Botox is marketed as an easy and glamourous way to get rid of wrinkles. But how safe is it? In an exclusive investigation Global News’ current affairs program 16:9 The Bigger Picture uncovered information that might make you think twice about drinking from the fountain of youth.
In the business of beauty, Botox is king. Providers claim Botox injections smooth wrinkled brows and erase crow’s feet quickly and painlessly. Those promises attract beauty seekers in droves. More than 5 million injections of the wildly popular drug are administered every year across North America, bringing in about $1.5-billion annually.
What exactly is this wrinkle-erasing wonder drug? Botox is made from botulinum toxin, a deadly neurotoxin that first garnered military interest as a bioterrorism weapon. One gram of crystallized botulinum toxin has the potential to kill more than one million people.
In smaller, diluted doses, Botox can turn back the clock on aging skin. Dr. Jean Carruthers is a Vancouver eye doctor. She discovered a cosmetic use for Botox 23 years ago. She was using Botox to treat eye spasms in her patients when she says she noticed an interesting side effect.
“It can be used for everything from frown lines to bladder spasms,” she told 16:9.
Dr. Carruthers didn’t patent cosmetic Botox, but U.S. based drug company, Allergan did. And from blushing brides to red carpet sirens, Allergan has been reaping the profit of Botox patients’ glowing accounts. But not everyone walks away happy after receiving a Botox treatment.
Dr. Sharla Helton is an obstetrician who ran a hospital in Oklahoma City, U.S. An athletic mother of two, she told 16:9 she saw Botox as a risk-free way to give her appearance a youthful boost.
“I was a lot like any other mid-40s female who was tired and raised kids her whole life,” she told 16:9. “I was completely reassured as a physician that there were no risks at all.”
Her first few Botox injections were without incident. But after a Botox session in 2006, Dr. Helton told 16:9 she knew something had gone terribly gone.
“I couldn’t walk more than two or three steps before I physically couldn’t support my weight,” she said. “I was in such severe nerve pain it felt like someone was electrocuting me.”
Dr. Helton suspected she had botulism. She called Allergan and spoke to a nurse who she says dismissed her symptoms as a “flu-like illness.” After her health deteriorated so dramatically she could no longer practice medicine or play with her children, she went to the U.S. National Institutes of Health where a team of neurologists confirmed unanimously that she did, in fact, have botulism.
Dr. Helton filed a lawsuit against Allergan and won a $15-million judgment. Allergan is appealing. The drug company turned down 16:9’s request for an interview about the case, providing instead a written statement.
“The product and its warnings were not defective,” Allergan’s statement said, pointing out that the jury in the Helton case found in Allergan’s favour in relation to the product liability and defective warning claims. While the jury in the Helton case found Allergan to be negligent, Allergan asserts that “the scientific evidence and qualified expert testimony in this case established unequivocally that Botox Cosmetic played no role in any symptoms allegedly suffered by Mrs. Helton.”
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Since 2001 when Botox was first approved for use in Canada there have been approximately 700 complaints about adverse reactions. Critics say Allergan isn’t providing enough information about the risks associated with the drug. But as 16:9 discovered through a series of undercover investigations, whether Allergan’s warnings are adequate or inadequate, many of those who administer Botox are making a concerted effort to downplay possible undesirable reactions.
From doctors’ and dentists’ offices to spas and gyms, Botox is available in a wide variety of settings. In Canada, only licensed physicians can purchase Botox. But who is holding the needle when it comes to the injections? At the Bellair Laser Clinic in Toronto, 16:9’s producer went in for a Botox injection. Staff asked her to fill out a medical history form but there was no doctor’s consultation.
At Skin Vitality, another Toronto spa, there was a doctor’s consultation but the doctor was not physically in the office. Dr. Lori Martyn oversees Botox procedures at Skin Vitality from a distance, using Skype. Dr. Martyn told 16:9 this method falls within both the legal and ethical guidelines set out by the College of Physicians and Surgeons of Ontario.
16:9 verified Dr. Martyn’s statement with the College of Physicians and Surgeons of Ontario. According to the College doctor consultations over the internet are allowed. The practice was originally intended to help doctors provide medical help to patients in remote areas. It’s a practice 16:9 discovered is popular among Botox providers.
But Toronto plastic surgeon, Dr. Cory Torgeson said he doesn’t think doing Botox consultations using Skype is safe.
“It’s a way for some doctors maybe to make some extra money while somebody else is injecting,” he told 16:9. “They lend their name and they reap the rewards. It’s preposterous. It just shouldn’t be happening. And it’s dangerous for the general public.”
16:9 discovered at least one instance where Dr. Torgeson’s concerns may be particularly well-placed. Barb Cecilioni is a registered nurse who works at multiple Toronto spa locations as well as her home. When an undercover 16:9 producer met with Cecilioni at her home, Cecilioni never asked for a medical history or offered a doctor’s consultation. Both steps are mandatory according to the College of Physicians and Surgeons of Ontario.
Just before Cecilioni began injecting Botox, 16:9’s producer revealed important medical information. She told the nurse she was pregnant. It was at that point Cecilioni told the producer, “Oh, you can’t have this. I was just going to get your consent form after.”
Cecilioni’s approach to administering Botox injections has raised official eyebrows in the past. The Nurses’ College of Ontario suspended her for a month. According to the disciplinary decision obtained by 16:9, Cecilioni diagnosed and treated two clients without their informed consent, acted outside her scope of practice and used a doctor’s’ name and prescription scripts without his informed consent.
What about the doctor who currently works with Cecilioni? Dr. Michael Boucher is the doctor with whom Cecilioni is now associated. He told 16:9 he was too busy to do an interview, so 16:9 reached Dr. Boucher using the labour-saving device so popular among Botox providers: Skype.
When 16:9 asked Dr. Boucher about supplying Cecilioni with Botox and whether he knew she was injecting Botox from her home without any kind of consultation, Dr. Boucher vehemently denied any such practice was occurring.
“The only time Barb does any injection is with my consultation. I see every single patient,” he told 16:9, adding, “I think you should get your facts straight,” before abruptly hanging up.
Subsequently, Dr. Boucher sent 16:9 a written statement saying the rules for administering Botox were unclear when Cecilioni was disciplined by the College. He also said his current practice “is in full compliance with the policies and rules of the College of Physicians and Surgeons and those of the college of nurses.”
As 16:9’s investigation uncovered, hands-off doctors and sloppy administration is just the tip of the iceberg. With Botox treatments costing around $500 or more, an underground network has cropped up, offering cash-strapped beauty seekers Botox on a budget.
16:9 found a company called Pretique online. The website cites a Calgary address and offers “Do it Yourself Botulinum Cosmetic Type A” kits. These kits are not approved in Canada but 16:9 obtained one easily for $200, no questions asked, no doctor’s consultation and no limits on how much product can be purchased.
When the package came, it was marked as coming from California, not Calgary. Inside were three syringes, a vial with 100 units of botulinum toxin and an instructional DVD.
16:9 showed plastic surgeon Dr. Torgeson that DVD. His response was shock and disbelief.
“They just showed injecting into the nasolabial fold. This is a very, very dangerous area if you’re not an expert,” he said. “Could you imagine someone watching this, then going out and trying it on their mother, or their wife or their friends?”
16:9 investigated the video itself and discovered the doctor featured in the DVD had no idea she was part of Pretique’s business. A plastic surgeon from Beverly Hills, California, Dr. Delores Kent told 16:9 the video was stolen from an instructional video she made for doctors’ use only.
“I can’t believe someone had the nerve to slice this video and fraudulently use it for their own purposes,” she said.
Pretique isn’t the only company selling botulinum toxin online. Laura D’Alleva had two websites, both registered in Canada, and said she had 2000 customers. Last June, legal troubles made her agree to shut her websites down and pay a $125,000 fine. She did not return any of 16:9’s phone calls or emails.
16:9 caught up with Health Minister Leona Aglukkaq at a public appearance and asked why Canada is letting botulinum toxin over the border.
“There is a lot that goes over the border every day,” said Minister Aglukkaq.
Later, Health Canada sent 16:9 a statement saying it’s aware of Pretique Cosmetics and an investigation is underway.
As a result of 16:9’s investigation, the board of directors for the Canadian Society for Aesthetic Plastic Surgery, an organization that represents more than half of Canada’s cosmetic plastic surgeons, held an emergency meeting. Representative, Dr. Wayne Carman told 16:9 the society is drafting a position statement to send to Health Canada and to law enforcement.
“Those of us who are plastic surgical professionals feel there needs to be a little tighter control on the use and application of Botox,” he told 16:9.
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