Dr Laurence Kirwan’s biography published on WIKIPEDIA gives an overview of his professional achievements and personal ethics.
Don’t throw your own Botox party at home
Given Norwalk, Conn., plastic surgeon Dr. Laurence Kirwan’s success with Botox injections through regular office appointments, why bother to throw a Botox party?
“It demystifies and takes out a lot of the fear people have,” he says. “And there is fear of Botox.” At a Botox party, when 10 or 15 people have already had the procedure, he says, it makes it easier for those who haven’t tried it yet. “Wouldn’t it be great to go into a car dealership and see 20 people who just bought a car from that dealer and they’re all chatting around saying how happy they were?”
The main thing with Botox parties, he says, is that they take place in a medical setting. “The concept of having Botox in a home or in a nonmedical setting, I have serious concerns about that.” Among them is the possibility of cross-contamination through needles, which would not happen in a medical office that ensures the safe disposal of needles. Also, he says, it’s necessary for the doctor to have “firm control,” which includes “a confidential, sterile setting” where the patient can sit in an examining room that provides proper lighting and in an examination chair positioned at the right height.
Dr Laurence Kirwan says he has “no problem with adequately trained nurses in a supervised atmosphere” injecting Botox. In fact, he taught his surgical administrator, registered nurse Lisa Topham, how to do it. “She already had extensive experience injecting collagen and has a huge clientele,” he says. Dr Kirwan says problems occur when nurses leave the “medical environment,” to open their own offices under the aegis of “medical supervision.”
“The minute you step out of a medical office,” he says, “there is no guarantee you will have any of these basic things that you would have in a medical setting.”
Stamford, Conn., dermatologist Dr. Robin Evans, who offers Botox injections in her practice, agrees that Botox parties are a positive, “as a way of a Botox information session and possible treatment within the setting of a physician’s office.” However, she adds, there shouldn’t be a group watching the treatment, nor should the party take place in a private home. Also, notes Evans, alcohol should never be served because it can increase the bleeding as well as “affect a person’s mental status in a way that could adversely affect the treatment.”
Recent media reports discuss the popularity of such “at home” Botox parties, where a doctor is hired by the host(ess) to inject a group of friends, and the host(ess) gets his or her injection for free.
“Lots of people in this world become light-headed and faint at the sight of needles,” says Evans, adding that in a medical office, this problem can easily be dealt with by support staff.
BOTOX: A new wrinkle to party time
A glass of wine? Some Brie? A touch of Botox?
For months now, we’ve been hearing about the gathering momentum of media-fed Botox parties. So, when we’re invited to what’s billed as Connecticut’s first Botox party, we’re psyched.
“Find out first hand why Botox is so much in the news and why it was just approved by the FDA,” the invitation reads.
Botox’s popularity is increasing
This is “just the tip of the iceberg,” says Dr. Laurence Kirwan of Botox’s growing popularity. A January Business Week article mentioned that worldwide, Botox sales totaled an estimated $300 million in 2001.
In widening circles, Botox is being touted as 2002’s answer to Viagra. The buzz is that even 20-year-olds are using it to avoid facial lines.
Our English-born host, Fairfield County plastic surgeon Dr. Laurence Kirwan, extends the offer to enjoy an evening of (nonalcoholic) wine, cheese and, for those of the media who wish, a complimentary Botox injection to erase our wrinkles. (Company policy prevents us from being among them.)
The event, held in Kirwan’s plush Norwalk office suite (he also has offices in Greenwich and Brookfield, plus commutes regularly to a London practice), includes invited guests in addition to media.
Since 1998, Dr Kirwan has been injecting Botulinum Toxin Type A, known by the trade name Botox, into facial muscles that cause crow’s-feet, furrowed brows between the eyes and forehead lines. Although in very low doses the toxin reduces the vestiges of aging skin, in its pure form, botulinum toxin is among the world’s most powerful toxins and can cause botulism, a rare paralytic disease that can be lethal.
“The way Botox works,” Kirwan explains during an earlier interview, “is that every muscle is stimulated by a nerve. The nerve releases a chemical called acetylcholine, which stimulates the muscle and makes it contract (which causes a line). The Botox actually binds to the nerve ending (which takes four to five days), not to the muscle, and it blocks the release of the chemical.” When new nerve endings grow out to the muscle, the Botox continues in its blocking action, he adds. It’s only when the new nerve endings actually grow into the muscle, which takes four to five months, that the Botox wears off.
“My advice to people is to have Botox three times a year, every four months, before (the lines) start to come back,” says Prof. Kirwan, who charges $500 per treatment area (frown lines count as one area, crow’s-feet another, etc.)
Interestingly enough, the toxin has been used by opthalmologists since 1989 to paralyze muscles in treating blepharospasm (involuntary spasm of the eyelids) and for people affected by strabismus (commonly referred to as crossed eyes). Its cosmetic use was discovered in Canada by a married medical couple, she an opthalmologist, he a dermatologist. They noticed the toxin was not only helping the eye conditions, but also getting rid of lines around the eye.
“The rest is history,” says the 50-year-old Kirwan, who admits to “personally’ using it himself for the last four years. “I believe more than 1 million botulinum toxin were done last year in this country,” he adds, observing that it’s been utilized for cosmetic purposes for about eight years.
Approximately 25 units are injected per treatment area, sometimes more, he says. The Botox is diluted with saline (saltwater), a combination Kirwan believes works best. Usually he does about six injections per area. “It’s effective in probably 95 percent of people,” he says, adding that if the treatment doesn’t work on a patient, perhaps the patient does not respond to Botox. “It’s a very small percentage, but it does happen from time to time.”
Although Kirwan says the treatment is safe and nonallergenic, he says a possible complication is a droopy eyelid, which may last two to three weeks. “I had it myself and we don’t know why it happens,” he says. “When we do the procedure, we are very careful not to let Botox drip into the eye or get into the area.” (According to a May 16 news release from Botox manufacturer Allergan Inc., the Irvine, Calif.-based pharmaceutical company, in addition to the temporary eyelid droop, other side effects most frequently reported during clinical trials include headache, respiratory infection, nausea and flu syndrome. Among the less frequent “adverse reactions” are facial pain, redness at the injection site and muscle weakness.)
As to the possibility of Botox buildup in the body, “the basic answer is ‘no,”‘ says Christine Cassiano, Allergan’s manager of public relations, explaining that the Botox dosage injected for aesthetic purposes is very small. However, there are some “patients on the therapeutic side whose average dosage is 200 to 300 units, who may build up a resistance. But it is a very small percentage of patients.”
On party night, the toxin’s validation is clearly reflected in the buoyant spirit of the crowd in Kirwan’s office — ranging from twentysomethings to baby boomers-plus — waiting to receive this magic potion.
Before proceeding with the injections, Kirwan greets the crowd with a small presentation. Inviting questions, he suggests those wishing a private consultation talk to him before the procedure begins.
Tamary Murphy, about to be Botoxed for the first time, is among those waiting patiently in the reception area. A thin coat of numbing cream has been spread on her frown line area. It will take effect in about 20 minutes.
At 38, this director of community relations for assisted living communities in the Southington area of Connecticut admits her frown line area has bothered her for some time. “People continuously say to me ‘you need to relax, you need to calm down,”‘ she says, noting that they think she’s constantly stressed out. “I don’t feel that, but I know that my face has always shown everything.”
She is soon ushered into an examination room. Kirwan asks if she is nervous. “Now, I am,” she responds with a weak smile.
“We’ll do this side, then the other,” he says, deftly injecting a syringe full of Botox into each of her frown lines. The silence is broken only by the steady click of media cameras. There is a little bleeding, followed by some redness and swelling, which subsides immediately.
“You’ll see the result in four to five days, and it will last from four to five months,” he tells her. Murphy is given an ice pack, to be held on the injected area for about 15 minutes. She’s also instructed to keep her head elevated for the next three to four hours and not to engage in any heavy exercise.
Kirwan’s surgical administrator, Lisa Topham, explains that by elevating the head, it is less likely the Botox will travel from the injected area into the eyelid area, thus minimizing the risk of droopy eyelid. Topham, a registered nurse who also administers Botox injections, says patients are additionally told to continue making the expression that created the lines in the first place: “If you have frown lines, you want to frown. If you have horizontal forehead lines, raise your brows, and squint your eyes for crow’s-feet.” Doing so evenly distributes the Botox through the area.
Murphy is much more relaxed once the procedure ends. “It wasn’t painful, but being poked with a needle isn’t pleasant,” she says, after Kirwan leaves to go to his next patient. “When the needle went in, I felt it a little bit.”
In an examination room across the hallway, Hartford-area radio personalities Megan Doll, 32, and Mary Scanlon, 28, wait for their Botox intro.
“I’m going to have the vertical (frown) lines done,” says Doll, who produces a radio morning show. “We’ve always said we’re going to do this since Botox came out. My husband thinks I’m crazy. He said, ‘Why are you getting it done if it’s just going to go away?’ and I said ‘Why do people get haircuts?’ That won the argument.”
“I can’t believe you don’t notice those things on my face,’ says Scanlon, co-host of a Hartford radio show. “They’re like ravines,” she says of her forehead lines. “I can stick my finger in them.”
“I hope he comes in here before the numbing cream wears off,” Doll says.