Botox for Boomers: Navigating the Hype and Hazards of Cosmetic Injections for Middle-Aged and Elderly

  In recent years, the popularity of medical cosmetology (referred to as “medical cosmetology”) for middle-aged and elderly people has been rising, and “beauty” is no longer the exclusive preserve of young people. Statistics show that the medical and aesthetic expenditures of seniors are increasing year by year and may become a potential consumption force in the medical and aesthetic industry in the future. Wrinkle removal and face slimming, firming and anti-aging, skin whitening and rejuvenation, and botulinum toxin injections have become popular medical aesthetics projects for middle-aged and elderly people. Among them, there are particularly many middle-aged and elderly people who choose Botulinum toxin injections, because as an old medical beauty technology, Botulinum toxin wrinkle removal is obviously very mature, and most beauty seekers also think it is very safe. However, not long ago, the media broke the news that the neurology departments of many tertiary comprehensive hospitals have successively admitted patients with botulinum toxin poisoning. The most serious patients even experienced symptoms such as general muscle weakness and loss of respiratory function, which were life-threatening. These patients, without exception, received botulinum toxin injections in private beauty salons. For a time, botulinum toxin, which was highly sought after by many middle-aged and elderly beauty lovers, turned out to be the “culprit” of harming people, causing panic. So, can middle-aged and elderly people still safely use botulinum toxin for beauty treatment?
Why “Toxic Substances” Can Be Used in Beauty

  Botulinum toxin is actually the common name of botulinum toxin, which is a type A toxin secreted by Clostridium botulinum during the reproduction process and is also a neurotoxin. It can inhibit the release of neurotransmitters from the presynaptic membrane, block the release of acetylcholine, block nerve impulses from nerves and muscles, and paralyze overly developed muscles. After long-term relaxation and paralysis, the muscles will form “disabling atrophy”, causing the originally hypertrophic muscles to shrink. Plastic surgery uses this characteristic to achieve the effect of “slimming the face” and “slimming the calves”. In addition, if botulinum toxin is injected around dynamic wrinkles, botulinum toxin can also weaken the superficial muscle tension that forms wrinkles, making the face look shiny, smooth, and more youthful and beautiful.
  Botulinum toxin is both a “poison” and a “medicine”. This is not only because botulinum toxin can be used for aesthetic purposes, but also for treating diseases, such as improving hemifacial spasm. Botulinum toxin is used to treat hemifacial spasm by injecting botulinum toxin to cut off the connection between nerves and muscles and prevent facial twitching by sacrificing the motor function of facial muscles. The traditional treatment for hemifacial spasm is surgery, which has high risks and costs. Therefore, using botulinum toxin to improve hemifacial spasm has become the first choice for many patients, as it is safer and more economical. However, it is important to emphasize that the injection location should be selected according to the twitching points on the patient’s face during treatment.
  Precisely because of the dual properties of “poison” and “medicine”, botulinum toxin is regarded as a double-edged sword. Once overdosed, it may cause poisoning or even death.
  The safe injection dose of botulinum toxin generally used for medical aesthetics is less than 200 units. If it is the first injection, the dose will be even less. The principle of “prefer less than too much” is advocated. In addition, according to literature reports, when the dose of botulinum toxin exceeds 500 units, poisoning may occur; when the dose exceeds 2,000 units, it may cause death threats.
  In addition, many beauty seekers choose Botox injections, not just for the face, but may be injected into multiple parts of the body. In this case, you need to be even more careful. Injections into multiple sites should not be scheduled at the same time, but should be injected in batches. It is best to have an interval of more than one week between two injections. At the same time, the total injection dose of each injection should not exceed 200 units. Don’t think that just because your face is smaller, you need to inject 200 units, but your legs are larger, so you blindly increase the amount. This is absolutely undesirable.
Beware of counterfeit botulinum toxin type A

  Experts remind us that we cannot just see those patients who were poisoned due to the incorrect use of botulinum toxin, but ignore the more important issue, that is, the necessity of scientific cosmetic surgery in formal medical institutions.
  According to media reports, several of the patients were treated in informal medical institutions or even beauty salons without medical qualifications, which eventually caused problems. Generally speaking, it is recommended that middle-aged and elderly people choose public hospitals for medical aesthetics projects such as botulinum toxin injections, because they have good safety, low prices, and convenient rights protection. Some illegal private beauty institutions have major safety risks, the most obvious of which is the issue of drug qualifications. In my country, botulinum toxin type A is commonly used and approved for clinical use, including a domestic variety (Hengli, Lanzhou) and an imported variety (Botox, United States). They are not only prescription drugs, but also included in the management of toxic drugs. Therefore, there are strict requirements for storage and use. Generally speaking, pharmaceutical wholesale companies can only sell type A botulinum toxin preparations to medical institutions (referring to public hospitals or private institutions). Undesignated pharmaceutical operating companies are not allowed to purchase and sell type A botulinum toxin preparations. When medical institutions purchase botulinum toxin type A preparations from distributors designated by pharmaceutical manufacturers, they must register and maintain records, have a dedicated person in charge, and have consistent accounts; each dose prescribed by a physician must not exceed two days’ dosage, and the prescription must be kept for two years, and the medicine must be refrigerated , store strictly at 2~8℃. In other words, if the doctor or hospital fails to do the above when injecting Botox, there is something wrong. Especially those that are prescribed for half a year or a year without a formal prescription, you need to be even more vigilant.
  In addition, the doctor’s injection proficiency, drug dosage, etc. are also closely related to the safety of treatment. The rise of the botulinum toxin beauty trend has caused some beauty salons without relevant qualifications to illegally use botulinum toxin type A from informal sources, driven by profits. This illegal behavior has serious harm to the health of consumers.
Do a thorough pre-injection assessment

  When injecting botulinum toxin, choose a regular medical institution and inject it strictly in accordance with safe dosage specifications. Toxic and side effects will basically not occur. However, this does not mean that the technology is completely free of adverse effects. Because it also involves physical differences. For example, some people will not experience any discomfort after injection, but some people may experience local complications of injection (such as blood bruising, swelling, pain, etc.) or regional adverse reactions (such as ptosis, strabismus, changes in eyebrow shape, bite). Abnormal muscle protrusions, etc.). Once these adverse reactions occur, specific botulinum antitoxin can generally be used to treat them as early as possible and in sufficient amounts. However, it should be noted that botulinum antitoxin is difficult to supply and generally requires contacting the Centers for Disease Control to obtain it.
  Of course, if it is used in excessive amounts or for people with allergies, very serious systemic adverse reactions may occur, such as fever, general malaise, difficulty swallowing, abnormal speech or breathing, loss of consciousness, anaphylactic shock, etc., or even direct fatality. For this reason, it is recommended that everyone communicate with a specialist before injecting and conduct a thorough pre-injection assessment.
  Finally, it is important to emphasize that the following categories of middle-aged and elderly people are not suitable for botulinum toxin injections: those who are allergic to the ingredients of the injection products or those with allergies (such as those with protein allergies), diabetics, those who have just taken aminoglycoside antibiotics, those who are immune disease or those suffering from organic diseases.

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