Research seems to have proven something pretty amazing: Botox can offer dramatic relief from facial pain – even severe facial pain – when injected properly and in the right places.
In the original study on the topic, botulinum-A toxin – what we simply call Botox – was injected in 13 patients with a severe facial pain condition called trigeminal neuralgia. The injections were carefully placed directly into key positions in the face of the patients, and the result was a dramatic reduction in pain.
More About The Study
In fact, 4 of the 13 patients in that original study no longer needed any oral pain medication at all, and the remaining patients all reduced the amount or pain medicine they needed by over half. That’s especially hopeful information for sufferers of trigeminal neuralgia since drugs aren’t always very helpful for them, according to neurologists familiar with the research. Also, some patients with the condition choose to avoid pain drugs because of unpleasant side effects and the possibility of pain becoming more intense and lasting longer.
To determine how much Botox should be used for this kind of treatment, an open-label study was conducted involving 13 patients to determine the minimal dosage. All of these 13 patients met the criteria for trigeminal neuralgia established by the International Headache Society. Four patients experienced symptoms in just one branch of the nerve while others had symptoms in two or more branches.
Patients were asked to report how much of their regular medication they needed before beginning the study and then at 60 days after having the injections. All patients started with severe pain and improved.
The amount of the dosage depended on how much surface pain was reported and ranged from a low of just 6.83 units to as much as 9.11 units.
Pain was shown to gradually reduce, and the Botox injections reached a peak of effectiveness 20 days after treatment. After 60 days, 4 patients no longer needed pain medication at all. The rest had reduced medication by half or more. There were 3 patients in the study who took more than one drug before the Botox treatment, and they all reduced to one drug at a lower dosage.
The study did not involve a long enough time frame to determine how long the Botox treatments last. But later studies have proven that the results from the original study are sound and that results can be longlasting.
Understanding The Condition
Trigeminal neuralgia is just one of the many medical conditions that may benefit from Botox treatment. Others include eyelid and ocular muscle issues, blepharospasm, dystonia, strabismus and more.
Also called simply TN, trigeminal neuralgia is known to be one the most painful human medical afflictions. The disorder of the fifth cranial nerve causes extreme, sudden and sporadic burning or shock-like sensations at the nerve’s branches in the lips, nose, face, eyes, forehead, scalp and jaws. Pain can last from only a moment to as much as two minutes. Attacks may happen rapidly and frequently over a two-hour period before subsiding. Some patients have a form of the condition called TN2 which involves constant pain at a lower intensity.
Dr. Katz understands that not all trigeminal neuralgia patients are alike, and he indicates that the sites injected for trigeminal neuralgia vary according to know trigger zones that differ from one patient to the next. It’s important, he adds, that injections are only given so that there are no motor side effects and no severe distortion of facial esthetics or changes in function. Any possible unwanted impacts can be reduced or even prevented by injecting 0.025ml of concentrated Botox at the trigger zone.
Great for aesthetics and life-changing for therapeutic purposes, Botox is a wonder drug for some people. And the people who choose to offer Botox injections are often seen as miracle workers by those who can find relief no other way.
If you are a medical professional interested in learning to treat your patients with Botox, call (858) 550-9533 today.
Very few people in the world would happily pick up a yoghurt that was six months out of date, and eat it with a spoon and a large smile on their face. Why? Because we have been conditioned for years to pay attention to use by dates because we believe that they are there to protect us – and we know, because we have been told so often and from so many quarters, that using something that is past its use by date is just dangerous. It won’t be as good! Many medical professionals have the same approach to the Botox that they use.
Every medical professional who works with Botox will know that if you mix your Botox with saline, that solution will be able to be used for up to two days, which is a not long time – but it could be longer. The manufacturers of the most Botox solutions always recommend that you mix it with saline, but we would recommend that instead, you mix it with bacteria static saline. If you do that, that solution will be perfect for using for up to two weeks, a whole two days longer which will enable you to keep it for patients that you want to see after a weekend, for example. After that, the Botox is considered to be out of date, and its shelf life has come to an end.
Altering the length of time that you can use your Botox solutions means that you could really easily save a lot of money, because you will not have to throw out your Botox solutions every two days. This will dramatically change your spending habits at work, and will make Botox injections even more cost effective than they already were for you and your practice.
One of the most aging thing that happens to our faces as we get older is that our foreheads and brows seem to get heavier and larger, causing them to slip down and overwhelm our eyes as well. This look overall definitely can age a person up to a decade more than they really are, and so a quick and easy way of reducing the appearance of a person’s age is to treat this. For many patients, they will unconsciously feel more tired and run down throughout their day just because of the way that they look. It is remarkable the effect that the way we look can have on us, and so many patients with heavy brows will come to you to ask for Botox injections across their forehead.
The key way to do this is to understand that there are two main muscle groups in our foreheads; one set that are up pulling upwards towards our hair line, and another set that are pushing downwards towards our eyebrows. As we get older, the group of muscles that are pushing downwards becomes stronger and more dominant which is what creates this look. In order to reverse it, you need to inject into the muscles on the forehead and help them to relax, allowing the group of muscles that pull upwards to become stronger, and give the patient a fresher, awake, and younger appearance.
It is incredible to see a patient first look at themselves after successful Botox treatment has been carried out on them to change the way that their brow looks; sometimes they do not even believe that they are looking at their own reflection! Help your patients to get a new lease of life by offering this life changing treatment, and help lighten heavy brows.
So much of who we are is dependent on the way that other people see us, and even people who are really confident on the outside will often have one thing about them that they are very self conscious about, and would never want to draw attention to. When someone goes to you as a medical practitioner and asks for Botox, they may be doing so because there is something about their appearance that they do not like and they want to correct it – and the absolute last thing that they would wish is to have their scars made worse rather than better! Although rare, this can happen in some cases, so when it comes to giving Botox injections how can you reduce scarring?
Scarring most often occurs on the forehead, and many patients will come to surgeries because they want scars on their foreheads diminished. It is possible to do this with Botox. The key thing to know is that a horizontal scar on a forehead is still interacting with the muscles around it, and by treating the muscles around it you can diminish the look of the scar really easily. As the muscles fibers are pulling, if you inject the muscles above and below the scar, then the muscles will relax and immediately make the scar less obvious and a lot smaller.
Many people find it difficult to believe that Botox injections really can make a difference to the way that a scar looks, but they can in fact have a hugely positive effect on the way that a scar looks, making it look smaller and much thinner as well – and many patients who have become accustomed to seeing a huge scar on their forehead will find it incredible to be able to finally ignore it!
When a person decides that they want to have Botox on their face, nine times out of ten they have decided to do that because they are self conscious about the way that they are aging. This is of course a perfectly good reason to decide to have Botox, but that can often mean that those patients are even more aware of any accidental side effects that may occur, and one of those is uncontrolled drooling – definitely not something that a self conscious person wants to suffer! That is why it is critically important for you to do your utmost to make sure that you prevent the side effect of drooling. But how can you do this?
Well, first of all, this occurs when Botox is injected below the nose and around the mouth, and in most cases drooling as a side effect will only occur in patients who have experienced Bell’s Palsy in the past. They may not really be aware of it if it was a very mild case, but there is an easy way to find out: ask them to pucker their lips. Most people will be able to do this easily, but if you see any asymmetry in their pucker you will immediately know that there is some weakness there already. This means that you should avoid doing any Botox injections around the mouth, because the muscles there are just not going to be strong enough.
Knowing your patient is the most important thing that we can do in medicine, and you’ll find as you go that prevention is better than cure when it comes to creating a drooling side effect. Getting to know your patient better will immediately help you to prevent this rather embarrassing and slightly inconvenient side effect.
As medical practitioners, it is our duty and our honour to be able to treat our patients – and that is why we always take any side effects that that patient may have from the treatment that we give them incredibly seriously. The very last thing that we would want is for them to suffer an unintended consequence due to the treatment that we give them, but unfortunately with absolutely everything that happens in medicine, there is always a slight chance that something could not quite go right. With Botox, one of the more frequent side effects is bulging in areas that the patient would definitely not want to experience! So how can you prevent bulge side effects when treating your patients?
The key thing to remember is that the depth of the injections that we give to our patients really does make a huge difference to the way that their bodies react. Superficial muscle is the first area of muscle that a needle can come across, and if the Botox injection only reaches superficial muscle, it becomes weaker and the deeper muscle will bulge through, causing a bulge that the patient will find very unsightly. This most commonly occurs when you are treating the muscles on the cheeks.
Another mistake that some people make when it comes to treating the cheek muscles is injecting too high on the face. If you inject the muscles too close to the ears, you will hit a gland and puncture this gland causing a huge amount of trauma, and it will swell up and bulge in order to protect itself – and this swelling will occur within seconds so you will know that you have made a mistake! To avoid this, you should always make sure that you inject the check muscle the lowest that you can.
With every single medical procedure there is the chance of side effects. That is just a fact of life that we as medical practitioners have to accept, and every single one of our patients have to accept when they decide that they want to have a procedure. There is absolutely nothing within the medical world that does not have some risk, but that does not mean that we should just simply accept that: instead, we should be working our hardest to reduce those risks, and minimise the chances of them happening to our patients.
When it comes to Botox, one of the essential things that you have to is to make sure that the concentrate, or the mixture of the solution of the chemical, is absolutely perfect. If it is not the right concentrate level, it can cause huge side effects in your patients. This is especially important if a patient has come to you from another medical practice, and they have side effects from receiving Botox injections from another doctor. What many people do not realise is that we will then use Botox to correct these problems, but at a 0.1 ml concentrate, nothing too strong. Anything stronger would just exacerbate the problem even further.
You should make sure to separate the 0.1 ml concentrate on the areas of the eyes as well, because these areas are very delicate and you do not want to give them the normal concentrate of 1 ml. To create a 0.1 ml concentrate, put the 1 ml concentrate into a vial and then remove 0.1 ml with a syringe. Then add that to the saline, to create that 0.1 ml concentrate – and you should always have some of this with you so that you can treat patients who really need that extra bit of care.
Botox is one of the most precise and delicate arts that you will find in medical science, and for some people it will take years and years of training to ensure that they can be confident in administering Botox to their patients to the absolute best of their ability. This is because the facial muscles that we all have are incredibly small and all connected, so one wrong move in one area of the face can lead to massive side effects in other areas of the face. One of the places that is the most delicate, and patients are the most conscious of, is the area around their eyes. So how can you make sure that you can prevent side effects around the eyes of your patients?
Unfortunately, side effects around the eyes are the most common side effect that patients who receive Botox will experience, and the most frequent is bruising – though rarer side effects include droopy eyes and blurred vision. Bruising happens when the patient is injected far too close to the eye. These delicate muscles will instantly get bruised, and this can also lead to swelling which is not very attractive and can be quite painful. The key thing to prevent bruising the eye is to make sure that you know where the bony area around the eye socket is – and then make sure that you never inject closer than an inch to this area.
By avoiding this delicate area by at least an inch, you can be confident that the Botox does not get too close to the eye, and it will therefore not become bruised, or droop, or cause vision problems in the eyes of your patients, and they will be very grateful to you for your skill and expertise.
Botox is becoming increasingly popular for many people, not just those who would typically be expected to be the traditional customer: affluent, female, and in their forties. Today, it is completely impossible to guess what sort of person is going to walk through the door to receive their Botox injections because the taboo of receiving it has completely disappeared. Now there are plenty of men who are happy to say that they have received Botox, people in their seventies or twenties, and those who would not be considered particularly affluent.
This widening of the appeal of Botox is because people are really understanding the incredible difference that Botox can make for a patient, especially when it comes to their forehead – but this is often considered to be one of the most difficult places to inject Botox properly. As not all patients are exactly the same, you will often have to consider each patient as completely fresh and new. Some will have lines on the bottom of their forehead, some in the middle of their forehead, and some on the top of their forehead.
The key thing to remember is that you want to inject into the muscles where they are the strongest, and this will be where the lines on their forehead are the deepest. It doesn’t matter if your first patient of the day has them deepest in the middle of their forehead and your second patient of the day has them at the top of their forehead – follow the lines, and you will find the perfect place to inject. Injecting in that zone will make sure that your Botox is the most effective, as it will diffuse around that area and ensure that every muscle is relaxed and your Botox injections will be the most successful.
When it comes to medicine, so much of what we have to do runs on instinct. We have to listen to our gut so often because it almost always leads us to the correct answer, even if we can only prove it through medical treatment much later on. However, that can sometimes lead to decisions that are just wrong, and that is never more true when it comes to choosing a needle for an injection.
Most of us would go for the very thinnest needle when we are about to give a patient an injection, and to our gut instincts that makes perfect sense; the thinner the needle, the easier it will be to push through the patient’s skin, the blunter the needle, the more painful it will be for the patient. However, if you do decide to use a 32G needle, the absolute thinnest, that does not necessarily mean that it is going to be the sharpest.
The bevel that is at the end of the needle is what decides how sharp or how blunt a needle is, and that does not really have anything to do with how thin or wide it is. A 32G needle may be very thin, but any other needle could be sharper, and therefore going to be much better to use with your patient. In fact, in some cases you can find that the bevel of a 32G needle is not only blunt, but completely bent over making it completely impossible for you to use it to inject a patient without a good deal of pain and discomfort for them.
That is why you should avoid the absolute thinnest needles, even though your gut may tell you that it is the best choice – instead, focus on the sharpness of the needle instead.