Who should be giving wrinkle-smoothing injections?

October 27, 2011 (CHICAGO)

But should your dentist or gynecologist be among those providing the service?

Some medical professionals whose specialty has nothing to do with skin care are getting certified to administer cosmetic treatments.

Critics say patients are being duped into thinking anyone can inject these neurotoxins and deliver a younger-looking you with no problems.

One woman who thought so, is now talking about her treatment gone bad.

"It's not like it's the gas station attendant who has got a needle. So what would ever go wrong?" said the woman, who wants to remain anonymous and will be referred to as Denise.

Something did go wrong for Denise, a Chicago businesswoman, who says she let a dentist friend learning to do the injection shoot Botox cosmetic in her forehead.

It was easy and less expensive and it was supposed to help smooth out wrinkles, but instead, she says she was left with a temporarily deformed-looking eye.

"Did I get off easy that my eye won't open all the way? Oooh -- lucky me," said Denise.

She called her plastic surgeon, Dr. Marc Karlan, who gave her Botox cosmetic in the past with no problems. He says the dentist did not do the injection correctly, probably hitting a muscle in her forehead too deep and too hard. The result: A drooping eye that lasted for weeks.

"It's chaos out there," said Karlan, who says there are too many unqualified practitioners who take a weekend course and then start offering the injection treatments.

Although it does not formally track this information, the American Academy of Dermatology says more calls are coming in from members who are seeing these kinds of complications.

"There are people in all different fields looking at this as a way to make money," said Karlan, a facial plastic surgeon at Northwestern Memorial Hospital.

There has been plenty of controversy over who can or cannot administer these neurotoxins. A spokesperson with the manufacturer of Botox cosmetic says this is a technique sensitive treatment, and that they recommend patients considering treatment seek consultation with a licensed and trained physician who specializes in facial anatomy, such as a dermatologist, plastic surgeon, oculoplastic surgeon.

The company also encourages patients to find out what kind of training the practitioner has undergone.

Many doctors who learn the technique say it is relatively easy. They contend this is more of a turf war with dermatologists and plastic surgeons who just don't want to share a piece of the Botox pie.

"We don't actually track complaints about Botox, but I think to say it's anarchy is a little bit excessive, said Dr. Brian Zachariah, chief medical coordinator at the Illinois Department of Financial and Professional Regulation (IDFPR).

Zachariah says that in Illinois, in order to use Dysport or Botox cosmetic, you must be a licensed physician or under the supervision of a licensed physician.

There are limitations on how certain practitioners can use Botox cosmetic or Dysport.

For example ABC7 was told a podiatrist can only use the neurotoxins therapeutically around the foot and ankle. Dentists are also restricted to therapeutic use around the face and in and around the mouth.

Suburban cosmetic dentist Zack Zaibak advertises Botox in his dental business. He says it makes sense that a dentist would administer this because they learn so much about the anatomy and physiology of the facial muscles and nerves. .

"For me it is personal preference, and I just try to focus on the smile," said Zaibak, of the Zaibak Center for Cosmetic Dentistry.

With all the training and expertise, even the best doctor can still hit a muscle wrong, temporarily distorting the face. So buyer beware.

While state regulators say enforcement is being stepped up, Zachariah says that "we don't have the manpower to go to every med spa, every doctor's office and ask, 'Are you doing Botox? Should you be doing Botox?', so we really depend on the consumer and the patient to inform us."

Denise says it took about seven weeks before her face was back to normal. She wonders if her bad outcome is all that unusual.

"How much of this is happening and nobody is talking about it?" said Denise. "Now I can look back and go, 'What was I thinking… seriously?'"

A spokesperson for the manufacturer of Dysport says the company is not prepared to make a statement on this issue at this time.

While most unwanted side effects from these treatments are temporary, labels do warn of the rare potential for serious problems, such as difficulty swallowing and breathing.

The labels also describe the possibility of adverse side effects such as drooping eyelids, but many patients have no problems and are pleased with the outcomes.

Illinois Dept. of Financial and Professional Regulation
To register complaints:

American Academy of Dermatologists

Academy of General Dentistry

Botox - Allergan

Dysport (R) USA - About Medicis

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