Kill wrinkles, not yourself: defying your age through medical treatments is all the rage, but doing it safely is of increasing concern

South Florida CEO, March, 2005 by Barbara Perkins

It is late on a Thursday afternoon and the waiting room of Oscar Hevia's dermatology practice in Coral Gables is packed with patients looking for a way to turn back the clock on aging.

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The 43-year-old physician runs one of the busiest Botox practices in South Florida. On a good day, Hevia and his associates inject as many as 30 patients with the popular anti-wrinkle drug. And the patients continue to line up there despite a health scare at an Oakland Park clinic last fall that left four people critically ill after they were injected with the full-strength botulism virus, which causes paralysis and can kill.

"People don't have to be scared about Botox," Hevia says, as long as they seek treatment from a reputable doctor and clinic.

Hevia specializes in cosmetic dermatology and says that Botox--a weakened form of botulism manufactured to relax the muscles around a wrinkled area--is an essential part of treating aging faces. Botox is used primarily in areas from the eyes up and there are other treatments that supplement its effects.

Hevia says there has been a surge in the use of injectables or fillers, which are used in areas of the face from the eyes down. Fillers, he says, are substances that are injected to replace volume in the face. Although fillers have been around for quite some time, new ones are constantly being introduced. Restylen and Captique, which are injectable gels, are two of the newest products being used according to Hevia.

"They're better because they're longer lasting," he says.

If administered properly, Botox and similar treatments are safe and effective. In the case of the Oakland Park clinic poisoning, an osteopathic physician, operating with a suspended license, injected himself, his assistant and a Palm Beach county couple with toxic doses of the botulism virus--not Botox, which is approved by the government for use in humans.

To be safe, Hevia advises patients who want Botox treatment to be sure to see a reputable doctor at a practice where they routinely inject patients with Botox. He suggests patients go to someone they know or go to someone whom others know and can recommend.

Once there says Hevia, "don't be afraid to ask the doctor directly if they are using the FDA-approved Botox," and he says patients should ask to see the vial. To be safe, Hevia says stay away from Botox parties: those non-office settings where Botox is injected.

"This is when Botox is being injected in someone's home," Hevia says. "A lady might call ten of her friends and they all show up and some doctor shows up, and gives them all Botox in her house."

Not only is the Botox there likely to be stolen, says Hevia, but it is also highly improbable that those administering it are licensed to do so. The FDA approved Calif.-based Allergan Inc. product Botox Cosmetic in 2002. It is the only federally approved wrinkle treatment on the market.

Hevia says he is amazed that incidents of fake-Botox poisoning are so rare, given that unlicensed doctors are so prevalent in South Florida.

"We have a very large immigrant population that may not be able to afford a reputable doctor," he says. In a typical scenario, Hevia says people will seek advice and referrals on wrinkle treatments from hair stylists in salons. "That person could be a doctor who is not licensed to practice in this country or it could be a nurse who is not qualified and is nonetheless performing procedures on patients," Hevia says. "You see it in the cosmetic and surgical realms all the time."

The objective in the practice of cosmetic dermatology, says Hevia, is not to alter appearances but rather to offer non-surgical methods to prevent the need for facelifts. "You still look like you," Hevia says, "just a younger, fresher you."