The University Record, May 22, 1995

Toxin allows smoothing of facial wrinkles without surgery

Medical Center Public Relations

The toxin that causes botulism, a rare but serious form of poisoning caused by eating contaminated canned or preserved food, is the most potent poison known to man. But at the Medical Center, facial plastic surgeons are using minute amounts of clostridium botulinum to safely minimize or erase vertical "worry lines" between the eyes--without surgery.

Botulinum toxin is deadly because it causes progressive paralysis throughout the body. Most untreated victims die of suffocation when their respiratory muscles freeze. But the very quality that makes botulinum so dangerous is what makes it so effective in reducing wrinkles. When the toxin is injected near the offending crease, the muscle tone underneath is weakened, causing the skin above it to flatten.

"In essence the toxin works by blocking the nerve impulse to the muscle; it temporarily paralyzes the muscle," says Shan R. Baker, director of the Center for Facial Cosmetic Surgery. The center is one of the handful of those nationwide that are using "botox" cosmetically. The toxin has been used medically since the 1970s to treat uncontrollable eye spasms and other neuromuscular twitching disorders.

Unlike silicone, collagen and fat injections, which merely fill in wrinkles, botox provides an entirely different approach to treating the aging face. Baker says, "by physiologically weakening the muscles, the wrinkles are removed naturally."

It takes three to five days for botox to do its job. Worry-line patients know it's taking hold when they can no longer furrow their brow. "On the third day, I tried as hard as I could to frown, but I couldn't do it," recalls 44-year-old patient Claudia Walters, of St. Clair Shores. "I was getting a permanent vertical line on my forehead between my eyes, and it made me look angry; now it's totally gone."

The treatment is limited to the upper region of the face. Muscles below the eyes cannot be paralyzed without distorting the patient's smile. Use of botox also is limited to those between the ages of 30 and 60, as wrinkles in older patients tend to be too deep to benefit significantly from the injections.