One recent and popular way of treating this problem is by the injection of botox in various points into the musculature of the over active bladder, to weaken the muscles so the sudden involuntary contraction of the bladder muscles is much lessened.  Following is a video view through a cystoscope showing how botox treatment of over active bladder is done.

A cystoscope is inserted under anesthesia through the urethra or urinary passage into the bladder with the bladder fully distended with water. Close to about 100 units of botox are injected into 20 to 30 points in the muscular wall of the bladder. Effect comes on about 4 days after the botox injection. The desired effect is a massive reduction in the uncontrollable urge to pass urine and the ability to control the urine till a convenient time.

The height of the breasts is affected by the position of the shoulders.  The muscles of the chest known as pectoralis minor and pectoralis major tend to rotate the shoulder inward and downward.  The opposing muscles of the back such as the rhomboids tend to pull the shoulder backward.  The theory is that if the muscles such as the pectoralis minor were weakened, this would result in unopposed movement of the shoulder upward and backward, thus lifting the breasts to a more prominent and esthetically pleasant position. This is the basis for the botax breast uplift procedure.

The fact that this works is proven in tests where the pectoralis minor on each side is given a botox injection dose of about 30units of botax (more commonly known as botox).  Botax weakens the pectoralis minor muscles and the breast uplift occurs as a result.  A somewhat pleasant side effect as yet unexplained is the stimulation of the nipples which remain erect for a month.

Breast Uplift With Botax - Before

Breast Uplift With Botax - After

The botax effect lasts about 3 – 4 months.  It is noted that the breast up lift effect is more obvious in people with slightly smaller breasts, about cup size A or B.  Upon wearing out of the effect in about 4 months, the breasts start to descend, and it is time for a repeat dose of botax. 

botox injection palms

What is the cause of the hands sweating?  There are a few known causes:
A hyperactive thyroid
Anxiety
Heat
Overactivity on the part of the person
More sweat glands in the palm than normal
Hyperactive sweat glands.

Whatever the cause, the end result is the same: an unpleasant feel on the part of the recipient of the sweaty hand shake, and embarrassment on the part of the man who has his hands sweating. 

It is because of this that there are all sorts of sweaty palms treatment offered in the market. 

A hyperactive thyroid is of course treated if one cures the hyperactive thyroid gland.  This will obviously cure sweaty palms related to hyperthyroidism.

The other causes are rather more challenging to treat.  Some more well known methods to treat, though not necessarily cure sweaty palms are:
1.  Constant wiping with handkerchiefs
2.  Application of chemicals that are said to suppress sweat gland function eg Driclor (ammonium chloride hexahydrate).  The tendency is for this to become less and less effective over time.
3.  Surgery – a procedure called thoracic sympathectomy whereby the nerves of the sympathetic nervous system in the chest cavity which control the sweating palms are destroyed.  Although this is about the only permanent way to control sweating in the palms, soles and armpits, a lot of people balk at the thought of surgery just to stop hands sweating.

4.  Injection of Botox (also known as Botax).  A very effective technic to cure sweaty palms.  Although the effect lasts only 1 year and needs to be repeated, it is considered a very acceptable and suitable alternative to surgery which may carry some risks. The procedure is simple in theory.  Under local anesthetic botox is given in multiple small superficial shots on the palm about 1cm apart and just under the skin  (not into the muscles of the palm).  The fingers are usually left alone as a degree of moisture is essential for a good grip.  Treatment results for hands sweating are usually considered satisfactory if done properly.

Wrinkles are divided into two types: the dynamic wrinkles (due to muscle overactivity, and disappear when the muscles are not active, or rested) and the static wrinkles (which form because of prolonged muscle activity, causing semi-permanent creases in the skin).  It is the dynamic wrinkles which we are concerned about now, as these are the ones that can be helped by botox cosmetic injection, which is given in the form of tiny injections into the muscles.  Static wrinkles can be helped only by injection of fillers, or in more extreme cases, by surgical facelifts.  It is primarily because prolonged contraction of muscles around the eyes tend to convert dynamic wrinkles to static wrinkles that early treatment with botox cosmetic injection is considered necessary.  (Think of a piece of paper that you keep folding again and again – these creases in the paper become permanent).
Botox cosmetic injection given directly into the appropriate muscles will cause the muscles to stop contracting.   The skin thus does not crease.  Usually you will feel the skin tightening at the injection site within 1/2hour from the time of injection.  The effect of wrinkle elimination will be very obvious after 4 days or so, and is expected to last between 4 to 6 months.

Botox Cosmetic Injection for Crows' Feet

Look at yourself in the mirror before the Botox injection, without smiling.  Then smile naturally and note the creases form by the outer corners of your eyes.  These are called crow’s feet.  These are the wrinkles that will disappear after your Botox cosmetic injection.  The disappearance of these wrinkles are what will make you look 10 years younger.

See your local aesthetic doctor for your injection.  These are professionally trained personnel who will know best how, where and when to give you your botox cosmetic injection.

Look into your mirror.  Frown.  See the frown lines form in between your eyebrows.  Imagine how unpleasant you would look if you wore this frown day in, day out.  And yet this is what happens to a lot of people.  Most times they are not aware of it, and only know about it if they involuntarily catch themselves in the mirror, of if some kind(?) soul tells them they are frowning all the time.  This kind of look would be disastrous for people in sales, or those who have to meet people in the course of their work or daily activities.  A persistent frown on your face tends to make people feel that you are a very unpleasant character.  Friends avoid you.  Sales drop.  Even if you are the CEO of a big company, it is important for you to look pleasant and approachable.

Botox Cosmetic Injection for Frown Lines

So what do you do?

Go to your local esthetic doctor.  This will either be a dermatologist, a plastic surgeon, or a physician trained in the use of, and licenced to use Botox for cosmetic purposes.  He will see you and assess your condition to see if you are a suitable candidate for botox (also commonly known as botax).

Certain major factors are not thought to give one good results for botox cosmetic injection.  AGE is one factor.  If you are above 65 years old, the muscles are lax already and will not respond well to a botox cosmetic injection.  If you have been frowning for a long time, the creases are permanent and will not respond.  Instead, fillers, threadlift or surgery will be recommended.  By and large, however, you will fall into the category of good responders.

The botox cosmetic injection is performed so fast that it is considered a lunchtime procedure.  All one has to do is to take a couple of hours off during lunch, keep your doctor’s appointment, have some local anesthetic applied on to the site of treatment on your face, go through a simple 10minute course of injections, and voila! you’re done.  Now get back to work.  Nobody will notice you have had a course of injections.  The needle marks on the face are so tiny nobody will see them.  Your friends and colleagues will only notice that after 4 days you look so amazingly pleasant they will not hesitate to be around you.  However take note that the effects last only between 4 – 6months,  after which you should go back to your doctor for a repeat round of Botox Cosmetic Injection.

Get a friend to stand in front of you.  Ask him to raise his eyebrows.  The horizontal lines you see on his forehead are commonly called forehead or surprise lines.  These, although you may imagine will only form when you are surprised, are surprisingly (no pun intended) present in a lot of people who are not.  They very often present in slightly older people whom, when age comes, have a problem of droopy eyebrows, and unconsciously raise them in order to see better.  And this action results in a permanently surprised look on the face.  However there is another group of younger persons who, perhaps unconsciously, try to look more alert to their colleagues, or perhaps to increase their field of vision, tend to look very surprised or earnest all the time.  These are the ones who will benefit from botox cosmetic injection (also known as botax )for forehead lines.

Botox Cosmetic Injection for Forehead Lines

Again, it must be stressed that botox treatments come in the form of injections.  Average Asian foreheads will need roughly 12 – 16units of botox to reduce (not eliminate) forehead lines.  The Caucasian forhead needs about one and a half times that due to thicker muscles and broader foreheads, and if the need is there to completely obliterate the forehead lines, one may need to double that dose.

Usually multiple tiny injections are given from one side of the forehead to the other, in three rows, starting upwards from a row about 1/3 of the way between eyebrows and scalp margin, about 6-8 shots into the forehead muscle per row, and 1-2 units per shot. 

Never try this on your own.  We are not responsible for any mistakes that happen, and you need to consult a qualified doctor who is licenced to give Botox cosmetic injection for this.

The effect comes on about 4days after injections, and tends to last about 4-6months.  However sometimes one has to come back for follow up about 1 week after the injections for a top-up, where undertreatment can be corrected with a further botox cosmetic injection.

Facial Wrinkles: frown lines, forehead lines, crow’s feet. 
These were the original intended usage of botox (also commonly referred to as botax), and were discovered quite by accident when the original promoters of botox (Drs. Alistair and Jean Carruthers) noted that while trying to medically correct squints by injecting botox, the patients lost their wrinkles)
Fine lines of the face (microbotox, mesobotox).
Very dilute solutions are injected in small amounts into the dermal layer of the skin, not into muscles.
Bunny lines along bridge of nose.
While this may be cute in some children, it can become an annoying habit if it persists in adulthood.
Reduction of the nasolabial crease.
With age and gravity, the cheeks tend to droop, and this results in the deepening of the crease lines that run from the sides of the nose to the corners of the mouth.  This causes the sufferer to look older.
Elevation of droopy corners of mouth
Again an age-related problem.  A couple of fine botox injections are placed in strategic corners of the mouth and this results in a slight uplift of the corners.
Smoker’s wrinkles of the mouth.
Persistent and chronic smoking causes the muscles around the mouth to over contract, causing deep wrinkles extending outward from the lips.  Some well-placed shots around the mouth cause the wrinkles to lessen.

Popply chin

Nefertiti effect (enhancing of the jaw contour)
Done by a few shots of botox to the playsma muscle in the neck and at the jawline.  This results in the facial muscles pulling the other way, causing the jawline to be more obvious and attractive.
 
Reshaping of the face
Due to chronic chewing, the masseter muscles of the jaw become extra bulky, and this results in the jaw looking rather square.  Injection of botox into the muscles cause the muscles to weaken and thus reduce in size, and the jawline as a result becomes smooth, slopy and pearshaped.

Platysma bands (turkey neck)
Aging causes the bands in the neck to stand out.  Botox will soften these bands so they are less prominent.

Horizontal crease lines on neck

Fine lines on upper chest
Part of the mesobotox procedure.

Eyebrow reshaping.
Becoming a very popular procedure among the young.  As you can see the above procedures are more often done in the above 30’s when gravity and overuse of muscles start exerting their effects.  In this case botox is used to enhance the features of the face rather than correct what are seen as defects.  One can reshape the eyebrows to one’s satisfaction: curved, bowed, straight, slanting, Spock-like, etc.

Muscle shaping (calves)
Some calves are rather bulky especially if viewed from behind.  Well placed injections of botox into the calf muscles cause some of the muscles to reduce in size, resulting in slimmer, more shapely calves.  One side effect of this is some slight weakening of the gait.

Breast uplifting (with the occasional side effect of persistent nipple erection, which may or may not be desirable)
Done by injecting botox into some muscles in the chest wall that drag the breast downwards, resulting in opposing action of some antagonistic muscles to be enhanced.

Reduction of oiliness and sweatiness of face (in mesobotox), oiliness of palms, armpits, soles of feet.
Many a time we shake hands with some sweaty-palmed people.  Not a very pleasant sensation.  Similarly we see giant patches of underarm sweat especially on ladies wearing white shirts.  These can be easily treated nowadays with well placed multiple botox injections in a more superficial level of palms and soles.

Most times the desired cosmetic effect is due to usage of the paralysing/weakening action of botox on certain muscles or muscle groups, balanced by the opposing action of the antagonistic muscle groups.  Sometimes the mechanism of action is not so well known, as in the reduction of sweating and oiliness of face.

Only some of the above uses are approved by the FDA for use in the United States.  This has resulted in other countries being in the forefront of usage of botox injections in the other areas.

These are:

cervical dystonia (spasmodic torticollis) (a neuromuscular disorder involving the head and neck causing painful spasms of muscles of the neck with abnormal positioning of the head).  Botox injections will reduce the spasms of these muscles.
blepharospasm – a situation where there is involuntary spasm of the eyelids or muscles around the eyes. Mild degrees of this affect almost everybody, causing tics or twitching of the muscles near the lower eyelids.  Botox treatments will do pretty well.

hyperhidrosis  An excessive sweating of palms, armpits, and soles of feet. A very embarrassing situation which results in cold wet palms and armpit sweat stains, especially obvious on white shirts.
achalasia of the cardia – a situation where there is failure of the sphincter of the lower esophagus to relax to allow food to pass through to the stomach, causing food to overflow potentially causing flooding of the lungs.
migraine and other headaches, which are thought to be aggravated my spasms or contractions of muscles in the scalp.
 
Other uses of botox commonly seen in other countries but which have not yet been FDA approved are:

pediatric and adult incontinence (possibly due to overactive bladder)
incontinence due to neurogenic bladder (related to spontaneous bladder muscle contractions when the bladder is full)
anal fissure (relaxation of the anal sphincter from the botox injection allows the fissure to heal)
spasms of muscles due to brain problems such as stroke, parkinson’s disease, cerebral palsy and also localised muscle spasms affecting the face, jaw or vocal cords and limbs
Pain of the Temporomandibular joints due to spasm of related muscles
wound healing
excessive production of saliva
diabetic neuropathy.
treatment of chronic headaches and muscle pains
weight loss and recently,

depression  (indirectly, by eliminating frown lines causing the patient to look more cheerful, and thus feel more cheerful)

Dysport (manufactured by Ipsen Ltd)
Neuronox (Medy-Tox Inc, Korea)
Myobloc (actually botulinum toxin type B) from Solstice Neurosciences, Inc.
Chinese botulinum toxin A (made by Tianjing Shenfa Chem Co.,Ltd. ) plus a host of others.

Because of trade issues, what was commonly referred to as Botox by virtue of familiarity, is now referred to as BTA (or botulinum toxin type A).

Prices for Botox Treatments vary considerably depending on the site of usage, the purpose of usage, the doctor, and the country.

In the United States, the average cost of a Botox treatment session is $350 per area. Other facial areas that require more than a single botox injection (e.g. around the eyes where crow’s feet tend to form) can range from $500 to $900. Large areas tend to cost more. The forehead for instance might cost as much as $1300.

Treatment costs in Asia tend to be considerably lower.  In Thailand, a quote was obtained for for botox treatments for forehead lines (8,000 baht/USD235), crow’s feet (8000 baht/USD235), and frown lines (6000 baht/USD180)

botox treatment image

You have to weigh the risks and benefits of getting your treatment in other countries.  The most important requirement is that the doctors must be qualified, and botox treatment is safe.  The costs in some Asian countries can be so low that the amount you pay for a procedure in the USA can be used to cover the same treatment in, say, Thailand + a hotel stay + airfare + a holiday arranged for you by a local tour group.  This, in essence is what is commonly known as medical tourism, where some companies are set up to offer you packages for expert treatment of health related problems in low-cost holiday destinations, which will cover your flightfare, insurance, accommodation, food, holiday, and more. Enjoy your Botox holiday!