Dr. Robert F. Gray - Botox A SHOT AT YOUTH

Modesto Bee, The (CA)

May 8, 2002
A SHOT AT YOUTH
BOTOX -- A DILUTED FORM OF THE BOTULISM TOXIN -- OFFERS AN ALTERNATIVE TO PLASTIC SURGERY

Author: KERRY MCCRAY, BEE STAFF WRITER
Edition: All
Section: HEALTHY LIVING
Page: F1

Patricia Richardi has never been happy with what she calls the "stress marks" on her forehead.

But the 46-year-old from Ripon wasn't sure what to do to make the fine lines go away. A face-lift was out -- too expensive and too time-consuming.

So, like thousands of others, Richardi began seeing a doctor who uses a needle the size of a hair to inject her brow with botulism toxin.

Yes, botulism. The bacteria associated with poorly canned food is the key to one of the most common cosmetic procedures in the United States.

The stuff is called Botox, and it's an extremely diluted form of the bacteria that causes food poisoning. The U.S. Food and Drug Administration last month approved it for cosmetic use.

"This is an alternative to a face-lift," says Richardi, who now has a smooth brow.

The FDA's approval doesn't mean much to doctors here and throughout the nation, who have been using Botox for years to smooth their patients' frown lines, forehead creases and crow's feet.

That's because the FDA already had approved the toxin for eye-muscle disorders and neck and shoulder spasms. Doctors are allowed to use approved drugs for unapproved purposes as they see fit.

Turlock dermatologist John Willsen, Richardi's doctor, has about 300 patients who get Botox injections, about 20 of them men.

Botox works, he explains, by temporarily blocking the nerves that signal facial muscles to contract when people squint, smile, frown or raise their eyebrows.

That doesn't mean people who receive Botox injections have expressionless faces, Willsen says. The 54-year-old doctor has been injecting himself with the toxin for the past five years.

"It doesn't make people have plastic expressions," he says, grinning to prove his point.

There can be side effects, though. The FDA says the injections may, in rare cases, cause droopy eyelids and nausea. To prevent the eyelid problem, Willsen said doctors inject Botox with the needle pointing away from the eye.

Despite the risks, Botox is still popular throughout the nation and in the Modesto area.

Dr. Theodore Staahl of Modesto injects about 10 patients with Botox each week. He doesn't need to advertise the procedure. Instead, he relies on satisfied patients to tell their friends.

Most of Staahl's patients are women in their 30s, 40s or 50s.

"They're the women who want something done and don't want surgery," he says.

A Botox injection, which costs about $400, is far more affordable than facial surgery, which can set people back thousands of dollars. Insurance doesn't cover the cost of Botox, unless it's for a medical use, like muscle spasms.

Unlike surgery, Botox injections are quick, about 15 minutes. Injections are done in the doctor's office. Some patients say they can see results in just a few days.

More than 855,000 people throughout the nation got Botox injections last year, some more than once. Many patients get refresher injections when the effects of the original shot wear off after about six months.

As doctors give more injections, they're discovering more uses for Botox. Staahl gives the injections to help patients who suffer from migraine headaches, as does Dr. Robert Gray of Manteca.

Gray has three patients who used to turn up at the emergency room about once a week for a shot that would temporarily relieve their headache pain.

Now, he injects these patients with Botox once every three to five months. Their headaches are much less severe. Gray's not sure how this works, except that Botox seems to relieve muscle tension that may lead to migraines.

Another use for Botox, this one popular with the Hollywood crowd: underarm injections to stop perspiration.

"At the Oscars, the women don't want sweaty armpits from all the lights," Gray says. "So they use Botox."

(BART AH YOU / THE BEE)

Dr. John Willsen of Turlock gives a Botox injection to patient Patricia Richardi. Botox is an alternative to cosmetic surgery.

Botox injections -- used to smooth frown lines, forehead creases and crow's feet -- last three to six months.