San Diego Botox doctors
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Bryan K. Chen, MD
San Diego Dermatologist
10672 Wexford Street Suite 205, San Diego |
179 answers | |
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Tom J. Pousti, MD
San Diego Plastic Surgeon
8851 Center Drive Suite 300, San Diego |
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36 answers |
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Arnold W. Klein, MD
Beverly Hills Dermatologic Surgeon
9415 Brighton Way M110, Beverly Hills |
21 answers | |
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Melanie D. Palm, MD
San Diego Dermatologic Surgeon
320 Santa Fe Drive Suite 310, Encinitas |
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17 answers |
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John M. Hilinski, MD
San Diego Facial Plastic Surgeon
3720 Fourth Avenue, San Diego |
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16 answers |
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Jason R. Lupton, MD
San Diego Dermatologist
12395 El Camino Real Suite 117, San Diego |
16 answers | |
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Mitchel Goldman, MD
San Diego Dermatologic Surgeon
9339 Genesee Avenue Suite 300, San Diego |
15 answers | |
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Amir Moradi, MD
San Diego Facial Plastic Surgeon
2023 W. Vista Way Suite F , Vista |
15 answers | |
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Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4765 Carmel Mountain Road 201, San Diego |
9 answers | |
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William Groff, DO
San Diego Dermatologist
9339 Genesee Ave Suite 300, San Diego |
8 answers | |
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Jason R. Hess, MD
San Diego Plastic Surgeon
4060 4th ave Suite 120, San Diego |
6 answers | |
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Barry Stuart Handler, MD
San Diego Plastic Surgeon
6699 Alvarado Rd. Suite 2305, San Diego |
5 answers | |
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H. Michael Roark, MD
San Diego Plastic Surgeon
9850 Genesee Avenue, Suite 130 Ximed Building, La Jolla |
4 answers | |
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Monika Kiripolsky, MD
San Diego Dermatologic Surgeon
6221 Metropolitan Street Suite 100, Carlsbad |
4 answers | |
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Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
9850 Genesee Avenue Suite 460, La Jolla |
4 answers | |
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Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
9339 Genesee Avenue Suite 125, San Diego |
3 answers | |
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Roy A. David, MD
San Diego Facial Plastic Surgeon
3252 Holiday Court Suite 206, La Jolla |
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3 answers |
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Steve Laverson, MD
San Diego Plastic Surgeon
477 North El Camino Real Suite D-304, Encinitas |
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3 answers |
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Vincent P. Marin, MD
San Diego Plastic Surgeon
1431 Camino Del Mar, Del Mar |
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3 answers |
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Marialyn Sardo, MD
La Jolla Plastic Surgeon
9850 Genesee Ave. Suite 410, La Jolla |
2 answers | |
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Maurice P. Sherman, MD
Del Mar Facial Plastic Surgeon
12845 Pointe Del Mar Way Suite 100, Del Mar |
2 answers |
Recent Answers
I had Botox injections 2 days ago. I wasn't given post-care instructions. Immediately after the treatment (half an hour after) I had a massage, where I lay down for 2 hours. My face was NOT massaged. Two days later, I still have bumps (like mosquito bites) in each of the places where Botox was injected into my forehead. I now realize that some doctors recommend their patients not to lie down for 6 hours after. Will this effect go away soon? Did I do something wrong?
No, I do not think you did anything wrong. Botox should be injected directly into the muscles involved; is hard to imagine (even theoretically) that position change after the treatment will make a difference. I doubt that you will see any difference in the efficacy of the treatment you have received.
Best wishes.
I got botox for lines on forehead & bunny line on 1 side. I felt my dr put more on 1 side of my forehead than the other (assumed there was a reason). Now,1wk later,brow on side she favored is very lifted (esp. outer 1/3, esp. when I raise them). I dont care if both brows angle up like that 1 or both are normal like the other-as long as theyre a matching pair. Its the gross asymmetry I cant do. Is 1wk long enough to give? Should it be fixed free? Should I just go elsewhere after such bad results?
The full effects of Botox are usually seen at 1-2 weeks following the injection. It is usually not difficult to address brow/forehead asymmetries with very few units of botox. Every provider has his/her own touch-up policy.
Some of the fine print in literature about Botox injections can be pretty scary. Hello, death? I'm wondering if anyone who has received Botox for cosmetic reasons has died, or has this only happened in people who've used larger, off-label doses of Botox?
It is important to note that the relative potencies of the various botulinum toxin products differ significantly within the toxin types and brands (Botox,Dysport,Xeomin and Myobloc). The potency of botulinum toxin is measured in functional units that correspond to the calculated median dose that would kill a mouse when injected into the stomach. Clinical doses range widely depending on the size of the muscle to be treated, the degree of muscle weakness required, and the specific botulinum toxin product used (the potency expressed in Units or U is not comparable from one botulinum toxin product to another). Spread of botulinum toxin effects is dose and brand dependant. Large doses rarely ever employed in cosmetic use can cause a Botulism – like effect. Botulism is a serious bacterial toxin-mediated neuroparalytic illness whose onset is typically marked by things such as double vision (diplopia), inability to control or coordinate the muscles used in speaking (dysarthria), and/or difficulty swallowing (dysphagia)), followed by progressive descending muscle Weakness or paralysis that can lead to respiratory failure and death. The clinical use of botulinum toxin products presents the potential for iatrogenic botulism, which may be described as the appearance of one or more clinical manifestations of botulism that has the potential to be clinically serious. This is can and has occured with cosmetic use. Local extension of effect of the botulinum toxin into anatomical structures (nerves and muscles) adjacent (contiguous) to the site of injection may occur and is described in product labeling.For example, dysphagia (difficulty swallowing) is described in product labeling as a "commonly reported adverse event following treatment with all botulinum toxins in cervical dystonia. It also has been seen when botulinum toxin products have been injected into the neck at doses as low as 60 units of Botox.also informed . the BLA ( Biologic License Application )or drug companies for various toxin products must also have a Approved Risk Evaluation and Mitigation Strategies (REMS) to ensure that the benefits of these products outweigh the potential for serious risks associated with the lack of interchangeability among the various botulinum toxin products.
There is also a lack of uniformity in the terminology used to characterize this adverse events associated with use of botulinum toxin products. Clinical seriousness may be considered with unintended extension of the toxin's neuromuscular blockade effects to anatomical structures beyond the targeted treatment site, whether these structures are close or far from the site of injection. Local weakness of the injected muscle(s) represents the expected pharmacological action of botulinumtoxin. However, weakness of adjacent muscles may also occur due to spread of toxin. On the other hand dysphagia or difficulty swallowing may also be a sign of distant spread of botulinum toxin effects when the agent is administered at a site other than the neck. This has been seen with a Myobloc (a type B toxin) in cosmetic doses and when large doses are used in everything from cerebral palsy to hyperhidrosis or excessive sweating,. The mechanism by which distant spread of the toxin effects occurs has not been well established. Patients must be aware of the reports systemic adverse reactions including respiratory compromise and death following the use of botulinum toxins types A and B for both FDA-approved and unapproved uses are suggestive of botulism, which occurs when botulinum toxin spreads in the body beyond the site where it was injected. The most serious cases had outcomes that included hospitalization and death, and occurred mostly in children treated for cerebral palsy-associated limb spasticity. Although current product labeling for Botox, Botox Cosmetic, Dysport and Myobloc contains a section advising physicians that patients with neuromuscular disorders may be at increased risk of clinically significant systemic effects, including severe difficulty swallowing and breathing and respiratory compromise, after local injection of typical doses of botulinum toxin, there is literature suggesting that "similar, potentially life-threatening systemic toxicity from the use of botulinum toxin products can also result after local injection in patients with other underlying conditions such as those with cerebral palsy associated limb spasticity." Back to the question...are any deaths which have been linked to Botox related to the cosmetic form of the toxin—and Allergan, the makers of Botox, went on record earlier this year to dispute the claim that the death of a woman in 2004 was caused by Botox Cosmetic. "In fact, says the California-based manufacturer, a medical review of this actual case demonstrates that the patient passed away in the winter of 2004 from complications associated with staphylococcus pneumonia, not from the Botox cosmetic treatment the patient received seven weeks earlier." However come again Botox use can result in pneumonia so a careful review of this case and another reported to the LA Coroner strongly indicates that Botox Cosmetic injected into the neck can and has very very rarely resulted in death.




















