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04-21-03: One prick closer to finding the Fountain of Youth
The Daily Standard

    Area residents have another weapon in the arsenal when it comes to fighting wrinkles.
    Dr. John Wilding, an ophthalmologist with Ohio Visions in Celina, Sidney, St. Marys and Bellefontaine, is offering Botox treatments for cosmetic purposes.
    Botox, or more specifically Botulinum Toxin Type A, blocks nerve impulses to muscles that cause wrinkles. The protein component of the toxin does not affect nerves so there is no numbness, Wilding says. The non-surgical treatment yields results that last from four to six months.
    "The cosmetic side of Botox is fun," he says. "It's a mini facelift - a way for patients to test the waters without surgery."
    Wilding focuses on the frown lines in the brow and crow's feet at the outside edge of the eye. These are the main areas of concern for patients between the ages of 30 and 50.
    Wilding administers five injections using small diabetic syringes and fine gauge needles. The ophthalmologist smiles, recounting how many of the people he treats ask whether he is about to start the procedure, when in fact it is already completed. Others complain of a slight stinging sensation.
    The brow and the outside area of the eye are not as richly endowed with nerves as other parts of the face like the lips. Although relatively easy to treat, the results are dramatic.
    Wilding does not push the limit, choosing to stay away from the mouth and the immediate area of the eye. Any miscalculations there could result in noticeable drooping, like the effects of a stroke.
   "I want happy patients," he says. "I prefer to stay in the safe spots and work within prescribed guidelines."
   His close friend from medical school, who is involved in Botox research, also recommends treatment in selected areas of the face. Treatment involving the entire face could produce mask-like results with a loss of expression.
    Wilding points out the small amount of toxin used in cosmetic treatment gradually wears off in four to six months, necessitating additional injections. A patient gradually requires a lighter dosage to achieve similar results.
    It isn't only women who come to the Sidney office for treatment. Men also are conscious of how they look in today's competitive business market. Salesmen, in particular, want to present a good appearance as they make calls at businesses and industries. Removing wrinkles from the brow takes away any suggestion of worry and stress.
    At $300 to $500 per treatment, Wilding considers Botox an ideal way for patients to "test the water" before trying more complicated procedures like dermabraison and surgical facelifts.
    "Botox is neither permanent nor threatening," he adds. "The results are temporary so you aren't stuck with the results for life. I haven't really had any negative complaints."
    A St. Marys woman, who laughingly claims she is middle age and holding, underwent the procedure a few months ago and is thoroughly pleased with the results.
    "I don't mind looking in the mirror any more," says the woman, who wishes to remain anonymous. "Botox zapped my crow's feet and it was easier than a trip to the dentist."
    Wilding offers a seminar for prospective patients. The first appointment includes an evaluation of the problem and what the patient wants to achieve. One vial of the toxin is enough to do four to six patients, with all treatments done in the Sidney office.
    Botox was first approved in December 1989 to treat two eye muscle disorders - one that causes crossed eyes and the other a rare condition that makes it difficult to open the eyes due to spasms. The next use was in treating cervical distonia, a condition causing painful involuntary contractions or spasms in the neck and shoulders. Only later did the drug gain acceptance in cosmetic application.
    Botox also offers hope to men and women plagued by migraine and other debilitating headaches.
    Wilding began treating patients with migraines last year with a success rate of over 80 percent. They are his happiest patients by far, often telling others how Botox has released them from excruciating pain. The injections are placed in areas where pain is most intense, including the facial, head and neck muscles.
    Dr. Douglas Van Fossen, a board certified anesthesiologist and interventional pain specialist, also uses Botox in the treatment of debilitating headache disorders at Advanced PainCare Inc. in Sidney.
    "The most unique aspect of Botox as a treatment for headaches is its duration of effect; patients typically experience three to four months of relief from a single treatment," Van Fossen says. "Botox is a novel and promising preventive therapy that is providing a significant advance in headache treatment."
    Wilding likens the current use of Botox to merely the tip of the iceberg, adding more developments are coming out of additional studies.
    A story published in the November issue of "Pediatrics" indicated the toxin enabled some children with cerebral palsy to walk without braces and ride tricycles. The report was attributed to Dr. L. Andrew Koman, lead researcher and an orthopedic surgery professor at Wake Forest University in North Carolina.
    Other applications include the treatment of spasmodic dysphonia, a neurological disorder affecting the larynx, and hyperhidrosis or excessive sweating.          
    "This is the richness of medicine - broader minds open to the possibilities of helping people in other situations," Wilding says. "We've only scratched the surface with Botox. I believe there are great potential benefits yet to be discovered, benefits that far outweigh the cosmetic value of temporarily removing wrinkles.


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