I did write about this topic, albeit tangentially, in this silly article when Kylie Jenner was rumored to be pregnant with her first child!

Botox in pregnancy

While no doctor will encourage you to get botox injections for cosmetic reasons while pregnant, it doesn’t mean you can’t or you shouldn’t. Simply put, there isn’t a large randomized controlled study comparing women getting botox while pregnant vs women not getting botox while pregnant.

Yes, a large study of this type would answer the question of whether botox was safe in pregnancy. But it will never happen. For obvious reasons, no one would conduct or fund a study that could potentially affect a baby. So we’re left to extrapolate from this retrospective study (studying patients after the fact), animal studies or personal stories of patients that have gotten botox during pregnancy.

As a plastic surgeon, I have injected patients with BOTOX® or XEOMIN® when they didn’t realize they were pregnant. And the patient and their baby turned out fine. So while there’s no evidence of a problem in being injected with these products while pregnant, it’s impossible to say they’re safe beyond a doubt. But there’s no evidence of birth defects associated with cosmetic botox injections that exceeds the risk in the general population. It’s a calculated risk similar to the risks we take walking across the street, not wearing a mask outside or speeding on the highway.

Botox while breastfeeding

This one is a little easier. Based on the LactMed database that evaluates medications and their presence in breast milk or their affect on the child, the evidence is quite clear:

“No data exist on the medical use of onabotulinumtoxinA [BOTOX®] during breastfeeding. However, it is not detectable systemically after intramuscular use, thus excretion into breast milk is considered unlikely. Breastfeeding appears to protect infants against botulism.”

In other words, botox isn’t detectable in breast milk. To further drive home the point, even in a patient that became ill after ingesting botulinum from tainted food (not cosmetic botox injections), she didn’t pass the toxin along to her fetus. So even if it’s present in high concentrations systemically during an active infection and still doesn’t reach the breast milk, then it’s even less likely to reach breast milk when present in lower concentrations associated with cosmetic, localized injections.

As an aside, botulism from tainted food is the same reason you don’t feed honey to a baby before the age of one because of the presence of the botulinum bacteria. After age one, children are better equipped to ward off the infection.

There you have it. The data. And now you can make an informed decision based on that.

Click here to check pricing from Dr. Kaplan!

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyHealth.

The post Botox, Xeomin or Jeuveau during pregnancy and breast feeding first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

This recent Wall Street Journal article highlights the increasing competition in the neuromodulator market. A neuromodulator is the fancy term for a chemical used to relax facial muscles, thereby reducing wrinkles, ie Botox! In most industries, when you have more competition, that benefits the consumer by forcing lower prices. Will these competitive forces cause Botox to lower its price? Don’t bet on it!

Why more competitors won’t force Botox to lower it’s price

It is a natural assumption that with more options for a particular product, prices will go down. That’s why competition is good. But Botox is different. We’re most familiar with Botox for relaxing the wrinkles in between the eyebrows. Or treating a gummy smile. Or narrowing the jawline. But it has other uses that are less cosmetic.

Botox (and it’s competitors Dysport and Xeomin) are also great for medically necessary problems. Babies that have problems with bowel movements can get Botox to relax the anal sphincter. It can help with hoarseness. It’s an appropriate treatment for torticollis – a severe spasm of the neck muscles that causes the head to tilt. Medicare and other insurance companies will cover the cost of Botox for these medically necessary issues.

But because Botox has an agreed upon cost with the Federal government (Medicare) and other insurers, they have to be consistent with their financial practices. For example, if Medicare or an insurance company agrees to a certain cost for Botox, the makers of Botox can’t charge doctors a different rate. Said another way, if they charge the doctors less that are using Botox for cosmetic purposes, then the government or insurers won’t agree to pay a higher amount. Or at least it will bring up the uncomfortable conversation of why they’re charging one group one amount and more (or less) to a different group.

So they can either charge everyone (doctors, Medicare and private insurers) less, or charge everyone a higher rate to obtain a higher profit margin. Because the makers of Botox generate a lot of revenue from the medically necessary side of business, they don’t want to take a hit by lowering the cost to be more competitive with the cosmetic side of their business. Make sense? If not, comment below.

While we’re on the subject, check pricing on Botox and Xeomin from Dr. Kaplan by clicking here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Will more competitors force Botox to lower it’s price? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.