Botox could ease arthritis and cancer without side effects: Single injection could offer pain relief for months

Botox, best known for smoothing out wrinkles, could also help soothe the pain of cancer, arthritis and migraines – without any side effects.
Sufferers of chronic back pain and women who have given birth by Caesarean section could also benefit from the ‘super-Botox’ jab.
A single injection could provide pain relief for months – removing the need for patients to take several daily doses of powerful tablets – and it could be injected into any part of the body.
Charities said the drug, invented by a researcher at Sheffield University, could revolutionise the treatment of pain.
The main ingredient of the Botox used to prevent wrinkles is a bacterial poison known as botulinum.
It works by preventing nerve cells from talking to muscles, which in turn stops muscles moving and wrinkles developing.
It can also stop pain signals from being transmitted for months at a time. The tetanus toxin ferries the pain-reliever to the spinal cord, where it stops pain signals being sent to the brain.
This News is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX

The history of BOTOX®

BOTOX® (onabotulinumtoxinA) is a type of medicine that is used to treat patients with certain neuromuscular conditions. One of the most researched medicines in the world, BOTOX® treatment is approved for medical uses across the world.

Since its FDA approval for aesthetic treatment in April 2002, the neurotoxin Botox has gone from a somewhat controversial treatment to a celebrity-endorsed wrinkle remedy. Injectables have become the new norm in cosmetic treatment. According to the American Academy of Facial Plastic and Reconstructive Surgery, the most common nonsurgical procedures last year were Botox and hyaluronic acid fillers.
It’s come a long way from its origins as an FDA approved treatment for two rare eye muscle disorders (strabismus and blepharospasm). The original name, Oculinum, doesn’t exactly roll off the tongue, but shortly after Allergan secured that first FDA approval in 1989, the product was rebranded Botox. Once physicians realized that Botox could treat wrinkles, the rest was history.
Botox reached nearly $1.6 billion in sales last year, attributing 51 percent to therapeutic uses and 49 percent to aesthetic uses. It became so successful that it gained its first FDA-approved wrinkle-reducing competitor in 2009-the sincerest form of flattery in the business world. However, Botox continues to evolve as new uses for the product are discovered. Used off-label, it treats a host of concerns such as crow’s-feet, down-turned corners of the mouth and bands on the neck. You may be surprised to learn that it has also been used, off label, to aesthetically treat enlarged pores, droopy eyebrows, a pointy chin and a droopy nose tip. Additionally, it’s an FDA-approved treatment for medical conditions ranging from chronic migraine to excessive sweating. Next up: the company is seeking FDA approval for the treatment of crow’s-feet.

1950s- Scientists discover that botulinum toxin can reduce muscle spasms.
1960s/1970s- Studies explore botulinum toxin as a treatment for strabismus (crossed eyes).
1988- Allergan researches other medical uses of botulinum toxin.
1989- Allergan introduces BOTOX®, the first botulinum toxin approved by the FDA to treat blepharospasm (eyelid spasms) and strabismus.
2000- FDA approves BOTOX® therapy for cervical dystonia to reduce the severity of abnormal head position and neck pain.
2002- FDA approves BOTOX® Cosmetic (onabotulinumtoxinA), the same formulation as BOTOX®, with dosing specific to moderate to severe frown lines between the brow.
2004- FDA approves BOTOX® for severe underarm sweating when topical medicines don’t work well enough.
2009- 20-year anniversary of BOTOX®
2010- FDA approves BOTOX® therapy for increased muscle stiffness in elbow, wrist, and finger muscles with upper limb spasticity.

2011- FDA approves Botox for detrusor overactivity associated with neurologic condition
2013- FDA approves to improve symptoms of overactive bladder in adults
BOTOX® is the first medicine to be studied and then approved by the FDA specifically for the prevention of headaches in adults with Chronic Migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older.
Compared to other cosmetic procedures, BOTOX® offers patients many benefits with its convenience, effectiveness and affordability. The entire procedure takes about ten minutes to perform, and patients can go home and return to regular activities immediately after. The results of BOTOX® injections are visible within the next few days.
At Dr. Bishara’s office we have weekly Botox specials in our Mansfield and Southlake office locations.  Please call our office at (817) 473-2120 to find out more about our weekly Botox specials or visit our website at

In the quest for youth—or at least a more youthful appearance—women and men are seeking treatments to minimize laugh lines, crow’s feet, and forehead furrows. A popular treatment involves injecting cosmetic wrinkle fillers into the face.  At Dr. Mark Bishara’s office in Mansfield and Southlake- we offer injectables for our patients.
Injectable cosmetic wrinkle fillers are soft tissue fillers approved as medical devices by the Food and Drug Administration (FDA). These devices are injected into the skin to help fill in facial wrinkles, restoring a smoother appearance. Most of these wrinkle fillers are temporary because they are eventually absorbed by the body.
Some people may need more than one injection to achieve the wrinkle-smoothing effect. The effect lasts for about six months or longer.
Successful results depend on:

  • health of the skin
  • skill of the doctor
  • type of filler used


FDA has approved absorbable injectable cosmetic wrinkle fillers for correcting soft tissue contour defects, such as moderate and severe wrinkles and folds. Some absorbable fillers are approved for restoring or correcting the signs of facial fat loss in people with human immunodeficiency virus (HIV).
FDA has also approved two absorbable injectable wrinkle fillers for lip augmentation in patients over the age of 21.
The only non-absorbable FDA-approved injectable cosmetic wrinkle filler is for correcting facial tissue around the mouth.
FDA-approved cosmetic wrinkle fillers should not be used for

  • increasing breast size (breast augmentation)
  • implanting into bone, tendon, ligament, or muscle
  • implanting into blood vessels

Filler Materials

Wrinkle fillers are made of various types of materials, and some include a combination of products. Some products also contain lidocaine, which numbs the skin at the injection site.
The materials used in injectable cosmetic wrinkle fillers include
Temporary (absorbable) fillers

  • Collagen injections are made of highly purified cow or human collagen. Collagen is a natural protein that is a major component of skin and other tissues in the body.
  • Hyaluronic acid gel is a protective lubricating gel, produced naturally by the body, that binds with water to plump the skin.
  • Calcium hydroxylapatite is a mineral that is a major component of bone. Calcium hydroxylapatite is a well-matched (biocompatible) material that dissolves in the body (biodegradable) and is implanted in the form of a gel.
  • Poly-L-lactic acid (PLLA) is a biodegradable, biocompatible, synthetic material from the alpha-hydroxy-acid family that has been widely used for many years in dissolvable stitches and bone screws.

Permanent (non-absorbable) filler

  • Polymethylmethacrylate beads (PMMA microspheres) are tiny round, smooth plastic particles that have been tested to be biocompatible. They are not absorbed by the body.


Getting injected with cosmetic wrinkle fillers is an elective procedure. As with any medical procedure, it poses risks. Most side effects occur shortly after injection and go away within seven days.
You should not use cosmetic wrinkle fillers if any of the following applies to you:

  • severe allergies marked by a history of anaphylactic shock
  • allergy to cow collagen or eggs
  • allergy to lidocaine
  • inflamed or infected skin
  • prone to form excessive scarring (keloid) or thick scarring (hypertrophic scars)
  • bleeding disorder
  • active inflammatory condition (cysts, pimples, rashes or hives) or infection; you should postpone treatment until the condition is controlled.

Tips for Consumers

Before deciding to get injected with a cosmetic wrinkle filler:

  • Be aware that the safety of these products is unknown for use in pregnant or breastfeeding women or in patients under 18 years of age.
  • Be aware that the safety is unknown when these products are used with Botox or other wrinkle therapies.
  • Be aware that the safety of these fillers has only been studied when used in the face.
  • Know the type of product that will be injected and all of its possible side effects.
  • Discuss fillers with a doctor who can refer you to a specialist in the fields of dermatology and aesthetic plastic surgery.
  • Select a doctor who is trained to do the procedure.
  • Have realistic expectations about the benefits you want to achieve and discuss them with your doctor.

What About Botox?

Botox Cosmetic is an injectable drug, but it is not a wrinkle filler. Instead of filling the wrinkle, it keeps muscles from tightening so the wrinkles don’t show as much. FDA has approved Botox Cosmetic only to treat wrinkles between the eyebrows.
At the office of Dr. Bishara and The Paragon Med Spa we offer both injectables, such as Botox, as well as fillers.  Dr. Bishara is a cosmetic surgeon and also performs the injections for all patients.  Please call our office to schedule an appointment at (817) 473-2120.

Good Skin Care in Your 20’s, 30’s and 40+

20’s: The Issue- Dullness

In-Office Fixes: Microdermabrasion and Chemical Peels
When you’re young skin cells turn over, exfoliating every 28 days.  But as you move into your mid to late 20’s, that process starts to slow, and a natural decrease in skins sloughing ability. You’re left with a layer of dead skin that doesn’t evenly reflect light. Lunchtime procedures like microdermabrasion and chemical peels take less than and hour and leave behind only mild redness. During a microdermabrasion treatment, an aesthetician buffs away the top layer of skin.  For maximum results, consider a series of 3 treatments, spaced apart- followed by a chemical peel. Microdermabrasion removes any build up and then the chemical peel makes skin look brighter and more toned evening out skin discoloration and tightening pores.

30’s: The Issues- Fine Lines, Redness and Sun Spots

In-Office Fixes for Fine Lines: Injectables such as Botox
Those little lines that used to disappear as soon as you stopped smiling or frowning are suddenly here to stay.  Movements that cause skin to repeatedly crease in the same place eventually wear down the underlying collagen, creating lines that remain after muscles relax. Injectable muscle relaxers containing botulinum toxin A, such as BotoxDysport and Xeomin, temporarily paralyze muscles so you can’t make those wrinkle-causing movements. Expect smoother skin 72 hours post-injection and results last 3-4 months on average.  If you have no lines to speak of yet, these injections can be used as a preventative measure.  Small doses can prevent muscle action so you’ll never get the creases to begin with.
**6.1 million people had Botox treatments performed in 2012**

In-Office Fixes for Redness and Sun Spots: Laser Procedures
A rosy glow can be a sign of good health, but a constant ruddy complexion is a red flag. For some it’s a sign of sun damage. Excessive UV exposure weakens blood vessels until they no longer constrict after dilating.  For others redness stems for rosacea, a condition marked by flushing, broken blood vessels and acne-like bumps. Other issues like brown spots are a sign of chronic sun damage triggered by overexposure of UV rays. Unlike freckles these marks don’t fade after reduced sun exposure- but they will get darker with even more.
An IPL-Fotofacial will target and treat unwanted discoloration, pigmentation, broken capillaries, age spots and sun damage.  It also lessens the appearance of rosacea, fine lines and wrinkles. At The Paragon Med Spa our medical microdermabrasion also includes a chemical peel. Our Laser 360 treatment offer 3 technologies in 1 visit.  The Laser 360 is meant to be done in a series of 3 treatments and produces optimal results.  During this treatment a fotofacial, skin tightening and laser skin resurfacing are combined to offer the most comprehensive correction and rejuvenation.  Bonus:  Your skin will look tighter and feel smoother.

40+: The Issues- Sagging, Deep Creases and Hollowed Cheeks

Genetics and the effects of sun damage really start to show in this decade, as skin’s elasticity takes a nosedive.  Sagging skin and crow’s feet that showed up in your 30s are probably more pronounced now. And due to natural volume loss, you may be noticing new wrinkles especially around the lips and in between the nose and corners of your mouth. With age, skin loses fat, exposing folds and creases.
In-Office Fixes for Sagging and Deep Creases
Fillers such as Juvederm instantly plump indentations.  JUVÉDERM® Ultra Plus is used to treat deeper and more severe wrinkles and folds, and provides results that last up to one year. Injections take about 15 minutes to administer and do not require any anesthesia. Patients should avoid strenuous exercise and excessive sun exposure for the first 24 hours after treatment, but can otherwise resume normal activities right away.
In-Office Fixes for Hollowed Cheeks
Injectables such as Radiesse, reign supreme here too.  Thicker fillers are ideal for filling out hollowed cheeks. Radiesse is a stiff material, so it’s good for replacing volume as well as lifting the skin.  Radiesse provides an immediate fill plus long-term collagen stimulation for 18 months to two years.
Dr. Bishara provides a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. Please call our office to schedule an appointment at (817) 473-2120 or click on the button below.


People always seem to be seeking treatment to reduce or eliminate the signs of aging on their face, hands and body. Minimally invasive procedures offer patients the results they desire without the hassle and lengthy downtime often associated with cosmetic surgery procedures. These treatments are designed to provide subtle enhancements that can improve your targeted problem areas, while allowing you to return to work and your regular activities the very same day.

Dr. Mark Bishara is proud to offer a wide range of dermal fillers and other enhancing, minimally invasive procedures in his Mansfield and Southlake offices.
Out of all minimally invasive procedures, BOTOX® Cosmetic is still the No. 1 non-surgical treatment performed in the U.S. after so many years. Why is this……because BOTOX works.
In our offices, patients are getting BOTOX treatments in record numbers. They want to look younger, healthier, and more vibrant. BOTOX can help patients achieve this at a reasonable price. These treatments work on patients of any age and with any skin type and have no downtime after treatment.
BOTOX can be used to relax the muscles of the face, temporarily erasing wrinkles on the forehead, between the brows, and around the lips, as well as laugh lines around the eyes. What’s more, studies show that when BOTOX is administered to younger patients, lines and wrinkles in those areas may be prevented altogether. There is definetely a trend of more BOTOX patients coming in their early and mid-20s.
The bottom line? New and improved treatments may come and go, but only a few will stand the test of time.

Sticking to a Schedule

It is important to stick to a schedule if patients want to get the most out of their Botox treatments. BOTOX can be great for quick rejuvenation if you decide that’s all you want, but its effects can also last longer if you maintain them.
There are many misconceptions regarding the most effective use of this injectable treatment. BOTOX is a great solution for women and men who may not be ready for facial cosmetic surgery and just want a little natural freshening. Even people who do proceed with actual cosmetic surgery benefit by BOTOX treatments afterwards to maintain the great results they got and make them last longer. At Dr. Bishara’s office you will receive a treatment plan based on your exact needs.
On average, the results of BOTOX appear within the first few days of treatment and last 3 to 4 months. The key to maximizing your results is planning in advance for your treatment sessions to occur every 3 to 4 months, just as the results are beginning to dissipate.
Injectable dermal filler treatments are also helpful as part of a patients’ personalized rejuvenation plans. Options such as JUVÉDERM® and RADIESSE® can enhance facial volume in key areas where we lose it with age, and thus restore youthful contours for a year, and they complement the results achieved with BOTOX.

We offer Botox weekly specials:

Wrinkle-FREE Wednesdays in our Mansfield office from 9am-5pm- Botox $10/unit
Wrinkle-FREE Rush Hour Thursdays in Southlake from 12pm-7pm- Botox $10/unit
At the offices of Dr. Mark Bishara and The Paragon Med Spa we would love to answer any questions you have regarding Botox and other fillers.  To schedule an appointment with Dr. Bishara, please contact our office directly at (817) 473-2120.