Botox a Fraud That Increases the Need for a Facelift?

Tom, Dr. Vijay Sharma's statements sound more like sensationalism for himself and have no scientific merit. In fact, it seems to me that Botox has actually lowered the number of facial cosmetic procedures performed - although this is just my observation. It certainly has lowered the amount of forehead surgery such as brow lifts. Additionally, in general, Botox is used in the periorbital region and above (forehead, glabella). Facelifts address the lower face, an area where Botox is not... more

Botox is mainly used for the upper 1/3 of the face. So if the doctor's rational was correct he would imply browlifting. However, in a relatively young patient in their 30's, 40's and sometimes 50's, Botox can help improve the wrinkles associated with muscle overactivity. Yes, down the road a browlift may be better, but most of these people do not need a full browlift until may years later.

Wrinkles and an aged appearance result from repetetive use of facial muscles --smiling produces laugh lines and crow's feet. Frowning creates frown lines. Botox prevents those muscle actions from occurring excessively. We can learn from an experiment of nature - facial paralysis from a stroke. In those patients, the paralyzed side literally is wrinkle free. Of course in the paralyzed face, the tissues droop as well, so maybe Dr. Sharma does have a point! Most doctors believe that after 3... more

Dear Tom, 1) Botox has an excellent safety profile. 2) Botox is extremely effective at temporary facial improvement ( lifting the eyebrows, lifting the corners of the mouth, relaxing neck bands, erasing wrinkles in the forehead and around the eyes, etc. ). 3) There is absolutely no evidence that using Botox will cause patients to need earlier facelifts. In fact, the opposite is true.

The use of Botox to improve the appearance of rhytids of the periocular, glabellar and forehead regions has been proven safe and effective. Moreover, the use of Botox in the perioral region could in no way lead to atrophied muscles and the need for a face lift. Dr. Sharma clearly doesn't understand the anatomy of the aging face. More then likely I suspect he is trying to sell his own "snake oil."

As you can see by the multitude of responses this assertion is silly. The plastic surgery community as well as dermatologists, etc... have been injecting Botox for years. The statistics indicate millions of treatments. dont you think that an untoward effect potentiating the aging process would have been well documented by now??? Those of us who are legitimate plastic surgeons base our recommendations on peer reviewed scientific observation and not conjecture

Tom, Since Botox is used mostly in the glabella, crow's feet and forehead area, I find the comments to make no rational sense. Facelifts are mainly sought for issues of the lower face (jowls, neck) while Botox treats the upper face. Whatever a patient has done to the upper face will not affect the aging of the jowls and lower face. I have been using Botox in my practice since 1998, and I find no correlation between the use of Botox and the need for a facelift sooner. In addition, many... more

The dominant use of Botox is to block the frown lines between the eyes. Other areas are of course treated but most are in the upper face. Relaxation of these muscles should not have anything to do with early aging leading to premature facelift surgery. If anything, I would expect the exact opposite to be true, namely that early prophylactic use of Botox and medical grade skin care and sun protection may prevent many people from ever needing a facelift.

Modern practitioners of every discipline today generally adhere to evidence-based medicine.  This means that medicine is practiced based upon the evidence supplied by randomized placebo-controlled clinical studies.  To the best of a physician's ability, treatment is based upon fact.  Botox studies are numerous and convincing.  Hundreds of trials exist thoughout the world confirming its safety and efficacy.  The collective advocacy... more

  Botox is a very effective in power for medication that is absorbed by muscles and helps them relax. It's method of action is very different from the concepts we use when we perform a facelift. In a facelift, we generally re-organize the deeper structures of the face to create a more youthful appearance. We then gently excise skin to create a smoother appearance over this rejuvenated framework. Some areas of the face are best treated with Botox, such as the crows feet and... more

The concept that Botox is a fraud is totally ridiculous.  I just don't see the connection between Botox and Rhytidectomy.  In fact, I think one could make a strong argument that Botox has actually decreased or delayed the number of face and brow lifts.

There is a very good reason why Botox is the number one cosmetic procedure performed in the United States - it works! There have been no published data to support that facial Botox injections accelerate facial aging. By relaxing the facial muscles that cause dynamic wrinkles, Botox can help prevent "etched in" lines in these areas from facial expression. Botox can also provide a subtle "chemical" brow-lift, affording a more feminine arch to the lateral eyebrow.... more

I agree with the other physician's comments. Botox is a rigorously tested drug that millions swear by. Those assertions are not based in any scientific data and do not reflect reality.

Hi Tom, In response to Dr. Vijay Sharma, I must say that his assertions make absolutely no sense what so ever, and have no scientific foundation. Botox is used mainly to treat the upper one third of the face. Face lifts are performed to correct problems with the lower half of the face and neck. The majority of properly trained, skilled, and experienced Botox injectors selectively treat the facial muscles. In this selective treatment, the emphasis is placed on weakening the depressor... more

Botox is a great product with a long track record and an essential tool in aesthetic medicine. Nothing will substitute for a well performed facelift but one does not preclude the other. Botox is most commonly used in the forehead, between the eyes and around the crow's feet. A face lift is most effective in the cheek, jawline and neck. A lifelong commitment to looking and performing at your best will involve many elements of aesthetic medicine. One should not fear that an early use of... more

That is certainly a provocative view, but unsubstantiated by anything I have seen published or presented at a scientific forum. Is Dr. Sharma suggesting that dermatologists are doing facelifts? The prevailing view, and the correct one is that Botox is a maintenance procedure used to put off the need for a facelift. And it is worth noting that Botox and facelifts generally don't treat the same conditions, although there is some overlap; sagging jowls aren't really a prime indication for Botox... more

Although Botox was initially approved in 1989, Botox csometic was approved only in 2002. We have barely 7 years of widespread use on which to verify or deny the claims of Dr. Sharma. A facelift is a procedure in which lax and ptotic (sagging) facial tissues are rearranged and brought back to a more youthful appearance/arrangement. It can invovle numerous adjunctive procedures to enhance the result. The general use of Botox is to effect muscle action and not the skin. As such there are no... more

It seems to me that this controversial article by Dr Sharma created an interesting debate. From a fact checking stand point, no facts can prove the clinical claim. Botox was used for years in a medical condition called Blepharospasm (frequent blinking). The newly discovered cosmetic use is a multi million dollar business that proved to be work for a certain focused goal which is getting rid of the dynamic wrinkles. The mechanism of aging has two components: Intrinsic: Genetics, free radical... more

There is no reasonable way to prove or disprove what Dr. Sharma is claiming - unless there is some data or study that I am not aware of. There is a reason why Botox cosmetic is such a popular procedure: generally, it does what it's supposed to do, which is decrease dynamic wrinkles of the face. It has a proven track-record of safety and efficacy.

I would like to know, what is the experience of the plastic surgeon from India regarding Botox? The most common area for the Botox injections are upper part of the face and most common form of the facelift is for the lower face. If the Botox caused weakness of the muscle, we would have seen an increased # of forehead lifts and eyelid surgeries. If you look at the data from a plastic surgery association, the # of forehead lifts has decreased since the introduction of the Botox. Thank you. more

I did not read the article. I don't share the same cynical opinion. I am ethical, and use botox to help my patients AVOID premature facial rejuvenation procedures. Botox us used to relax overactive muscles that cause wrinkles-mainly in the forehead, preiorbital region, and lips. Botox will not cause jowls, prominent nasolabial folds, sagging neck. The effects are temporary. I am in solo practice. I know many plastic surgeons professionally. I have no reason to suspect that any one of... more