Dr. Saber’s Blog

The Amazing History of Botox

As we noted in a recent blog, Botox (botulinum toxin type a) has demonstrated unparalleled versatility during its relatively brief tenure as a recognized medical treatment. The New York Times has called Botox “medicine’s answer to duct tape.”

The American Society of Plastic Surgeons estimates that in 2018 more than 7 million people received Botox injections for therapeutic use, effectively treating a myriad of conditions.

What are the current uses of Botox?

Botox injections (as well as their cousins Dysport and Xeomin) are currently used for aesthetic erasure of facial wrinkles and fine lines around the eyes. But we also use them (with minimal side effects) to address medical conditions including (but not limited to): 

Illustrations of the various uses of Botox. Text reads: Conditions that can be Treated by botox. Hyperhidrosis. Lazy Eye. Chronic Migraine. Bladder Disfunction. Cervical Dystonia. Muscle Contractures.
  • Chronic migraines
  • Spasticity
  • Muscle disorders of the neck (cervical dystonia) for patients with Parkinson’s
  • Blepharospasm (an eye muscle that remains involuntarily closed)
  • Hyperhidrosis (excessive sweating usually in the underarms and palms)
  • Drooling
  • An overactive bladder (urinary incontinence)

The current primary use of Botox, like many other ultimately successful medications (Viagra began as a hair growth stimulant, Propecia for hair growth was used to constrain prostate growth), was discovered by accident.

How was Botox discovered?

I’m glad you asked because we’ve got a great answer! After playing at a Belgian funeral on December 14, 1897, a group of 34 musicians dined on some tainted ham. They promptly developed the double vision and stomach pain characteristic of the bacterial poisoning known as botulism. Three of them died.

The remaining ham was sent to Emil van Ermengem, a professor of bacteriology at the University of Ghent. He isolated the responsible neurotoxin and named it bacillus botulinum after botulas, the Latin word for sausage.

Notable Botox events along the way include:

During World War I

Chemists serving in the United States Army attempted to weaponize the bacterium clostridium botulinum, but they repeatedly failed to produce a compound stable enough for use in the field.

In World War II

Various scientists experimented with botulinum toxin, but it remained only a biological curiosity for decades.

In the 1970s

A San Francisco ophthalmologist named Alan B. Scott discovered that botulinum toxin injections were effective in controlling the muscle weakness that causes strabismus, i.e., crossed or wandering eyes.

Dr. Scott gained approval from the Food and Drug Administration (FDA) for botulinum toxin as a treatment for ophthalmological conditions.

In 1987

Dr. Jean Carruthers, a Vancouver, BC ophthalmologist who had worked with Dr. Scott in San Francisco, successfully used botulinum toxin to treat a patient’s blepharospasm (involuntarily closed eyelid). Then the patient came back for another appointment.

The patient demanded another injection in her glabellar lines (the area between a person’s eyebrows). “But your eye is open,” said Dr. Carruthers.

“I know, but that shot took away my frown lines, and it made me look like I don’t have any worries,” said the patient.

Dr. Carruthers, together with her dermatologist husband, began the use of botulinum toxin as an aesthetic cosmetic treatment.

The news of injecting botulinum toxin traveled fast!

That moment is recognized as Botox’s pivot point from an obscure treatment for rare ophthalmological conditions to an ever-expanding multi-billion-dollar medical juggernaut for cosmetic purposes.

In 1991, Dr. Scott sold his patent rights to the pharmaceutical giant Allergan for $9 million and Allergan changed the name to Botox. In 2002, Botox was granted FDA approval for cosmetic purposes. Much to the delight of Allergan and its shareholders, Botox has continued to expand in a myriad of treatment modalities.

Even though botulinum toxin was for conditions affecting the muscle contractions that control eye and eyelid movements, the Carruthers’ off-label cosmetic use was perfectly legal. It was well within the ethical constraints that informally control new uses for established medications.

Doctors continue to notice, and their patients continue to report, an ever-expanding galaxy of new beneficial results [of Botox].

How does Botox Cosmetic work for cosmetic procedures?

Acetylcholine is a combination of choline and acetic acid that serves as a substance to control nerve impulses within the human nervous system. It’s a neurotransmitter that can activate muscle spasms. Botox (or its near-identical cousins Dysport and Xeomin) weakens muscle contractions by interfering with the production of acetylcholine.

So, Botox begins its facial cosmetic work by weakening, to the point of near-paralysis, a muscle group known as corrugators by blocking the production of acetylcholine.

These corrugator facial muscles are located at ground zero for frowns: the area between the eyes and above the nose. At this injection site, Botox erases frown lines and gives the brow a lift. Botox injected around the mouth improves lip and laugh lines. When injected around the eyes, it erases eye creases and crow’s feet.

How does Botox help migraines?

Man receiving Botox injection to forehead

We now know that Botox injections for migraines work well in curbing their terrible pain, and it was FDA-approved for that purpose in 2010. The origin of migraines is a mystery, so it is only natural that how Botox intervenes to help chronic migraines also remains mysterious. However, researchers suspect that Botox enters the nerve endings in the injection site and blocks the release of neurotransmitters that convey pain signals.

Botox is effective against chronic migraines, but it takes some time; it becomes more effective after the second and third treatments. Patients report that two Botox treatments reduce the number of headache days by about 50%.

Are there any limits to the effectiveness of Botox?

It doesn’t seem so. Doctors continue to notice, and their patients continue to report, an ever-expanding galaxy of new beneficial results.

Our earlier story reported on the encouraging results of large-scale clinical trials regarding the effectiveness of Botox and Dysport as a treatment for depression. Another, much smaller, report reviewed six cases where the use of injectable Botox appears to have caused a substantial reduction in the symptoms of borderline personality disorder. It is still theoretical, but the authors of the report ask:

“Could it not be that the glabellar injection of botulinum toxin does not specifically relieve depression, but rather globally attenuates negative emotions associated with many psychiatric disorders?”

In other words, the active ingredient in a bunch of tainted sausages may provide a never-ending cornucopia of relief to those suffering from both physical and mental disorders.

Why choose Saber Plastic Surgery for Botox in Encino?

Dr. Sepideh Saber, MD, FACS is an American Board of Plastic Surgery-certified Los Angeles California plastic surgeon practicing in the Encino and Pasadena area.

She graduated from Stanford University’s world-renowned medical school and did her plastic surgery residency at the University of Southern California (USC). She then completed a fellowship at New York University (NYU) in the extremely challenging and delicate area of hand surgery as well as microsurgery.

Dr. Saber offers a more sensitive, female perspective for patients of all ages, genders, and orientations. Former patients of all ages and from all walks of life have praised not only their outcomes but her caring, thoughtful approach to all types of appearance and health-related matters.

To request a consultation, call 818-643-6939 or schedule a consultation online.

Dr. Saber takes her patients’ safety very seriously. Her facility’s Covid-19 patient safety procedures exceed all CDC and World Health Organization recommendations. Masks are required in our office at all times during the coronavirus pandemic.

The practice of Dr. Saber is located in Encino, CA for patients throughout the Los Angeles area. We are also convenient to Encino, Woodland Hills, Sherman Oaks, Calabasas, Burbank, Glendale, Hidden Hills, Agoura Hills, Northridge, North Hollywood, Malibu, Topanga, Canoga Park, Reseda, Valley Glen, Chatsworth, West Hills, Winnetka, Universal City, Bel Air, Beverly Hills, Downtown Los Angeles, Silverlake, and Echo Park.

Dr. Saber graduated from Stanford University’s world-renowned medical school and did her plastic and reconstructive surgery residency at the equally lauded University of Southern California. She then completed a fellowship at New York University in the extremely challenging and delicate disciplines of hand surgery and microsurgery.

Dr. Saber offers a more sensitive, female perspective for patients of all ages, genders, and orientations. Former patients from all walks of life have praised not only their treatment outcomes but her caring, thoughtful approach to a wide array of appearance and health-related matters.
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    Dr. Sepideh Saber, MD, FACS

    👩🏻‍⚕️ Board Certified Plastic Surgeon
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    ✨ Our lovely patient came in for our Bilateral Breast Reduction procedure✨

The procedure gave her tremendous relief of back pain, neck and shoulder pain, bra strap grooving, and rashes under her breast folds. Our patient also feels much more comfortable wearing any type of clothes she likes. 

Give us a call to set up a complimentary consultation with #DrSaber who will create a customized plan for you!
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    I was fortunate to find Dr. Saber after researching board-certified surgeons who specialize in breast cancer reconstruction revision surgery. I knew I was in good hands from the moment I spoke with the lovely and efficient Marlene, Dr Saber's office manager. Dr Saber patiently listened to my concerns and, after examining me, explained what I could realistically expect the outcome to be from another surgery. She also explained to me that she would need to review my previous surgery notes before we could discuss a possible further surgery, which I found comforting and highly ethical. I also discussed a couple of other procedures that I would like done, including fat removal from my large upper arms that had caused me great embarrassment for several years. Dr. Saber is an excellent surgeon who is incredibly kind and genuine. She truly understands the female body and the emotional aspect of body insecurities yet, she is transparent about what can and cannot be done and takes time to discuss realistic expectations and outcomes. My breast reconstruction revision surgery will take place in the New Year, but in the meantime, I have the most fabulous upper arms that I recently flaunted in a strapless dress (something I have not done in years). Dr Saber is truly one of a kind, and I still cannot believe how fortunate I am to have found her. I highly recommend Dr Saber.

    Linda DeCarlo November 29, 2023

    I don’t have enough wonderful words to describe Dr Saber and Marlene! I had a tummy tuck done this year and from start to finish the entire experience was amazing. Marlene is always so helpful and works so hard to make every detail a breeze for you. When I had my consultation with Dr Saber I was at a point of complete agony with my body. She instantly took that stress and frustration off my shoulders! As a woman not being heard by doctors for years I left that consultation with happy tears knowing I had finally found my Dr. It was a major surgery and I felt completely zen and at peace going in because she really does make you feel that safe. I didn’t think I would ever look the way I do now! She gave me the gift of having the body I kept fighting for. I will never stop recommending her.

    Monica Prusa October 9, 2023

    I saw Dr. Saber when I broke my wrist. I ended up having to have surgery. She did an excellent job and I am healing nicely. She was very professional, but was also very kind and compassionate. I would highly recommend her!!

    Sandy Schaupp September 13, 2022

    I LOVED DR SABER!!! There are a few reasons why I chose her. One was because she’s a female Doctor that was my goal who also did a good job (which I was able to confirm with all her before and after photos) and what sold me was my safety in mind. She made me feel like I was in the best hands ever along with Marlene who coordinated everything THANK YOU LADIES! Dr Saber helped me get back the body I have always desired. I had a lot of stomach fat from weight gain and I lost weight so a lot of my weight was in my front lower and upper abdomen. Now I have a super beautiful curvy body like an hourglass after a tummy tuck and lipo she did. She understood the assignment hahaha . I’m 32 years old no kids just wanted to enjoy my younger body looking and feeling beautiful and she really took good care of me. Even after hours I had an emergency due to my fault but she was there and got back to me very quickly and I’m very grateful. I also think her work says a lot because I stopped taking pain medication on the 3rd day after surgery and was fine with very minimal pain I was able to tolerate the healing process. Highly recommend going with her I just had a wonderful experience and would do it all over again if I had too. Maybe after I have kids. Thanks Dr Saber and team <3

    STEPHANIE d July 15, 2022

    Dr.Saber is by far one of the best plastic surgeons. I love how she takes her time to explain any procedure to the patients understanding. She always makes sure to answers any and all questions.From fillers to body contours she’s the one you want.

    Katherine Melara February 15, 2022

    Dr Saber is amazing! She is caring and very informative. I went in for fillers and she explained procedure step by step. I highly recommend her and look forward to future visits.

    Amanda Vazquez December 18, 2020

    Dr. Saber was friendly, knowledgeable and professional. She took time to listen, answer all my questions and was forthright in her recommendations. Her staff was friendly and helpful. I was very happy with the results and plan on going back. If you are looking for a first rate professional experience look no further she is the doctor for you!

    T R December 18, 2020

    Dr. Saber is one of a kind plastic surgeon with a heart of gold. She is a well verse plastic surgeon that puts her patient's needs before anything else. She genuinely cares about every single patient, and her work speaks for itself. I notice every post-operative result on her Instagram (@saberplasticsurgery) the patients have this glow that radiates through. I have been going to Dr. Saber for my Botox for the past 3 years, and love the results every time. I know who I will be going to for any future plastic surgery needs, and will confidently refer family and friends to Dr. Saber for any Botox, fillers, and plastic surgery consultations.

    Rudy Garcia December 16, 2020

    I have nothing but great things to say about Dr. Saber! I am so pleased with my results from a breast augmentation she performed on me back in late June! She answered all my questions and concerns before and after my surgery. She’s very easy to get in contact with and she’s so nice. She made feel so comfortable throughout the whole process. 100/10 Lover her work!!

    Amanda Villegas October 15, 2020

    Dr Saber is hands down the best surgeon! She took her time answering my questions and explained procedure in detail. After doing liposuction six months ago, I am extremely happy with my results and I appreciate her so much.

    Marlene Cosentino October 15, 2020

    Dr. Saber is so kind and thorough with her patients! She is an amazing doctor and genuinely cars about everyone she comes in contact with. I would recommend her to anyone for any hand surgery or cosmetic procedure.

    Rachel Meach October 15, 2020