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Approaches to Treatment in Movement Disorders- Role of Botox

Dystonia Recently, the Cedars- Sinai Movement Disorder Program conducted a small seminar, the purpose of which was to educate people with afflcited relatives, caregivers, and professionals, on the approaches to treatment and management of movement disorders like dystonia. The three main prongs of treatment when it comes to management of dystonia, are medication, use of Botox injections, and deep brain stimulation.

It must be noted here that the role of Botox in the treatment of movement disorders is based on its action essentially on nerves. Botox is well known for its role in the cosmetic industry, and its use to eliminate wrinkles. The way Botox is used for patients of movement disorders is derived from the same effects. Botox helps patients regain control over involuntary muslce twitches and spasmodic contractions, because it acts on nerves and works to block their conduction to muscle fibers. The result is a muscle that does not contract as frequently or as spasmodically.
Of course, medication and deep brain stimulation are also open options. However, medication can sometimes end up causing side effects that do more harm than the regulatory control that they offer. Deep brain stimulation using controllers implanted in the clavicle region, are useful to provide impulses to the deeper parts of the brin using the generators implanted there. However, it is an invasive process, and the recent advances in exact placement of the electrodes have made it much more feasible to use Deep BRain Stimulation. The use of Botox injections for the ehad, neck, and upper body area, is also very beneficial. A combination of all three treatment approaches may well be the bst way to combat Movement Disorders like dystonia.

Uses of Botox – Now For The Bladder

Anterior view of female bladder

Anterior view of female bladder


Botox is a term which has now received every day use and familiarity because of its huge applications in the cosmetic industry. Botox is used, as we all know, for reducing the appearance of wrinkles in both men and women. It also has quite a few therapeutic applications, such as in the treatment of cervical dystonia, blepharospasm, chronic migraines, etc. A new potential application has emerged that could very well popularize the use of Botox even more.

In May 2015, The American Urological Association was presented the results of multicenter surveys conducted by three different teams, on the use of Botulinum toxin (Onabotulinum toxin A) for the treatment of Overactive Bladder Syndrome as well as neurogenic bladder dysfunction. Overactive bladder syndrome is a condition where patients feel the need to urinate multiples times in the day and the night, s much so that it interferes with daily routine. In addition, most patients also have urinary incontinence, which means that they frequently lose bladder control and end up leaking urine, in small amounts. As you can expect, this has a huge negative impact on their quality of life. And both these conditions are worsened by lifestyle diseases such as diabetes, having a sedentary routine and lack of exercise, obesity, drinking coffee or any sources of caffeine, etc. So while a number of factors are implicated in worsening it, there is no exact cause, which makes treatment difficult.

However, the study conducted proves otherwise. In a three year study which was initially randomized, researchers found that the patients who were injected with Botox had almost completely restored bladder control. The mechanism of action of Botox, even in the face, is that it acts on nerves and stops them from transmitting signals. This action, in the bladder, translates to directly reducing the ‘feeling’ or ‘urge’ to urinate even on a partially filled bladder. As a result, patients do not need to ‘go’ as often, and can control their bladder vastly better. It was also noticed that patients with fewer treatments had much better response than patients who received more treatments, which only goes to show the lasting efficacy of Botox for the bladder. In fact, some patients were able to maintain control for up to a year after just one treatment. This mode of treatment of bladder control issues with Botox could very well revolutionize the treatment approach for people with urinary incontinence.

It was also noted that patients showed brilliant responses to long term therapy, with a noticeable reduction in the number of times they had to urinate during the day and night, as well as better control over the ‘urge’. The lack of side effects was another significant factor. However some patients did develop mild urinary tract infections, possible as a consequence of intstrumentation, but urinary tract infections are already an extremely common occurrence in people with urinary incontinence, so the link may be to the preexisting disease rather than the treatment. There were no other side effects noted at all.

A second study was conducted to analyze the effect of Botox in patients who have Overactive Bladder syndrome which doesn’t have a specific cause (idiopathic), to determine if acute urinary retention occurs in patients who have been given Botox and required catherization, and if so, if it occurs because of the treatment. It was found that a large percentage of patients who developed acute urinary retention were diabetics. But in the course of the whole study, only a small percentage developed acute urinary retention, and the researchers settled with listing acute urinary retention as a possible risk, as well as needing to alter the definition of urinary retention to better be understood, as well.

A third study was conducted in patients who have neurogenic bladder problems. Neurogenic Detrusor Overactivity is a condition seen in patients who have had spinal injuries or nerve injuries, or are suffering from nerve degenerative disorders like multiple sclerosis. As a consequence of the overactivity, the detrusor muscle contracts while urinating, interrupting the voiding of the bladder. This leads to urge incontinence, residual urine volume in the bladder, nighttime wetting and leaking of the bladder during the day, etc. While the conservative mode of treatment is teaching these patients to catheterize themselves to void their bladder completely, Botox injections have come to the forefront as an excellent treatment option.

The aforementioned study was conducted over  a period of four years, measuring the response in patients as well as the change in the consistency of the response in patients, over the four year period of time. It was found that not only did almost all the patients have a reduction in bladder overactivity by more than 50%, but the response was sustained. Their bladder control did not diminish over the period of time, either, but rather, improved. This makes Botox eminently suited in becoming the first line of treatment for suitable patients, rather than having to make the patients catherize themselves just to void their bladder.

Further applications of Botox (onabotulinum A toxin) are also being researched.

Are you a medical professional interested in learning how Botox can be used to enhance your business? See our live interactive, online course at dentox.com/all-courses/botox-training/

New Procedure Treats Severe Migraines without Endoscope

woman headache

Study at Massachusetts General finds migraine symptoms eliminated in more than half of sufferers

A new version of an existing surgical procedure used to treat severe chronic migraines offers some degree of relief in more than 90% of patients who underwent the procedure at Massachusetts General Hospital.  Doctors at the hospital’s division of Plastic and Reconstructive Surgery found that more than half of the 35 patients who are treated with the non-endoscopic version of the procedure to treat migraine headaches caused by compression of craniofacial nerves were completely free of their migraine symptoms a full year after the procedure. The study can be found in the Journal Plastic and Reconstructive Surgery.

William G. (Jay) Austen, Jr., MD, chief of Plastic and Reconstructive Surgery at MGH, who led the study, said that his team found the surgery using the same incisions used in cosmetic procedures were highly effective for treating many cases of severe migraine. Formerly, this procedure involves using an endoscope, which often made it impractical as some surgeons lack access to the equipment or are inexperienced with the equipment. The team hopes the non-endoscopic version will lead to wider availability of the treatment.

Dr. Bahman Guyuron, MD, a plastic surgeon in Cleveland, found that many patients with migraines who underwent cosmetic procedures involving the forehead experienced relief of their migraine symptoms. A number of studies by him and other researchers support the idea that compression certain terms can be an important factor in migraine symptoms for some patients. That some patients experience temporary relief after injections of botulinum toxin (Botox), which tends to release pressure and overactive muscles, offers additional support.

While the original version this procedure involved use of an endoscope to remove certain muscles, the Massachusetts team has focused on developing alternative methods for accessing specific areas of nerve pressure using the same types of incisions frequently used in cosmetic procedures.

Participants in the study all experienced chronic migraines confirmed by a thorough neurological exam and had not been able to get relief from more conventional therapies. All participants had experienced temporary symptom relief from Botox or nerve blocks. Trigger point specific to the patient’s were identified based on each individual symptoms and histories. The procedure was used to release the specific sites from muscles, connective tissue, bony structures, and blood vessels.

For the study, researchers looked at 35 patients who underwent 43 total procedures. Of the 43 procedures, 90.1% provided relief of symptoms defined as at least 50% improvement in frequency, duration, and severity. And 51.3% of the procedures patients experienced complete elimination of their symptoms, 28.2% of patients experienced at least 80% improvement, while the remaining 20.5% experienced between 50 and 80% improvement.

Austen points out that patient selection is crucial. Patients should undergo a thorough neurological evaluation prior to having the surgery. The procedure is still relatively new and studies are underway to develop better ways of determining which patients are good candidates for the procedure. The researchers are hoping to establish stronger evidence that the procedure will be successful when performed by other surgeons at other centers. It is too early to call this procedure a migraine cure, but the results do suggest that it can improve the quality of life for many patients.

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Dermal Fillers & Botox Training Review

Botox and How it Works

doctor botoxBotulinum toxin, more commonly known as Botox, is a neurotoxin created by the Clostridium botulinum bacteria.  Botox is used to treat some types of muscle-related conditions and to remove wrinkles by temporarily paralyzing the tiny muscles in the face.  While Botox is the most well-known form of botulinum toxin type A, it is also available under the names Dysport and Bocouture.  A second type of botulinum toxin, type B, is available under the name Myobloc.

Some important points about Botox

Botox is used more than 6 million times every year in cosmetic procedures, making it the most popular cosmetic treatment.  It works by paralyzing the small muscles responsible for formation of wrinkles.

Botox can also be used to treat migraines, excessive sweating, some muscle-related  disorders, and some bladder and bowel conditions.

The bacteria that produces botulinum toxin is found in the environment, especially the soil.  Environmentally, it is largely inactive.  However, it can cause botulism, a potentially fatal infection that causes respiratory failure.  A single gram can kill more than a million people, while two kilograms would be sufficient to kill the entire human population.

History of Botox

The bacteria that produces botulinum toxin is found in an inactive state in the soil and in sediment of untreated bodies of water.  It also lives in the intestinal tracts of many mammals, in the gills of fish, and in the organs of many shellfish.  The bacteria and its spores are generally harmless.  They only become a problem when the bacteria cells begin producing the toxin, usually when cell populations increase to a certain point.

Neurotoxins are so named because they target the nervous system and disrupt communication between the neurons.  botulinum toxin is divided into eight different types.  Of those, subtypes A, B, E, and occasionally F are the types that cause botulism in humans, while the others illness in other animals.

Botulinum toxin is thought to be among the most highly poisonous substances known.  It has been estimated that one gram could be lethal to approximately a million people.  Untreated, botulism can cause respiratory failure and can be fatal.

Botulinum toxin is a classic example of the idea that it is the dose that makes a substance poisonous.  Botulinum toxin has been used to treat a variety of muscle-related conditions, including cerebral palsy, as well as migraines and certain bladder and bowel conditions.  However, the most popular use of the toxin is to paralyze the small muscles under the skin of the face to minimize wrinkles.  

Clinical use of botulinum toxin is based on the ability of the toxin to block nerve signals from reaching the targeted muscles so they are unable to contract.

Muscle contraction is caused when nearby nerves release the neurotransmitter acetylcholine.  The acetylcholine binds to receptors on the cells of the muscle, telling it to shorten.  Botulinum toxin prevents the neurons from releasing acetylcholine.

Uses of botulinum toxin

Most people know of Botox as a cosmetic procedure for reducing wrinkles, especially around the eyes, but Botox has been approved for many other uses, including:

  • Eyelid spasms,
  • Muscle spasms in the neck or shoulder, especially when the cause is unclear,
  • Migraines, especially those linked to craniofacial nerve compression,
  • Excessive sweating,
  • Leaky bladder,
  • Crossed eyes,
  • Spastic limbs after a stroke
  • Some cases of urinary incontinence, and
  • Overactive bladder.

Aside from these FDA approved uses, botulinum toxin has also been used off-label for:

  • Difficulty swallowing due to Achalasia (a problem with the esophagus,
  • Anal fissures and dysfunction,
  • Excessive salivation,
  • Nasal allergies,
  • Dysfunction of the Sphincter of Oddi (a band of muscle that controls flow of juices from the liver and pancreas into the intestines)
  • Muscle spasticity associated with cerebral palsy, and
  • Uncontrolled spasms in the jaw, face, tongue, or vocal cords.

Botulinum toxin powder is given in minute doses.  A powder is diluted in saline and injected directly into the target muscles.  In most cases, the toxin begins to work in 24-72 hours, though in rare cases it can take up to 5 days before the full effects are noticed.  Botulinum toxin is not recommended for use in women who are pregnant or breastfeeding, or by anyone who has previously experienced an allergic reaction to botulinum toxin.

Safety and side effects

Treatment with botulinum toxin is usually well-tolerated by most people with few side effects.  In rare cases (about 1%), patients develop antibodies that make further treatments ineffective.  Some patients may experience additional side effects after treatment, including:

  • Discomfort, swelling, redness, or fluid retention near the injection site,
  • Numbness,
  • General feeling of illness,
  • Nausea,
  • Temporary weakness or paralysis of muscles beyond the treated area,
  • Temporary drooping of the upper eyelids,
  • Temporary weakness of the lower eyelid or muscles controlling eye movement,
  • Difficulty swallowing,
  • Weakness in the neck,
  • Flu-like symptoms,
  • Damage to the nerves in the neck,
  • Dysfunction of the gall bladder,
  • Double or blurred vision,
  • Bleeding,
  • Vision problems,
  • Dry mouth,
  • Rash or hives,
  • Fatigue, or
  • Wheezing.

New research is being conducted and new uses for Botox are being discovered all the time.  Following are some recent developments on Botox.

Botulinum toxin offers some relief to migraine sufferers, but does not seem to be quite the miracle cure that some believe, according to researchers from the Medical College in Milwaukee, WI in a study published in the (JAMA) Journal of the American Medical Association.  The researchers noted that Botox was not significantly more effective than a placebo.

Researchers in Australia have discovered a new way to block the toxin’s action, which could lead to the development of new treatments for botulism.  The study is published in the International Journal of Biological Chemistry, August online edition.

The journal JAMA Facial Plastic Surgery recently published a study that found Botox may effectively improve skin elasticity for as long as 4 months.

Botulinum toxin has been steadily increasing in popularity as a minimally invasive cosmetic procedure.  Since 2000, procedures have increased 700%.  In 2013, Botox was administered 6.3 million times for cosmetic procedures alone.

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Botox: Effective at Treating Chronic Migraine

depressedWhile there have as yet been no double-blind, placebo-controlled studies proving the effectiveness of Botox as a treatment for severe chronic migraine, Botox may well be one of the best preventive treatments for severe chronic migraine sufferers.  This opinion is based on a number of small controlled trials combined with a large number of anecdotal reports, and extensive clinical observation.

A person with chronic migraines is defined as having headaches at least 15 days out of the month, with actual migraine symptoms at least 8 days a month.  In one clinic, over the course of 13 years, nearly 2,000 patients were treated with Botox, and it is estimated that, of those, 60-70% got relief from Botox.  Many of those had tried multiple other therapies to no avail.

One of these patients was a 76 year old woman who had endured migraines for 60 years.  After dozens of different medications, nerve blocks, and other therapies, she saw a neurologist, who recommended Botox.  After a single treatment, she experienced three months of total relief from her migraines.

One of the most interesting things about Botox is that it is quite safe.  This is probably due to the fact that it is a local injection, rather than a systemic treatment like medication, and that it is used in minute doses.  Botox is used for so many different conditions that it has been used in millions of times in the past 20 years.  Botox is a bit pricy, but studies have shown that it actually reduces healthcare costs in migraine patients, not to mention the costs attributed to time off work and reduced productivity.

Recent reports have raised concerns regarding FDA review of the safety of Botox.  It is important to note that the safety issues were related to two very specific groups of patients.  The first group was children with cerebral palsy who received Botox to treat spasticity.  There is a concern that they could receive too many doses leading to system toxicity.  The second group of concern is patients who were treated with Botox for torticollis, a condition where tightened or spastic neck muscles prevent normal head movement, who developed trouble swallowing.

There was also a case of an unlicensed practitioner who injected himself and three others with a dose 3,000 times higher than normal with commercial grade botulinum toxin.  All victims spent several months on a respirator, but ultimately recovered.  

Though generally safe, Botox is just like any other drug in that it does carry some risk of side effects.  Most side effects are temporary and usually mild.  These include worsening of pain immediately after the injections, bruising, redness, and undesirable cosmetic outcomes (such as mismatched eyebrow height).  Injections in the trapezius muscles can lead to a collapsed lung, and injections in the neck muscles can cause weakness requiring a soft collar temporarily.  Most side effects, especially the more serious ones, are generally avoidable through proper technique.

While it is possible to have an allergic reaction to Botox, severe reactions are extremely rare, probably because the dosage is so minute.  The typical dose for treating headaches is only 5 nanograms, or 5 billionths of a gram.  For those not familiar with the metric system, there are more than 28 billion nanograms in an ounce.

Myobloc, another botulinum toxin product, is available, but with some disadvantages.  It has a very low pH (is quite acidic), so injections are more painful.  It takes effect a little faster, but doesn’t last quite as long as Botox.  The risk of it spreading beyond the treated area is also higher, increasing the risk of muscle weakness near the treated area.  Despite the disadvantages, in those rare instances when a patient develops antibodies to Botox, Myobloc may still be effective.

It is important that Botox only be used in patients who have undergone thorough evaluation.  It is important to rule out factors that may be contributing to headaches, such as too much caffeine, too little magnesium, or hypothyroidism, as eliminating contributing factors may be sufficient to offer relief.  Then, triptans or other therapies, including medication, exercise, nutrition, and supplements should be tried.  Anticonvulsant medication or a β-blocker may also be considered prior to Botox.

Botox has not been approved for use in women who are pregnant or breastfeeding, but is appears to be safer than many other migraine medications, many of which are also not approved.  Just because it isn’t approved does not mean pregnant women cannot receive Botox.  Many have, and with excellent results.

After so many years of using Botox for so many different conditions, why have there not been more studies to prove the safety and efficacy of Botox?  There are a couple of reasons.  

One of the biggest reasons is the difficulty in conducting double-blind trials of injectable medications because placebos produce a response so frequently.  While there have been a number of small trials that support the efficacy of Botox in treating chronic migraines, large studies have failed to reduce the number of headache free days.  However, when patients using prophylactic medications are eliminated, the difference becomes more significant.  This difference clarifies why it is important to exclude patients on prophylactic medications from migraine trials.

Another trial was poorly designed because the injections were only given in the front of the head.  In that study, patients given 25 units of Botox showed improvement, while those receiving 75 units did not.  It is possible that patients with strictly frontal headaches were more concentrated in the lower dose group than in the higher dose group.

Two other medications, topiramate (Topamax) and gabapentin (Neurontin), have proven moderately effective, but have not received FDA approval for migraine treatment.  

There is some concern that Botox has become a popular treatment due to higher reimbursement rates by insurance companies than some other treatments.  While a valid concern, nerve blocks are also reimbursed at a high rate, without gaining the popularity that Botox has achieved.

Another round of trials in progress will hopefully persuade the FDA of the safety and efficacy of Botox for chronic migraines.  

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Botox Use for Medical Conditions

botox injectionMillions of people are using Botox to get rid of wrinkles and fine lines. Common names for botox include Dysport, Xeomin, Vistabel, and Myobloc. The demand for botox injections increased by 700 percent over the past 15 years, while reconstructive surgeries increased by only two percent. The world’s most popular cosmetic treatment works by temporarily paralyzing muscles. Its benefits go beyond a younger looking skin.

Botox Isn’t Just Skin Deep

Botox has the ability to improve skin appearance, reduce fine lines, and treat medical conditions like hyperhidrosis, incontinence, migraines, difficulty swallowing, and muscular disorders. The results can be life changing. Many people have successfully used botox to treat excessive sweating in their hands, underarms, and feet. Some have struggled with this problem their entire lives before discovering botox.

A good example is JoAnn Kemist who receives botox injections in her hands every three months. JoAnn has been suffering from hyperhidrosis since her teenage years. Now she is able to control this problem and lead a normal life without having to worry about sweat stains and odor. Her treatment costs almost $10,000 a year, but it’s worth the price. Botox injections block the signals sent to the sweat glands, which helps stop sweating.

Botox Could Change Your Life

Beyond cosmetic applications, botox helps is treating over 20 health conditions, such as:

• Hemifacial spasms
• Overactive bladder
• Urinary incontinence
• Chronic migraines
• Blepharospasm
• Post-stroke upper limb spasticity
• Strabismus
• Shoulder and neck muscle spasms

Many physicians also recommend botox for allergic rhinitis, laryngeal dystonia, cerebral palsy, hypersalivation, anal fissures, and achalasia. Researchers are currently testing a new injectable version with longer lasting results. Clinical trials have already been performed in Mexico and Canada. This revolutionary product could save millions of lives, from Parkinson’s patients to stroke patients and people dealing with chronic pain.

Health professionals can see our Botox Training Program here.

How Botox Can Change Your Life

botoxMore than 11 million people receive Botox injections every year. This popular treatment is performed by physicians, dermatologists, dentists, and even nurses. Even though botox is used mostly for cosmetic purposes, it has the ability to treat a wide range of disorders, from migraines and excessive sweating to strabismus. For many patients, it’s a life changing treatment that restores their confidence.

What Is Botox Used for?

This medical and cosmetic treatment is made with Botulinum toxin, a poisonous substance that paraluzes the muscles. Despite its high toxicity, this substance has proven to be a valuable therapeutic aid when used in small doses. Botulinum toxin can help in treating uncontrollable blinking, crossed eyes, cerebral palsy, multiple sclerosis, stroke, overactive bladder, cervical dystonia, severe sweating, chronic migraines, and allergic rhinitis.

Besides its cosmetic uses, Botox is a valuable treatment for hyperhidrosis. This medical condition causes excessive sweating, affecting people of all ages. Botox injections can temporarily block the signals from the nerves stimulating the sweat glands. Most times, botulinum toxin is injected in the armpits. However, it can also be used on other areas of the body, such as the feet or palms of the hands.

https://youtu.be/9RGDfUa7USs

Gain Control over Your Life

This treatment helped millions of people get rid of chronic migraines, repetitive neck spasms and other debilitating conditions. When injected into the forehead, botox helps relieve tension headaches while smoothing out frown lines. Botulinum toxin can also be injected into the masseter muscles for treating bruxism, a disorder that causes excessive clenching and grinding of teeth.

Many adults, especially women, request botox injections for overactive bladder, which affects over 20 percent of people. This treatment is also used on patients with abnormal spasms of the eyelids, abnormal head position and neck pain, increased muscle stiffness, and tennis elbow. Botulinum toxin seems to justify its title as “the poison that heals,” offering relief for a variety of medical conditions that are unresponsive to standard treatment.

Interested in offering Botox to your patients? Check out our Botox Training Program.

Change Your Life for the Better with Botox

applying botoxWith more people taking steps to look younger, botox is growing in popularity. This product is made from a purified neurotoxin called Botulinum Toxin Type A. Commonly referred to as “the poison that heals,” botulinum toxin is actually the deadliest substance known to man. In large doses, it can cause botulism, a life-threatening disease. When used in extremely small doses, botox relieves migraines, severe sweating, upper limb spasticity, pain from missing limbs, and muscle spasms.

How Poison Can Heal You

Botox injections have been used since the early 1970s. Most people receive botox treatment for crow’s feet lines, glabellar lines, and wrinkles. However, botulinum toxin products can be also used for a variety of medical disorders, such as:

  • Hyperhidrosis
  • Frey’s syndrome
  • Hemifacial spasms
  • Chronic migraines
  • Urinary incontinence
  • Bladder dysfunction
  • Tennis elbow pain
  • Cervical dystonia
  • Strabismus
  • Blepharospasm
  • Multiple sclerosis
  • Anal fissures
  • Pelvic muscle spasms
  • Difficulty swallowing
  • Hair loss

Medical professionals often recommend botox to patients with movement disorders, mental conditions, and chronic migraines. Botulinum toxin has been shown to be effective in treating headaches and leg stiffness in stroke patients. This product works by blocking chemical nerve signals to certain glands or muscles, limiting their activity.

New Uses for Botox

Every year, researchers are finding new uses for botox. This miracle cure does much more than removing wrinkles. The latest studies indicate that botulinum toxin could become a standard treatment for depression in the future. Currently, it’s being used for treating over 20 different medical conditions, from focal neuropathies to eye disorders and cerebral palsy.

When administrated by a knowledgeable professional, botox can be a valuable cure. Its effects last up to four months and can improve your quality of life. This product is a favorite choice for millions of patients who can not tolerate or don’t respond to other medications.

Health professionals interested in offering Botox, see our Botox Training Program.

How Can Dermal Filler Help Your Patients?

As a dental professional, you already work on people’s mouths and their heads and necks in general. But getting proper training to administer dermal fillers can allow you to perform cosmetic procedures on the face so you can keep more than just your patients’ teeth looking youthful and healthy.

A dermal filler is simply a material that is injected beneath the skin to fill out a wrinkled or hollow area, like around the marionette lines, oral commissures or nasolabial folds. It can also be used for lip augmentation and many other kinds of procedures.

And today, patients are increasingly turning to dentists and other healthcare professionals they’re visiting anyway to handle their cosmetic procedures like Botox and dermal fillers.

Many of today’s dentists are becoming right at home with handling cosmetic procedures as an extension of the services they’ve been doing to improve appearances — and therefore lives — for years. With the right training and a little experience, performing injectable cosmetic procedures can be a great way to help patients while enhancing the bottom line of any dental practice.

While some medical professionals may actually be a bit squeamish about performing procedures on the face, that’s nothing new for dentists and other dental professionals who make working on the face and head their life’s work.

There are many different kinds of fillers on the market, and there’s a good chance that many of your patients are already having dermal filler injections elsewhere and are familiar with many of the big brand names in the industry. Give them a new place to turn for these helpful procedures when you start offering cosmetic dermal fillers in your office — and add value to your practice. Doing so is an intelligent decision that will serve and your clients well for decades to come.

And what’s better than increasing your value in the eyes of your clients?

Sign up for Dr. Katz’s online dermal fillers course here.


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