Breakfast with Dr. Frank Beninger, discussing -
"What you should know about Surgery"
Int: How do the injectables work? There seems to be about 4 or 5 different products on the market, and I am not sure if they all do the same thing or if each one does something different?
Dr. B. A little bit of both. We really have two classes of injectables. One, the fillers, and the other is BOTOX™ which at the moment is by itself. We don't have any other competitive product to it. BOTOX™ is different, it works by paralyzing muscles, it's not a filler. The other products are the fillers and they are used to fill up volume deficit. Deep lines and wrinkles, depressed scars, and in that group we have a multitude of products available. Most of those are temporary, some are short lasting, some are medium lasting and some are long lasting, and some are permanent
Int: Is that the difference in the fillers and injectables, with the exception of BOTOX™?
Dr. B. It's really the duration of action, although it's a different type of product that's being used for different durations of action also.
Int: Is BOTOX™ safe?
Dr. B. BOTOX™ has been shown to be extremely safe. It has very few side effects, its complications most commonly would be some bruising and swelling, the effects are intermediate
and last about 3 - 4 months. Many people wish they would last a lot longer, however perhaps with with future research and development, it will probably become the case.
Int: Are those expensive procedures?
Dr. B. If you compare them to the cost of surgery, they are considered quite economical. Prices are changing fairly rapidly, mainly by the competition in the market place. Newer products that are being developed and released . is also helping to drive the cost down of these products down.
I think overall, people are going to find a lot of these treatments are very economical.
Int: If you get BOTOX,™ and it lasts for 4 months, and then the person has to come back and have it done again, how many times can the person get BOTOX - and when they start BOTOX does that mean they have to take it for years? How does that work?
Dr. B. They can start or quit anytime they wish. Certainly with BOTOX, one of the concerns that people have is, does it have a cumulative effect on the body because it is a toxin. Does this toxin build up and eventually become dangerous, or does it create other problems? The answer to that is NO. BOTOX™ itself is metabolized and inactivated quite quickly, and it's really just the effect it has on the nerve and muscle that gives it the prolonged clinical effects. So certainly there are no toxins building up in our bodies, like lead poisoning or other heavy metals. So it is safe to use long term.
Int: How about the other fillers and injectables, it was very fashionable a few years ago to have fuller lips . If someone wanted fuller lips , how many times would they need to have the injectable or filler to have that look.
Dr. B. It depends on the size of their lips, and the size they desire. Some people could have one treatment and others 4 or 5 treatments. It really depends on the desired outcome. If you are thinking of doing something fairly dramatic, you are probably wiser to stick with the temporary products. You may change your mind later on as to what you think is fashionable and attractive, five, ten twenty years later, and if you use something that's permanent then you are stuck with it, and you may require surgery to reduce or remove it.
Int: What would happen if you did have something permanent and wanted a facelift, would the injectable material be removed?
Dr. B. Not necessarily, if someone has had their laugh lines filled, they can still have a facelift, and quite often after the facelift, they are going to have an even smoother looking appearance. A facelift helps reduce the laugh lines, but certainly doesn't take them all away. If you have had a t filler it will generally give you an even nicer, or more harmonious result.
Int: The business of looking good is here to stay. Whether you have a facelift, an injectable or BOTOX™. BOTOX™ was the largest non surgical procedure performed last year. One of the things that concerns me, is that I hear of women going to plastic surgeons with one problem, and come out with ten new problems. What is the reason for that?
Dr. B. I have seen that myself, and there are times when I will suggest options on a treatment, when a patient comes in and asks about a procedure. An example of this is when someone complains of heavy eyelids and has asked for an eyelid lift. There are times when doing an eyelid lift isn't an appropriate operation. The effects of having low eyebrows can contribute to heavy eyelids, and those people are often better treated by doing a brow lift, instead of the surgery that they initially asked about. People need to know more about the procedures that are available and what they can achieve. This way they can then choose the best procedure to get the desired result. Sometimes people come in with a particular problem, then during the consultation you find that the procedure they are seeking, is not going to correct that problem, therefore an alternative operation may be mentioned to them. For example, some people may come in wanting a facelift and their understanding is a facelift is going to rejuvenate their neck, their face, their eyes, their forehead, when in fact all it's going to do is the cheeks down to their neck. In those cases you have to tell them that the eyes, and forehead is not going to change and that they are going to require other procedures. Finally they may have one surgery done and it's not going to be in balance or harmony with the rest of their appearance. So you may have to explain another operation so that their overall result is symmetrical, harmonious and in balance. If someone has a very old looking face and an old looking forehead and all they do is a facelift, they are going to have a fresher more youthful looking face, but an old looking forehead, and the two will look out of balance with each other.
Int: In terms of a facelift I even thought that myself, the facelift would be done and that's the end of the story. I guess we never think in terms of the eyes the cheeks and the rest of it. So that's a very good point for those of us considering a facelift.
There you have it, Dr. Frank Beninger from the Beresford Clinic in Toronto Canada, injectables, fillers, Botox, Cosmetic Surgery, the choice is yours. Thank you Dr. Beninger.
