Is this pen the slippery slope to DIY Botox?
Several years ago I made a documentary about what is known as cosmetic medicine — all the things a doctor can do to alter the appearance of a patient without actual surgery.
It was called SuperBotox Me and in the space of 48 hours I was jabbed nearly 80 times by a variety of medics, including the late Fredric Brandt, the dermatologist whose clinic counted Madonna among its patients.
I now consider myself something of an aficionado of botulinum toxin — popularly known as Botox — which, when injected into a muscle, paralyses it, preventing the movement that creates a wrinkle.
So when I heard about the Juvapen — a new device for administering the stuff — I was intrigued. What’s wrong with the old delivery system, of a syringe and very fine needle?
BernardPierre laGrand, CeO of the Swiss company that makes the Juvapen, says that comparing it with a handheld syringe is like comparing an automatic car with a manual one.
The ‘pen’ itself is small and rectangular, not much bigger than a matchbox with a side panel where the doctor presses the appropriate button to determine exactly what quantity to inject. This device is then attached to the barrel of a syringe and needle, but rather than injecting by hand, the doctor touches a lever and a small motor whirs as it drives a precise amount of the toxin into the skin. It’s halfway to a robot giving you Botox.
according to laGrand the pen was developed for noncosmetic procedures requiring tiny doses of the drug. Trials show it brings the accuracy of the dose to within 2 per cent of what was intended, as opposed to 50 per cent if the needle is held in the old ‘freestyle’ way.
That’s a big difference. If the lines between the eyebrows, say, require 0.5ml of Botox, a 2 per cent margin of error means that only 0.01ml of Botox could be injected by mistake, while 50 per cent allows for a far larger 0.25ml extra dose.
In real terms, it’s the difference between a hard, immobile face and a soft, natural look.
LaGraND tells me the pen allows tiny, precise quantities to be administered with very little margin for error, and that this opens Botox up to new uses, such as microneedling over the chest to get rid of crepey skin.
Dr Jules Nabet, a French doctor with clinics in Kensington, Paris and Monaco is, you would think, a dab hand at injecting infinitesimally small amounts of Botox. He tells me he was one of the pioneers of what he calls ‘baby Botox’. No, not injecting newborns, but using a minimal amount of the toxin to leave natural movement in the face.
So why is he using the pen? ‘I have done this job for 30 years
and I do around 30 Botox treatments a day. I know exactly what I have to do with the needle,’ he says. ‘But my patients tell me it’s less painful because you are not, tok, tok, tok [he mimes the fast pricking style of handdelivered botox] you are doing it sl-ow-ly.’ He draws out the word as he presses the pen into my face and delivers a jab.
‘Ouch!’ after 16 injections with the pen and two without, I don’t find it dramatically less painful — more a different, blunter pain to the sharp pricks you endure with a needle.
I find it reassuring that Botox hurts. It is not a pampering treatment. This is medicine and as such it is legally available only from doctors, dentists or nurses under the supervision of a doctor. Indeed, aware of the dangers to patients having these so called noninvasive injectable treatments, last week the General Medical Council issued new guidelines that will ‘protect patients from poor practice’ and ‘help drive up standards in the cosmetic industry’. However, these guidelines do not apply to dentists and nurses.
Many beauty therapists think they are able to inject Botox, but they’re wrong — and it’s deeply worrying that some still do it, sheltering behind inadequate ‘supervision’ by dodgy doctors.
So I can’t help but be concerned when Mr laGrand tells me his company’s pen makes it easier to teach beginners how to inject Botox. Indeed, the firm’s website is called toxinmadesimple.com.
Is this ‘made simple’ approach the first step to letting beauty therapists loose on Botox? ‘No,’ he insists. ‘It just makes it faster and more accurate. It allows the less experienced to do a good job.’
Do we really need ‘less experienced’ injectors? Click on the link for the British association of Cosmetic Doctors — it goes straight to a page packed with expensive, short courses for doctors, dentists and nurses who are new to injecting Botox.
any doctor can legally set himself up as a cosmetic specialist, even without any relevant experience or training. It’s these inexperienced new guys who might be attracted to the Juvapen.
‘It will help them inject exactly the right dose,’ says Dr Nabet. However, he admits: ‘We cannot say it will make them better. Botox isn’t just about the injection, it’s about where you inject, too.’
MOre than once I have been a model for a famous injector while he does courses for doctors wanting to improve their cosmetic skills. These doctors sometimes have Botox themselves and the results can be alarmingly poor. They can’t seem to see there’s any problem, so what will they do to their patients? Injecting botulinum toxin requires a level of knowledge of human anatomy — and doing it well requires artistry, too. The Botox pen will do nothing to stop the sort of doctors who inject 1ml of toxin between the eyebrows when they should be injecting 0.5ml.
I spoke to some of Dr Nabet’s competitors. They expressed surprise that someone of his generally wellrespected status would use it.
One doctor described it as ‘simply rubbish. Botox should be painless and accurate if done properly. a good doctor doesn’t need a pen to do it’.
The last thing the industry needs is a pen for beginners. What it needs is some kind of medical aesthetics test to ensure the professional knows how to use his needles, not just medically, but artfully.
It’s time to stop letting any old doctor, dentist or nurse loose on people’s faces.
Botox is meant to make a person look better, not weird. a pen can’t stop that happening.