Proper dosing, application technique key to optimal botulinum toxin use

Botulinum toxin (BTX-A) is a powerful tool for beautifying patients and smoothing wrinkles, but to achieve the best results takes a strategic approach.

Glynis Ablon, M.D., assistant clinical professor, University of California, Los Angeles (UCLA) spoke yesterday about how to use the toxin to its fullest potential - accentuating the positive impact it can have, while minimizing or eliminating untoward side effects of its use.

In a separate presentation, Benjamin Ascher, M.D., a Paris-based board-certified plastic surgeon discussed optimal dosing of the drug. He cited low rates of complication and long-term sequellae from its use, and reported that 2 BTX-A, one from Allergan and the other from Ipsen, were reliable. Dr. Ascher says he has used the products for 12 years on 10,000 patients. He adds that botulinum toxin B (BTX-B) from Elan Pharmaceuticals, seemed to be less effective and durable - producing more patient headaches and general reactions.

He said clinical conversion tables drawn up between the three drugs yielded: one unit of the Allergan product is approximately equivalent to between three and four units of the Ipsen product and 50 units of the Elan product in these indications. He adds that a current trend is to reduce the dose for each injection per region to be treated.