Perfect skin of the upper third of the face: comprehensive correction

From this article you will learn:

• what are the analogues of the drug Botox®,
• analysis of their composition, reviews from a cosmetologist,
• price for 1 unit in clinics.

To complete the picture, we decided to write a review about three drugs based on botulinum toxin type A, which are more budget-friendly options for botulinum therapy. We will talk about the drug "Botulax" (Korea), which is positioned as a complete analogue of the well-known drug Botox®, as well as Chinese botulinum toxins - under the trademarks "Refinex" and "Lantox".

One unit of botulinum toxins from well-known brands, such as Botox, Xeomin or Dysport, today costs about 270-320 rubles, which is due to the high purchase cost of these drugs. At the same time, the low cost of the same Refinex or Lantox allows cosmetologists to sell 1 unit from 150-170 rubles. But is there a difference, and why do most cosmetologists still prefer more expensive drugs, or prefer drugs in the mid-price category (for example, Korean Botulax).

Comparison of botulinum toxin composition –

In this article we will dwell in detail on the pros and cons of Botulax, Refinex and Lantox. As for botulinum toxin preparations of other brands, you can read about them in the articles at the links below -

→ Instructions for the drug Botox® → Instructions for Dysport → Instructions for the drug Xeomin

Botulax: reviews from a cosmetologist

This is a drug based on botulinum toxin type A, which is produced by Korean. Release form: in bottles of 50 and 100 units. Recently, companies that work directly with Korean suppliers have also become available in bottles of 200 units, but all the information on them is in Korean. If the release form of 50 units can be considered as individual for working with one patient, and its cost is not much lower than the same bottle of 50 units of Botox®, then Botulax bottles of 200 units can already significantly reduce the final cost of 1 unit for the patient.

As we said above, the Korean botulinum toxin Botulax is an almost complete analogue of the drug Botox®. The molecular weight of the toxin is the same 900 kDa, in addition, the drug contains the same amount of complexing proteins (5 ng), as well as similar values ​​of serum albumin and sodium chloride (500 and 900 μg, respectively). The drug is also diluted with saline, and there are simply no features of clinical use that distinguish this drug from Botox®.

→ Botulax instructions for use (download in PDF)

1 unit of Botulax has full therapeutic equivalence to 1 unit of Botox, i.e. if you previously applied 12 units of Botox to your eyes on each side, then you need the same amount of Botulax to achieve the same effect. Patient reviews of Botulax are good, but contradictory regarding the duration and severity of the effect. Some say that it acts more gently and less lasting than Botox, others say the opposite. These reviews are not related to the drug itself, but to the peculiarities of its use by your cosmetologist.

Firstly, in order to compare the effect, you need to enter the same number of units into the same zones. Secondly, the degree of dilution of the toxin with saline plays an important role. For example, if a doctor removes 0.5 ml of a drug containing 3 units of botulinum toxin at each injection point, then the effect will be more severe than if the doctor removes 0.1 ml of a drug containing the same 3 units of botulinum toxin at each injection point. This is due to the fact that the larger the volume of the solution, the stronger the diffusion will be, i.e. the drug, after being introduced into the tissue, spreads over a large area. Accordingly, this reduces the concentration of toxin in tissues.

The third point is the freshness of the solution. According to the law, a diluted botulinum toxin preparation from any manufacturer can be stored for no more than 24 hours, because after this, it loses its effectiveness in proportion to time. But beauty salons and clinics are trying to purchase large volume bottles of 100 and 200 units (for Dysport - 500 units) in order to reduce the cost of the drug and maintain a high markup. Therefore, responsible clinics organize so-called “Botox days”, when several previously consulted patients are invited to a specific day. In this case, the entire bottle of the drug is used.

But in beauty salons, for fear of losing a client, they almost always offer injections right away. This only happens when the bottle has been diluted for a long time and is stored in the refrigerator until it is used for one or several weeks. Or in this case, if the bottle is diluted right in front of you, then you are lucky, because... you will receive freshly diluted 30 units, and the remaining 70 units will be given to various losers. It’s even worse when you don’t see how the doctor draws the drug from the bottle, but you only see the already drawn syringe, the solution in which has probably been re-frozen and thawed. You can read more about the options for deception when injecting botulinum toxin in the article at the link below.

→ Why suddenly Botox “doesn’t work”

Well, bottles of a diluted drug that have been left in the refrigerator for more than 24 hours, or especially re-frozen and thawed, will be much less effective and last less long. In addition, the time and duration of action are affected by specialist errors when diluting the drug with saline, as well as incorrect injection technique. Now you understand how many subtle points on which patient reviews about the strength and duration of the effect of botulinum toxins of different brands depend, although we have not yet listed all of them.

Conclusions: reviews of Botulax from clients and cosmetologists indicate that it is a good, effective analogue of Botox, and we did not note any shortcomings in working with it. Manufacturers honestly publish information about the amount of complexing proteins in this drug, which, for example, you will not learn about much cheaper botulinum toxin drugs, such as the Chinese Refinex and Lantox (read about them below). For Botulax, the price for 1 unit starts from 150-170 rubles from private cosmetologists, but on average it is usually about 200-250 rubles.

Contraindications to drugs

There are no differences in application restrictions. The procedure itself is contraindicated in the following cases:

• pregnancy, lactation period;
• cancer;
• diabetes;
• gravitational ptosis;
• neuromuscular disorders;
• myasthenic syndromes;
• hernias on the eyelids;
• autoimmune diseases;
• epilepsy;
• damage to the integrity of the skin on the face;
• exacerbation of chronic ailments.

Buyanov Sergey Yurievich (Expert Doctor):

Preparations containing botulinum toxin should be used with caution in cases of high intraocular pressure and the risk of developing glaucoma.

Refinex: reviews from cosmetologists

The purchase price for high-quality, proven botulinum toxins leaves much to be desired, so when Refinex botulinum toxin appeared in a store for cosmetologists, I became interested. When asked about the manufacturer, they told me about Korea; many sites write about Japan.

But as it turned out in reality, botulinum toxin “Refinex KC” is manufactured by the manufacturer KC Pharmaceuticals (China), which is confirmed by the registration certificate for this drug. Available in bottles of 50 and 100 units.

Refinex is botulinum toxin type A (with a molecular weight of 150 kDa), i.e. just like the German drug Xeomin. In addition, it contains 0.9 mg of sodium chloride, 30 mg of mannitol, 30 mg of dextran and 0.5 mg of albumin. On Refinex, reviews from cosmetologists will be as follows... For example, the manufacturer does not disclose the origin of albumin (bovine or human), because if the source is collagen-containing tissue of cattle, it is very allergenic for humans.

Also, the manufacturer does not disclose the number of complexing proteins in the drug, the magnitude of which will determine the rate of development of secondary resistance to botulinum toxins. And if the manufacturers of Xeomin (0.6 ng), Botox and Botulax (5 ng each) openly publish these data, the manufacturer of the drug Refinex carefully keeps silent about this. This fact, together with the content of albumin of unknown origin and gelatin of unknown origin, makes the use of that drug in my eyes not entirely safe.

Therefore, if I were the patients, I would be careful not to do it in different beauty salons, where a priori there are neither nurses nor doctors capable of providing qualified assistance if anaphylactic shock suddenly develops. Well, one more and big minus is that according to the instructions for use, the drug can only be used after dilution for 8 hours. For example, for most other botulinum toxins this period is 24 hours, and this, in principle, also indicates that the technology for stabilizing botulinum toxin molecules in Refinex is not good enough.

Important: by the way, if you carefully read the instructions for use of Refinex, the manufacturer does not openly recommend using this drug for “patients prone to anaphyloxia.” Those. apparently there is still an animal origin of albumin and gelatin. Well, on Refinex the price per unit will be approximately the same as that of the drug Botulax (i.e., the purchase price for a 100-unit bottle for cosmetologists will start from 8,000 rubles). In principle, in our opinion, it is not so cheap that you can risk the development of anaphyloxia.

And finally, you will probably be “pleased” that most of the Refinex botulinum toxins end up in Russia counterfeitly. On the website of RosZdravNadzor you can find a whole investigation with test purchases of this Chinese botulinum toxin. And if you go to the official website of the drug Refinex KS, you can find factual errors in the composition of the drug, as well as gross errors in medical vocabulary.

Description of the procedure

Neurotoxin injections have been clinically proven to be harmless and effective.

Any drug consisting of botulinum toxin damages nerve impulses and blocks muscles. Long-term immobilization of fibers helps smooth out skin folds and creases caused by contractions.

Buyanov Sergey Yurievich (Expert Doctor):

Under the influence of botulinum toxin, muscles relax due to the blockade of synapses - nerve endings in contact with muscle cells. Due to this, skin tension is reduced, and therefore wrinkles are straightened.

After restoration of functionality, when new neuromuscular connections are formed, the defects return, and the habit of not frowning is preserved, because while the muscles were paralyzed, the need for obsessive movements did not arise.

Purified botulinum toxin is a natural protein produced by the pathogenic bacteria Clostridium botulinum (clostridia). This is a strong organic poison that is safe in acceptable doses; in injectable preparations the substance is stabilized and bound by auxiliary proteins

Botulinum therapy can eliminate not only visual aesthetic errors, but also pathological defects.

Indications for use:

• facial asymmetry;
• horizontal wrinkles on the forehead;
• visible folds between the eyebrows;
• “crow’s feet” around the eyes, mouth;
• drooping eyelids;
• involuntary movements of the eyelids (blepharospasm);
• painful spasms of facial muscles (hemispasm).

The procedure is also carried out to prevent static wrinkles.

Lantox: reviews and composition analysis

This is botulinum toxin type A from a Chinese manufacturer, developed at the Lanzhou Institute of Biological Products.
In 2008, it appeared on the Russian market, and the certificate for the drug explicitly stated that it was made in China. Now, for some reason, out of fear, this drug has been declared the first Russian botulinum toxin. If earlier the purchase price of a bottle of 100 units was about 3,500 rubles, which was 3 times cheaper than that of Botox (but that was how it should have been), now the cost of a bottle of 100 units of Lantox is about 9,000 rubles. This is despite the fact that the cost of a 100 unit bottle of original Botox is now about 12,500 rubles. That is, if earlier Lantox was a cheap Chinese botulinum toxin, now it is an expensive botulinum toxin, which costs the same as Korean botulinum toxins.

What can you say about this drug? –

The molecular weight of botulinum toxin molecules is also 150 kDa, and before dilution it can be stored like Refinex - only in the freezer. As minor components, the drug contains 5 mg of gelatin, 25 mg of dextran and 25 mg of sucrose. Particular attention should be paid to the origin of gelatin. The manufacturer does not hide the fact that this is the skin and bones of cattle, i.e. collagen-containing tissues (24stoma.ru). Therefore, we immediately conclude that this is not very safe and increases the risk of developing anaphylactic shock.

And of course, the manufacturer does not talk about the content of complexing proteins in the composition of the drug - the very proteins to which the immune system responds with the formation of toxin-blocking antibodies. Therefore, when the manufacturer is silent about the obvious important criteria for botulinum toxins, we are forced to assume the worst - there may be a high risk of developing secondary resistance to botulinum toxins.

→ Lantox instructions for use

Comparative characteristics of drugs for facial rejuvenation: Botox and Dysport

Let's summarize the above. Let's consider all the characteristics of the drugs in comparison.

*Values ​​are not absolute; there are patients in whom Botox has a duration of effect comparable to Dysport.

Conclusions:

There are a large number of botulinum toxins from different manufacturers. When assessing their safety, it is always worth looking at the presence of animal proteins. Albumin and gelatin can be dangerous in this regard. Higher quality preparations contain purified human serum albumin, cheaper ones contain porcine or bovine albumin, as well as gelatin made from collagen-containing tissues of cattle (skin and bones).

It is worth looking at the terms and conditions of storage. For example, what does it mean that undiluted Refinex can only be stored in the freezer, although other botulinum toxins can be stored until diluted and at a temperature of 2-8 degrees Celsius. This indicates insufficiently good stability of botulinum toxin molecules. With regard to the drug Refinex, the poor stability of the toxin molecules is confirmed by the fact that after dilution it can only be used for 8 hours. We hope that our article was useful to you!

Sources:

1.

, 2. Personal experience with the clinical use of botulinum toxins, 3. National Library of Medicine (USA), 4. https://www.roszdravnadzor.ru/,5. https://www.lantox.ru/, 6. https://botulax.ru/, 7. “Injection methods in cosmetology” (B. Asher).

POST-PROCEDURAL

After completion of the procedure, in order to minimize hematomas and reduce the inflammatory reaction, it is recommended to use Post Procedure Cream / Restoring cream with peptides (Mesaltera by Dr. Mikhailova, Lab. TOSKANI, Russia), which has regenerating, anti-inflammatory and angioprotective properties.

The patient is given the following recommendations:

within four hours, you should bend your face down and lie down, you should not touch the injection sites for six hours, avoid thermal procedures and strong physical exertion for several days, refrain from drinking alcohol for two to three days, and from visiting the bathhouse for five to seven days. and saunas. A follow-up examination is scheduled two to three weeks after the procedure; if the effect is insufficient, additional correction can be performed at that time.