On Wednesday, Saunders said at a conference that Allergan is planning to sell its women's health and infectious disease businesses, putting more attention on Allergan's four "core" businesses, which are eye care, aesthetics, diseases of the central nervous system, and gastrointestinal conditions. Allergan's stock fell on the news, suggesting investors haven't been appeased yet.
I had no idea my health insurance could take Botox away from me. I checked Cigna’s policy and found out that in order to continue receiving Botox coverage after one year, I need to get at least seven fewer migraine days — or at least 100 fewer migraine hours — per month compared to pre-Botox treatments. (I keep a diary to record when I have migraines.) Worse still, if I were to change my job — and therefore change my health insurance — my new insurance could ask me to run through the cheap medication gauntlet again before covering Botox.
The idea of a needle going toward your forehead, in between your eyes, or at your eyebrows might be a little daunting, but rest assured, not only is Botox FDA-approved, but it’s a very common (and highly-requested) procedure. It’s commonly used for cosmetic reasons, but it also helps alleviate a slew of other health concerns.”Botox was first approved by the FDA in 1989 to treat blepharospasm of the eyelid, and now can treat hundreds of medical conditions, such as hyperhidrosis (excessive sweating) or chronic migraines,” dermatologist Jill S. Waibel, MD. She also notes that it was only approved for cosmetic purposes in 2002. “Since then, millions of people have had Botox done safely and effectively. It is important to remember that Botox is safest when used by a board certified dermatologist or a plastic surgeon.”

Botox is considered as an elective procedure which means that the insurance does not cover the cost. But in case of treating medical conditions, an insurance can cover the cost of the treatment but make sure to consult your doctor regarding the coverage. Botox injections can also be used to treat conditions such as excessive perspiration (hyperhidrosis), migraine and muscle spasticity.


With depression, Rosenthal and Finzi think it may relate to what's known as the facial-feedback hypothesis, a theory stemming from research by Charles Darwin and further explored by the American philosopher and psychologist William James. The theory posits that people's facial expressions can influence their mood. Lift your face into a smile and it may just cheer you up; if you can't frown or furrow your brow in worry, perhaps you won't feel so anxious or sad.
In 1986, Oculinum Inc, Scott's micromanufacturer and distributor of botulinum toxin, was unable to obtain product liability insurance, and could no longer supply the drug. As supplies became exhausted, patients who had come to rely on periodic injections became desperate. For 4 months, as liability issues were resolved, American blepharospasm patients traveled to Canadian eye centers for their injections.[48]
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As with all therapeutic proteins, there is a potential for immunogenicity. The detection of antibody formation is highly dependent on the sensitivity and specificity of the assay. Additionally, the observed incidence of antibody (including neutralizing antibo dy) positivity in an assay may be influenced by several factors including assay methodology, sample handling, timing of sample collection, concomitant medications, and underlying disease. For these reasons, comparison of the incidence of antibodies to onabotulinumtoxinA in the studies described below with the incidence of antibodies in other studies or to other products may be misleading.
Still, there have been enough concerns that the FDA instituted a REMS (Risk Evaluation and Mitigation Strategy) requirement for all botulinum toxin preparations that specifically addresses the issues of distant spread of the toxin and the risk of problems, leading to death, from swallowing or breathing issues in certain patients who may be susceptible after botulinum toxin treatment. All products, including Dysport, Myobloc, Xeomin, and Botox, are monitored via this strategy. This is specifically aimed at a certain population of patients receiving more than the usual doses of botulinum toxin and not aimed at the casual user of Botox, per se.
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.
According to the PREEMPT injection paradigm, 5 units of onabotulinumtoxinA is to be administered to two sites on each side for a total dose of 20 units across four sites in the cervical paraspinal muscle group near the midline. The first injection site is approximately 1 cm left of the midline of the cervical spine and approximately 3 cm (2 fingerbreadths) inferior to the occipital protuberance. The second site is measured approximately 1 fingerbreadth diagonally up at a 45° angle from the first injection. The injections should be administered in the most superficial aspect of the muscle, angling the needle 45° and superiorly. To aid in the placement of the injections, the patient should be positioned upright with the head in a neutral position. If the neck is flexed too far forward, injections may be too deep. Injections that are too low or too deep in this muscle group can lead to muscle weakness and neck pain. Injectors should use a suboccipital approach to ensure that the injection sites are not too low. In addition, a horizontal line can be visualized across the neck, approximately 2 fingerbreadths down from the occipital protuberance, to make certain the injections remain above the line and are not administered too low in the neck. The higher these injections are, the more likely that they will be in the muscle fascial condensation, which will minimize the potential for neck weakness. These injections should not be done below the hairline. Patients who have trigger points in the neck should not be injected at these sites as these are generally areas where muscles may be weakened and injections of onabotulinumtoxinA at these sites might worsen their neck issues.
Shah says that it’s harder to treat wrinkles with just Botox as they get more and more ingrained into the face. “Some people may need just a few injections, but some may require more treatments, such as laser treatments or a series of smaller procedures, which are going to cost more. Whereas if they came in five years earlier, I may have just been able to use Botox to get the same effect,” she says.
There are no studies or adequate data from postmarketing surveillance on the developmental risk associated with use of BOTOX in pregnant women. In animal studies, administration of BOTOX during pregnancy resulted in adverse effects on fetal growth (decreased fetal weight and skeletal ossification) at clinically relevant doses, which were associated with maternal toxicity [see Data)].
BOTOX was evaluated in two randomized, multi-center, 24-week, 2 injection cycle, placebo-controlled double-blind studies. Study 1 and Study 2 included chronic migraine adults who were not using any concurrent headache prophylaxis, and during a 28 -day baseline period had ≥15 headache days lasting 4 hours or more, with ≥50% being migraine/probable migraine. In both studies, patients were randomized to receive placebo or 155 Units to 195 Units BOTOX injections every 12 weeks for the 2-cycle, double-blind phase. Patients were allowed to use acute headache treatments during the study. BOTOX treatment demonstrated statistically significa nt and clinically meaningful improvements from baseline compared to placebo for key efficacy variables (see Table 24).
Forehead – The horizontal lines and furrows on your forehead will not magically disappear. Which is why you should consider getting a Botox injection before they start to set in permanently. These lines will become more excessive with age, and will age to your appearance.Over time by repeatedly injecting these lines the deeply etched lines will become progressively improved

In overactive bladder patients with analyzed specimens from the two phase 3 studies and the open-label extension study, neutralizing antibodies developed in 0 of 954 patients (0.0%) while receiving BOTOX 100 Unit doses and 3 of 260 patients (1.2%) after subsequently receiving at least one 150 Unit dose. Response to subsequent BOTOX treatment was not different following seroconversion in these three patients.
In 2005, the national average cost of a BOTOX® injection was just over $375. However, the cost of BOTOX® treatment varies from area to area. In 2005, the northeastern United States had the highest BOTOX® average cost, at just over $500, while the western states had the lowest average, at under $370. It is important to keep in mind that these statistics may be somewhat misleading, as the cost of BOTOX® injections in Los Angeles will almost certainly be higher than BOTOX® treatment price in say, a rural area of Pennsylvania.
In both studies, significant improvements compared to placebo in the primary efficacy variable of change from baseline in wee kly frequency of incontinence episodes were observed for BOTOX (200 Units) at the primary efficacy time point at week 6. Increases in maximum cystometric capacity and reductions in maximum detrusor pressure during the first involuntary detrusor contraction we re also observed. These primary and secondary endpoints are shown in Tables 21 and 22, and Figures 7 and 8.
There are eight types of botulinum toxin, named type A–H. Types A and B are capable of causing disease in humans, and are also used commercially and medically.[3] Types C–G are less common; types E and F can cause disease in humans, while the other types cause disease in other animals.[4] Type H is considered the deadliest substance in the world – an injection of only 2 ng can cause death to an adult.[5] Botulinum toxin types A and B are used in medicine to treat various muscle spasms and diseases characterized by overactive muscle. Commercial forms are marketed under the brand names Botox and Dysport, among others.[6][7]

Allergan is Bold for Life. We build bridges, forging powerful connections with customers, patients, and each other. We act fast, seizing opportunity when we see it. We power ideas, innovating throughout our organization and advancing the best ideas, regardless of source. And, we drive results, taking initiative and carving new paths that lead to better outcomes. To fuel our culture, we need bold thinkers. People with integrity. When you work at Allergan, your boldness is encouraged.
The drug has come a long way since its ability to smooth facial wrinkles was first discovered, by accident. In the 1970s, ophthalmologist Dr. Alan B. Scott started studying the toxin as a therapy for people with a medical condition that rendered them cross-eyed. "Some of these patients that would come would kind of joke and say, 'Oh, Doctor, I've come to get the lines out.' And I would laugh, but I really wasn't tuned in to the practical, and valuable, aspect of that," Scott told CBS in 2012. Scott named the drug Oculinum and formed a company of the same name in 1978. In 1989 he received FDA approval for the treatment of strabismus (the crossed-eye disorder) and abnormal eyelid spasms.
With small children, I find that being prepared allows us to function better.  My family food preps for the week with fruits, veggies and snack-size portions. I keep the snacks on a shelf that my children can easily reach, so they can choose a healthy option if they’re hungry and I’m unable to get up. Meals are well-thought-out and prepared ahead of time, in case of a migraine attack. I always have a back-up plan for my children. I have alternative arrangements for them after school if I am unable to care for them or myself. I also have activities planned. I keep crafts around that occupy my children’s time but also keep sound and stress to a minimum. We color, build Legos and play with Play-Doh all while sitting in rooms with strategically placed lights and brightness. I save screen time for when I need a few moments of quiet. We keep a routine and schedule, but also stay flexible. A schedule allows my family to know what to expect for our days and evenings. My children are able to continue their day if I have a migraine attack because they know what needs to be done and in what order. We have strict bedtimes that allow my children’s brains to grow and mine to recover. Along with this, I have taught them that moms don’t always feel well, and we may need to adjust the schedule from time to time to accommodate my migraine. I keep medication that can fight a migraine attack with me for use on the go and safely at home. I see a neurologist on a regular basis who helps me manage my migraine symptoms and medication.
The recommended dose is 50 Units per axilla. The hyperhidrotic area to be injected should be defined using standard staining techniques, e.g., Minor's Iodine-Starch Test. The recommended dilution is 100 Units/4 mL with 0.9% preservative -free sterile saline (see Table 1). Using a sterile 30 gauge needle, 50 Units of BOTOX (2 mL) is injected intradermally in 0.1 to 0.2 mL aliquots to each axilla evenly distributed in multiple sites (10-15) approximately 1-2 cm apart.
The efficacy and safety of BOTOX for the treatment of primary axillary hyperhidrosis were evaluated in two randomized, multi center, double-blind, placebo-controlled studies. Study 1 included adult patients with persistent primary axillary hyperhidrosis who scored 3 or 4 on a Hyperhidrosis Disease Severity Scale (HDSS) and who produced at least 50 mg of sweat in each axilla at res t over 5 minutes. HDSS is a 4-point scale with 1 = “underarm sweating is never noticeable and never interferes with my daily activities”; to 4 = “underarm sweating is intolerable and always interferes with my daily activities”. A total of 322 patients were randomized in a 1:1:1 ratio to treatment in both axillae with either 50 Units of BOTOX, 75 Units of BOTOX, or placebo. Patients were evaluated at 4-week intervals. Patients who responded to the first injection were re-injected when they reported a re-increase in HDSS score to 3 or 4 and produced at least 50 mg sweat in each axilla by gravimetric measurement, but no sooner than 8 we eks after the initial injection.
In recent years, a number of high-profile lawsuits have been brought against Allergan in which plaintiffs claimed that off-label uses--for ailments including a child's cerebral-palsy symptoms, for instance, or an adult's hand tremors--resulted in lasting deleterious side effects. Still, the drug's acceptance in a growing number of doctors' offices worldwide, and its revenue growth, show no signs of slowing.
Some critics say Botox makes you lose all the personality from your face, leaving you with a significantly less range of motion when you laugh, or get angry or upset. While it’s true that your movement will be restricted, a moderate amount of Botox will still allow you to react and communicate in a lively way. “Botox relaxes the wrinkle-forming facial muscles at the sight of injection, such as crow’s feet, glabella (the ‘furrows’ in between the brows), and frontalis (forehead lines),” Dr. Waibel says. “Botox does not affect other facial muscles that are used for overall facial expressions.”
Food-borne botulism results, indirectly, from ingestion of food contaminated with Clostridium spores, where exposure to an anaerobic environment allows the spores to germinate, after which the bacteria can multiply and produce toxin.[citation needed] Critically, it is ingestion of toxin rather than spores or vegetative bacteria that causes botulism.[citation needed] Botulism is nevertheless known to be transmitted through canned foods not cooked correctly before canning or after can opening, and so is preventable.[citation needed] Infant botulism cases arise chiefly as a result of environmental exposure and are therefore more difficult to prevent.[citation needed] Infant botulism arising from consumption of honey can be prevented by eliminating honey from diets of children less than 12 months old.[71]
But even if the laws remain unchanged, as long as off-label uses are permitted by law, expect doctors to keep pushing the boundaries of Botox's applications--sometimes in the name of medical progress and sometimes with remarkable results.Norman Rosenthal, the Maryland psychiatrist who recommended Botox for his suicidal patient, says he's seen the upside firsthand. The patient, persuaded by Rosenthal, did indeed get Botox shots on his forehead and between his brows. Days later, Rosenthal got an email from the patient. It was a thank-you note. Finally, the patient wrote, he was feeling better.
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]

It may be necessary for the patient to have additional procedures, such as the use of filler substances (for example, Restylane, Perlane, Juvederm, Sculptra, or Radiesse) in order to plump up the wrinkles that are now relaxed. Additionally, it may be necessary to have two or three sessions of Botox treatment for deeper wrinkles before results become optimal. The area of the crease between the eyes is a particularly ideal area for Botox use in conjunction with filler as these fixed wrinkles don't always respond optimally to Botox alone. There is some controversy about using filler in that area as it may block veins or arteries and result in loss of blood and a scar to the area. Generally, the smaller particle fillers, such as Restylane or Juvederm Ultra, are best in the area between the eyes for this reason.


The efficacy of BOTOX for the treatment of upper limb spasticity was evaluated in three randomized, multi-center, double-blind, placebo-controlled studies (Studies 1, 2, and 3). Two additional randomized, multi-center, double-blind, placebo-controlled studies for upper limb spasticity in adults also included the evaluation of the efficacy of BOTOX for the treatment of thumb spasticity (Studies 4 and 5).
What is Botox? | How much does Botox cost? | Where can I find Botox deals near me? | How does Botox work? | How long does it take for Botox to work? | How long does Botox last? | Is Botox a treatment for migraines? What about sweating? | Am I eligible for Botox? | Dysport vs. Botox | What are the Botox injection sites? | What are the side effects of Botox?
Most practices have a flat cost for each injection of BOTOX® Cosmetic, though some will break it down by “units” used per treatment. Flat rates are usually somewhere between $300 and $1000, while per-unit rates are usually around $10-15 per unit. Though the BOTOX® Cosmetic price paid by physicians is normally about $400 for each vial (each vial contains 100 units, or enough for about 4 or 5 treatments), the vial must be used within a few hours of opening, so if the entire vial is not used, the physician will often have to throw the rest out.
Galli has been living with migraine for most of her adult life, but recently, her attacks became more severe and frequent. “My whole life went upside down and nothing was the same,” Galli says, upon being diagnosed with chronic migraine. “The person I used to be wasn't there anymore. I didn't even recognize myself.” To cope with the symptoms that often accompany chronic migraine, Galli found herself retreating to a dark room, waiting for the pain to pass, but it never did. In response, Galli says, she asked herself what she could do to feel better but also share her story. “Everyone around me that knew how high energy, and how much of a go-getter I am, asked what was happening? Where was that person?” When she came across the announcement of the Migraine Moment Film Contest, she saw it as her opportunity to bring awareness about what it is like to live with migraine and bust the misconceptions surrounding this invisible disease. Enter: “Invisible Hero.”
When moving a spastic limb through its range of motion, one feels a resistance to movement that increases with the speed at which one moves the limb. This is the definition of spasticity, but other terms such as increased muscle tone, hypertonicity, spastic dystonia, or flexor / extensor spasms are used to describe this resistance. In clinic the term "muscle spasticity" will be used to reduce confusion of terms.
The biological blocking powers of Botox are used to treat migraines, muscular disorders, and some and bowel disorders. It can treat muscle stiffness, muscle spasms, overactive bladder, or loss of bladder control, too. It's also used to stop excessive sweating. "Botox blocks glands the same way it blocks nerves in muscles," Sobel tells SELF. However, don't expect to stop sweating entirely, he says. "You've got to sweat somewhere." What's more, Botox will last far longer in these sweaty situations since the glands are far smaller than the muscles treated, says Rowe.
Sedation is not often used because the injection time is so short. A local numbing cream (anesthetic) is used instead. Young children often behave as if no numbing cream was used. This may be due to not fully understanding what is being done and having a fear of "shots." In these cases, gentle holding (restraint) is done to keep the area of the shot still. Two staff members sometimes give the injections at the same time to decrease the time of the session.

With this in mind, the average cost for treating forehead lines varies from approximately $200 to $600. Patients with fine lines or smaller facial muscles won’t require as many units of Botox to achieve a successful outcome, whereas patients with stronger facial muscles (such as pronounced corrugator muscles which cause deeper frown lines) could require more.
BOTOX, highly diluted botulinium toxin, works to prevent migraine by blocking the release of a chemical in muscle cells that transmits the signal to contract to muscle fibers. Research into using BOTOX to treat migraines began after patients receiving it for other conditions reported improvement in their migraine symptoms. In 2010, after years of research and collecting clinical data, the FDA approved BOTOX for treating chronic migraines.
In many children, there are a few muscle groups that can have very active spasticity. A more focal approach to these muscles would be better than a widespread approach. In this case a doctor may advise a nerve block to interrupt the signal to the muscle that is spastic. Once the signal that is carried to the muscle by the nerve is interrupted, the spasticity will decrease.
Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.
Although one cannot predict exactly who will respond, I find that those patients who are going to respond will note some improvement in headaches following the first set of injections. Repeat injection sets can be performed on the same patient no sooner than every 3 months, as long as a benefit is seen. Most insurers require that you document at least a 50% improvement in the chronic migraine frequency and/or severity for continued coverage. I usually recommend that my migraine patients have a second set of injections before deciding that this treatment modality is of no benefit to them.
Lalvani previously worked in organizations dedicated to diabetes, breast cancer and kidney disease, but strongly identifies with our community because she is living with migraine. She recalls first getting what she thought were terribly debilitating headaches when she was 18. “I had no idea what a migraine was,” she said, “and I never saw anyone around me have a migraine, so I had no idea what I was dealing with, and no one else around me knew what I was dealing with.” Lalvani is excited to see the progress that’s been made recently in migraine care and the tremendous effort that AMF has put forth in helping advance research to produce therapies at a faster rate. As you know, the mission for AMF is to drive and support impactful research that translates into treatment advances as well as mobilize the community for patient support and advocacy.
In order to minimize the chance of developing a bruise, the key thing to prep for your injections should be to stop all blood thinners (like aspirin, Advil, Motrin, fish oil ,omega 3  vitamin E and other product) prior to making an appointment for an injection. Staying off blood thinners for at least one week is ideal but chilling the skin prior to treatment will reduce the chances of a bruise.
Botox is a brand name of a toxin produced by the bacterium Clostridium botulinum. There are other brand names for botulinum, such as Xeomin. In large amounts, this toxin can cause botulism, which you probably associate with food poisoning. Despite the fact that one of the most serious complications of botulism is paralysis, scientists have discovered a way to use it to human advantage. Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles.
The last thing I've found to be a little frustrating is that my body tends to metabolize the Botox a bit faster than I can get it. While Ravitz tells me I can't get the treatment any more frequently than every three months, because that's the rate at which the body can develop antibodies against it, I find my migraines amping up in frequency again about two to two and a half months after I get the shots. However, given the fact that with the Botox, my migraines have gone down from about four a week to one or two at most, it's absolutely increased my quality of life, and I'm glad I gave it a shot...or 40.
The recommended dose is 50 Units per axilla. The hyperhidrotic area to be injected should be defined using standard staining techniques, e.g., Minor's Iodine-Starch Test. The recommended dilution is 100 Units/4 mL with 0.9% preservative -free sterile saline (see Table 1). Using a sterile 30 gauge needle, 50 Units of BOTOX (2 mL) is injected intradermally in 0.1 to 0.2 mL aliquots to each axilla evenly distributed in multiple sites (10-15) approximately 1-2 cm apart.
Bronchitis was reported more frequently as an adverse reaction in patients treated for upper limb spasticity with BOTOX® (3% at 251 Units to 360 Units total dose) compared to placebo (1%). In patients with reduced lung function treated for upper limb spasticity, upper respiratory tract infections were also reported more frequently as adverse reactions in patients treated with BOTOX® (11% at 360 Units total dose; 8% at 240 Units total dose) compared to placebo (6%). In adult patients treated for lower limb spasticity, upper respiratory tract infections were reported more frequently as an adverse event in patients treated with BOTOX® (2% at 300 Units to 400 Units total dose), compared to placebo (1%).
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.
Botulinum toxin (BTX) is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species.[1] It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction and thus causes flaccid paralysis. Infection with the bacterium causes the disease botulism. The toxin is also used commercially in medicine, cosmetics and research.
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