted in patients with OAB with symptoms of urge urinary incontinence, urgency, and frequency (Studies OAB -1 and OAB-2). Patients needed to have at least 3 urinary urgency incontinence episodes and at least 24 micturitions in 3 days to enter the studies. A total of 1105 patients, whose symptoms had not been adequately managed with anticholinergic therapy (inadequate response or intolerable side effects), were randomized to receive either 100 Units of BOTOX (n=557), or placebo (n=548). Patients received 20 injections of study drug (5 units of BOTOX or placebo) spaced approximately 1 cm apart into the detrusor muscle.

The studies using Botox for depression, like other research into Botox's off-label potential, were so encouraging that they caught the attention of Allergan. In Rosenthal and Finzi's research, 74 people with major depressive disorder were randomly assigned to receive Botox injections or a placebo. Six weeks later, 52% of the people who received Botox experienced a drop in reported symptoms, compared with 15% of the people given a placebo. "Over 50% of people responding is a high number," says Finzi. "These are people who have already tried other treatments, and they are significantly depressed."


Botox costs can vary anywhere from $200 to $400 or more depending on the physician, location, units purchased, desired profit margin, ongoing promotions, etc. Many doctor's offices price Botox based on cost per unit, but others price Botox injections based on the area of the injection. Whether Botox is charged by the unit or by the area might not matter that much if the Botox treatment is effective, but if you want to know exactly how much you are paying for your treatment, you need to know the number of units of Botox per treatment and the cost per unit. (An honest practice will not hesitate to give you this information if you ask.)
This is because the discretionary procedures tend to be out of pocket, and providers are used to answering the question: how much does it cost? An MRI, on the other hand, might have several prices: A sticker price, a negotiated or reimbursed rate (what the insurance company pays), the rate that Medicare and Medicaid pay for treatments for people who are older and those who have low income, an out-of-network price, and so on. We know about this because we’ve done pricing surveys for about 35 common procedures in seven U.S. metro areas, collecting cash or self-pay prices for both medically necessary procedures (an MRI, a colonoscopy) and discretionary procedures (Botox, Lasik).
Botox should only be injected with sterile instruments in a doctor's office or a medical spa — not at Botox parties at your local nail salon or neighbor's living room. Botox injection is usually performed with some local anesthesia or a numbing cream. You may feel some minimal discomfort from the shot, but today's needles are so thin and fine that the procedure is often painless. Depending on the extent of treatment, the procedure can take anywhere from a few minutes to 20 minutes.
When receiving Botox, it’s critical to know what you’re getting and to be sure that you get what you pay for. Usually, the cost of Botox is calculated on a per unit basis. This is the preferred option of many patients and surgeons as you only pay for the units of Botox used to treat any given area. This means that if you only require ten units to correct your forehead wrinkles, you simply pay for ten units at the specified price and that’s it.
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Botulism is an illness caused by a neurotoxin produced by the bacterium Clostridium botulinum. There are three types of botulism: food-borne, wound, and infant. Symptoms include muscle paralysis, dry mouth, constipation, slurred speech, and blurred vision. If food-borne and wound botulism are detected early enough, they may be treated with an antitoxin. Infant botulism is treated intravenously with BabyBIG (Botulism Immune Globulin).
Botulinum toxin produced by Clostridium botulinum is the cause of botulism.[9] Humans most commonly ingest the toxin from eating improperly-canned foods in which C. botulinum has grown. However, the toxin can also be introduced through an infected wound. In infants, the bacteria can sometimes grow in the intestines and produce botulinum toxin within the intestine and can cause a condition known as floppy baby syndrome.[32] In all cases, the toxin can then spread, blocking nerves and muscle function. In severe cases, the toxin can block nerves controlling the respiratory system or heart, resulting in death.[1] Botulism can be difficult to diagnose, as it may appear similar to diseases such as Guillain–Barré syndrome, myasthenia gravis, and stroke. Other tests, such as brain scan and spinal fluid examination, may help to rule out other causes. If the symptoms of botulism are diagnosed early, various treatments can be administered. In an effort to remove contaminated food which remains in the gut, enemas or induced vomiting may be used.[33] For wound infections, infected material may be removed surgically.[33] Botulinum antitoxin is available and may be used to prevent the worsening of symptoms, though it will not reverse existing nerve damage. In severe cases, mechanical respiration may be used to support patients suffering from respiratory failure.[33] The nerve damage heals over time, generally over weeks to months.[4] With proper treatment, the case fatality rate for botulinum poisoning can be greatly reduced.[33]
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