May 16, 2008 8:59 am US/Eastern
Botox Lifts: The Next Breast Thing?
Cosmetic Toxin Used To Improve A Woman's Posture, 'Lift Up' Breasts
Plastic Surgeons Disturbed By Practice, Warn Against 'Off-Label' Uses
By STEVE FINK, WCBSTV.COM
NEW YORK (CBS) ―
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Some doctors are now performing the "Botox breast lift." Plastic surgeons, however, aren't on board with the procedure. (File)
CBS
It is one of the most powerful, poisonous, and paralytic proteins known to man, yet why is dermatologic wonder-drug Botox – the cure-all phenomenon that's taken the cosmetic world by storm – being injected into women's breasts these days?
"Dermatologist to the Stars," Dr. Patricia Wexler, proudly advertises the answer to that question at her Manhattan practice. The Murray Hill-based doctor, who has her own cosmetic line and has been featured on "The Oprah Winfrey Show," recently began offering Botox injections in the breast as a quick-fix for women who want to non-invasively give their breasts a temporary lift.
"Botox is about a yin and yang of muscle movement. If you weaken a muscle that's pulling something down, the muscle which is pulling up has nothing to oppose it," explains Wexler. "So if you weaken the pectoralis minor muscle, which is pulling the breast down, the rhomboid muscle in the back is going to have nothing to oppose it, so it's actually going to pull up your back and give you better posture and actually lift your breasts up."
The procedure requires three injections on each breast and is performed with a needle she says is one of the tiniest in medicine.
Wexler says the effect lasts anywhere between 10 and 12 weeks, though other doctors say it could keep the pec muscle at bay for up to six months. Still, she says the only downside is the cost: between $1,500 and $2,000 for both breasts.
"I think it's something you wouldn't do on a regular basis, but if somebody were to have a very special gown that would be very difficult to wear with a bra, and you wanted to have a lift of your breast for that special occasion, this is a very effective way of giving one a lift without any risk or downside," she says.
But plastic surgeons seem to wholeheartedly disagree with Wexler, who contends that the Botox boob job "doesn't have the same complications and downside from having a surgical breast lift."
In fact, it seems the idea of using Botox in the plastic surgery community for anything considered "off-label," or not approved by the Food & Drug Administration, is grossly unacceptable.
Dr. Anthony Griffin, a prominent Beverly Hills board certified plastic surgeon – who works closely with Allergan, the company that manufactures Botox – fears Dr. Wexler's practices with the drug could have more than just a paralyzing effect on her patients' pecs.
"This is not an acceptable practice. Nobody has peer-reviewed this and this is something the company has not endorsed," says Griffin. "She is jeopardizing everybody's use of Botox. That's what disturbs me – I like the product. It works, it's great, but if people start misusing it, they're gonna pull it off the market."
What's more, Griffin, who has frequently appeared on ABC's "Extreme Makeover," says injecting Botox into the chest muscles is dangerous.
"Here's the other thing we know about Botox: it can drift. It can drift around and very often in the face you end up paralyzing the muscles you don't want to paralyze. I just can't imagine somebody paralyzing my pec," he says.
"You're not gonna be able to do pushups, ski, roll over in bed, all those things that you use your pec for. It weakens that. This is a gimmick."
Griffin's gripe grabbed the support of one of New York's top board certified plastic surgeons in Dr. Stephen Greenberg, who practices out of Long Island. Greenberg disputes both the effectiveness of the lift and the health risks associated with the injection.
"This is idiotic. I would absolutely recommend against it. It's just nonsense," Greenberg says of the procedure. "I think it's a reach. I think that the complications outweigh by far the potential minimal benefit that you have."
Among those complications: "There are blood vessels or nerves or other sorts of injuries that you can run into when injecting into the chest wall muscles."
Even Allergan agrees that doctors should stick to the approved treatments.
Caroline Van Hove, a spokeswoman for the company, told WCBSTV.com that Botox should not be used for "off-label purposes," though such uses were left in the hands of doctors.
"Allergan does not promote Botox Cosmetic, or any of our products for that matter, for uses that are not approved by the FDA. However, in the United States, physicians may use medications 'off label' if in their professional judgment such use is medically appropriate," says Van Hove.
But that's exactly why Wexler, who has been an avid supporter of Botox since it hit the market in 1989, performs the procedure in the first place. She finds it more appropriate, safer and less painful than its surgical alternative for those who want a temporary result.
"There's no anesthesia, there's no scarring, there's no post-operative pain, and certainly the risks are less," she says.
"The results are very varied," adds Dr. Francesca Fusco, a dermatologist who practices with Wexler. "I have colleagues in the practice who have injected patients and some are very pleased and some are a little less than pleased."
Plastic surgeons worry most that though there haven't been any reports of any medical miscues with the procedure thus far, that doesn't mean disaster isn't an injection away.
"Something will happen. It may not happen in this particular patient, it may happen 25 patients down the line, but just because something is successful and good for one thing doesn't mean it should be overreached and tried in every aspect," says Greenberg. "I mean they're gonna start drinking the stuff if it makes you live longer."
Currently, the National Institute of Health lists more than 70 clinical trials where Botox is being used to treat various cosmetic and health problems.
Trials being tested in the United States and overseas include the treatment of migraines, herniated discs, drooling, overactive bladder, post-stroke spasticity, clubbed feet, and even for children with cerebral palsy -- another very controversial trial being tested in Europe.
Earlier this year, the FDA announced it was reviewing the safety of Botox after reports surfaced that some of those children with cerebral palsy had died.
Botox has only been approved in the United States to help treat crossed eyes, uncontrollable blinking, excessive underarm sweating, frown lines between the eyes, and neck or head pain caused by a disorder known as cervical dystonia.
(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)
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