Developments in temporary, permanent fixes, fillers

Newport Beach, Calif. - Anti-aging therapies are shifting as the U.S. Food and Drug Administration approves an assortment of fillers and as researchers continue to study the use and safety of botulinum toxin.

At the Pacific Dermatologic As-sociation meeting, botulinum toxin pioneer Alastair Carruthers, M.D., of Vancouver, British Columbia, told dermatologists that results of higher doses of Botox injections in men are longer- lasting and safer than previously thought, according to recent studies of thesafety of the injectable.

Using himself as an example, Dr. Carruthers says that using 50 units provided only moderate results that lasted a couple of months. However, a 100-unit dose would last six months or longer.

Dr. Carruthers believes a lot of doctors are under-dosing, not out of safety concerns but because of the cost.

"If doctors are worried about losing patients because of the cost of Botox, they should reduce the fee per unit and put more units in. They will actually make more money in the long run, because people will be more satisfied with the results and will be more likely to come back because they are happier."

Dr. Carruthers also warns thatdiluting Botox is more detrimentalthan money-saving.

"One of the biggest issues with patients' dissatisfaction is inadequate dosage. If Botox doesn't work, patients aren't going to be happy - so give them the juice.

"It's not like you're using a filler. With a filler, you can put more volume in, if you like, so it will fill more. But Botox is a drug, like penicillin. You need the dose to achieve the effect. Doctors need to think of Botox as a drug, and the right dose will depend on the place, time and circumstance."

Dr. Carruthers points out the growing market for fillers in the past year.

"I think we had pushed collagen as far as it would go, and Restylane is very different. It offers increased duration, a different feel in the tissue, and it is of non-animal origin. These are all positive factors that will increase the number of people desiring fillers.

"About half of all fillers are injected into the lips in many practices, and Restylane is fabulous in the lips because of the natural appearance and feel. It passes the kiss test."

Dr. Carruthers doesn't think the new fillers will completely replace collagen.