Changing Faces: America Nods to a Popular Protein
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SANTA MONICA, Calif. - WisconsinEagle -- It's one of the most popular proteins in the world, but don't eat it. It was the debut microbial injection for disease treatment and paved the way for a host of others since culled from a family more than a trillion strong, 99.999 percent of which have yet to be discovered.

In the top tier of its class, the ".001 percent" have changed the faces of Earth.

Considered one of the safest cosmetic procedures available, its pioneer brand is approved for use in 98 countries and, in under two decades, 100-million vials (or roughly 10-billion units) have been sold in the United States alone.

It's everywhere. Early last year, 17 camels disqualified from a beauty pageant (forfeiting a potential cut of $57 million in prizes awarded) at an annual event in Saudi Arabia. Their caretaker had been cosmetically altering them with the treatment.

Botulinum was discovered in the 1800s after a batch of ill-prepared ham affected a couple dozen Germans. "Botulus" is the Latin root for the word sausage.

Less than 1 gram of it in purified form makes the world's cosmetic and medical supply for a year — where a few billionths of a gram dissolved in saline serve cosmetic and medical needs.

As a toxin, it's not quite alone. Other toxins turned medical implements include a diabetes drug synthesized from Gila monster venom and an antihypertensive drug developed from snake venoms, while opium and hemlock numbed surgical pain for more than 1,000 years. Arsenic is used to treat a rare blood cancer, and from the lethal foxglove plant comes a drug that increases circulation and strengthens the heart.

Today it's more than a vanity product. It treats medical conditions ranging from migraine headaches, to eye squints and leaky bladders, excessive sweating and a dozen more. Another 800 patents have been issued for potential uses of the product.

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"When injected into specific trigger sites, the muscles relax, reducing or eliminating migraine headaches," says Utah Plastic Surgeon, Dr. Kevin Rose. "One site is injected at a time, with the patient monitoring their headaches for a period of one month after the injection. This process is repeated usually 3 or 4 times or until we have determined which sites have responded to the treatment. This migraine treatment offers relief that lasts without the nausea, grogginess, and other side effects of medication."

"Botox is an established treatment for excessive teeth grinding (also known as bruxism) and even for TMJ. The side benefit of this use is that it can help slim down the face, which is especially appealing for women who want a less square or masculine-looking jaw," says Dr. Reza Tirgari of a San Diego Med Spa, Avalon Laser.

The injections are the most commonly administered minimally invasive cosmetic procedure in the US and have increased by 845% since the turn of the decade.

"Wish-pics" and the selfie filters in Snapchat, Tinder and Instagram, says one study, are partly accountable for some of the $2.95 billion spent last year on the procedure, a 28% increase in seven years of 20-somethings going under the needle.

There are four such injectables on the market, none are the generic or unaltered toxin and none are dosage-interchangeable.

One of them is produced in a hypersecure Irish facility thousands of times more sterile than a hospital operating room. Its air is filtered 200 times per hour, and every employee undergoes a 40-step sterile dressing process that might take you more than 30 minutes — twice the time it takes to give or get a treatment, which can be completed in 15 minutes, or faster than a haircut or an airport shoeshine.

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"It is fully absorbed in five minutes or less, so there is no need for activity restrictions later on in the day," says facial plastic surgeon Richard W Westreich, an MD and FACS in New York.

Botox is the most widely researched and studied treatment of its kind. 528 peer-reviewed articles have appeared in scientific and medical journals.

"Botox has changed the cosmetic industry," says Dr. Mike Majmundar, a board-certified Georgia plastic surgeon who is one of the top 100 national injectors by volume. "It started off with improving lines in the forehead and between the brows but now it can be used around the eyes, lips, nose, and for the neck in addition to treating a myriad of concerns including TMJ, migraines, excessive sweating, drooling, tics, and so many others." Majmundar was named one of Atlanta's top doctors.

Studies suggest the treatment has expanding potential uses. For example, an estimated 176 million women are afflicted by endometriosis, a disorder with no cure and which produces chronic pain in the pelvic floor, but which may be relieved by botulinum.

"Botox has now been linked to a decrease in major depressive symptoms," says Tirgari. In one study, about half of the recipients saw a significant decrease in depression, he says.

Treatments typically hold for four to six months, but that's not for want of product efficacy. "It doesn't wear off. The body makes new nerve connections. That's why they can't make a stronger Botox. It's not about the product. It's the patient," says Westreich.

New uses and delivery methods are developed frequently. One such procedure tightens, smoothes and hydrates the skin, minimizes pores and reduces oil production. The first of its kind and FDA-approved, "AquaGold" is a trademarked "micro-infusion device that uses a customized cocktail of Botox, Hyaluronic Acid, Platelet-Rich-Plasma (PRP), and a variety of vitamin complexes," says Rose.

"Hair-thin 24 karat gold needles deliver anti-aging products directly under the skin."

And so America celebrated a first-ever National Day in its honor.