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A new wrinkle in the Botox fad: Botox may cause new wrinkles

New York, NY (January 23, 2003) -- Can use of Botox cause new facial wrinkles? Is laser hair removal safe for those with darker skin? What are some alternatives to plastic surgery? From skin safety to anti-aging procedures, dermatologists at Weill Cornell Medical Center at NewYork-Presbyterian Hospital answer these questions and more, providing expert advice on a range of cosmetic skin treatments.

For patients receiving Botox injections to remove facial wrinkles, skin adjacent to the treatment area may become more wrinkled, says Dr. David S. Becker, Clinical Assistant Professor of Dermatology at Weill Cornell Medical College and Assistant Attending Physician of Dermatology at Weill Cornell Medical Center at NewYork-Presbyterian Hospital.

"After receiving Botox, a patient may unconsciously attempt to re-create the facial expressions in the area where treatment has paralyzed their facial muscles, "said Dr. Becker. "What can happen is that other, nearby muscles compensate--this can have the effect of actually creating new wrinkles."

One of the most popular areas for treatment is the so-called scowl lines between the eyebrows. "In this case, following treatment, muscles in the upper nose, middle eyebrow, and eyelid, may try to recreate the expression of a scowl. Repetitions of this action cause new wrinkles." While the resulting new wrinkles are less prominent, the patient and their physician will need to observe carefully this development and decide whether to discontinue treatment or use Botox on additional areas.

Dr. Becker emphasizes that Botox has been proven to be safe and effective for treatment of wrinkles.

Other current dermatological issues include laser hair removal for persons of color, new hair transplant technologies, cosmetic considerations of skin cancer surgery, how to know if your dermatologist is safe, and the effectiveness of anti-aging technologies.

á Laser light hair removal is safe for individuals with all skin types, even the more difficult to treat darker skin types, reports Dr. Harvey Jay, Clinical Assistant Professor of Dermatology at Weill Cornell Medical College and Assistant Attending Dermatologist at NewYork-Presbyterian Weill Cornell. Of 498 procedures and 250 consecutive new patients studied, minor side effects were observed in only two percent of patients treated. Additionally, no anesthetic is necessary for the painless procedure.

á Say goodbye to "plugs" or "cornrows." New techniques allow men and women getting hair transplants to have natural-looking hair, says Dr. Marc Avram, Clinical Assistant Professor of Dermatology at Weill Cornell Medical College and Assistant Attending Physician of Dermatology at NewYork-Presbyterian Weill Cornell. Hair follicles are transplanted in their natural groupings, varying from one to four hairs--exactly how they grow on the scalp. Previously, hairs were transplanted in groups of ten or more per graft and appeared "pluggy" and unnatural. With these novel techniques, men and women can now consistently expect natural appearing transplanted hair.

á How do I stop the clock of cosmetic aging without undergoing plastic surgery? Treatments and technologies include retinoid rejuvenation, laser treatments, bovine collagen, and radiofrequency skin tightening, reports Dr. Neil S. Sadick, Clinical Professor of Dermatology at Weill Cornell Medical College and Clinical Affiliate at New York-Presbyterian Weill Cornell.

á Having a thoroughly trained dermatologic surgeon is critical, says Dr. John A. Carucci, Assistant Professor of Dermatology at Weill Cornell Medical College, and Assistant Attending Physician of Dermatology at NewYork-Presbyterian Weill Cornell. It is also important that your physician be well-versed in the latest research, treatment options, and safety considerations. Dr. Carucci is also Director of Mohs Micrographic and Dermatologic Surgery, and Co-Director of the Center for Aesthetic Laser Surgery at Weill Cornell Medical Center.

á Over one-million Americans are diagnosed with non-melanoma skin cancers every year. What should your doctor know about preserving appearance during removal of skin cancers? The treatment of choice for selected and non-melanoma skin cancers is Mohs micrographic surgery because it provides the highest cure rates and allows for maximum conservation of normal skin, reports Dr. Carucci. The doctor describes methods to minimize noticeable scarring following skin cancer surgery.

The above findings are reported in the current issue of Cosmetic Dermatology, the official publication of the American Society of Cosmetic Dermatology & Aesthetic Surgery. This special issue has been co-edited and compiled by Dr. Carucci and Dr. Sadick. Articles include "Muscle Recruitment as a Potential Side Effect of Botulinum Toxin Therapy," "Safety of Intense Pulsed Light High Removal in 250 Consecutive New Patients," "Hair Transplantation for Men and Women," "A Structural Approach to Non-Ablative Rejuvenation," and "Optimizing Cosmesis in Repair of Defects After Removal of Skin Cancers by Mohs Micrographic Surgery."

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