In Texas, medications like Botox can only be obtained by a qualified physician (with a medical license). Within a doctor’s office however, the treatment can be delegated to and then administered by, anyone.

Because the market for Botox and cosmetic procedures can be very lucrative, there is a strong allure for physicians with inadequate training to begin offering these treatments. Currently there are no regulations pertaining specifically to the training and qualifications of those who administer a cosmetic injection. Such regulations would also apply to treatments like Juvederm, Sculptra, Radiesse and other popular wrinkle reducers.

The medical board will discuss a regulation that would allow only doctors, nurses and physician assistants to administer a controlled substance such as Botox.

With the move to more natural foods and lifestyles, many people are seeking to attain the results of traditional cosmetic augmentation without the use of implants or facial fillers. The growing popularity of autologous fat grafting, which transplants fat from one part of a patient’s body to another, has meant that more cosmetic surgery patients are able to achieve their desired all-natural beauty.

But there are benefits to this procedure that extend far beyond the augmentation of breasts or lips; a company in Dallas, Texas called BioLife Cell Bank has established a bank into which patients can deposit fat extracted in the course of liposuction. The fat can be stored for future cosmetic use and may someday have significant implications for medical and genetic research.

Fat extracted from a patient’s body has a variety of applications:

• filling wrinkles on the face
• correcting sagging earlobes
• breast augmentation
• buttocks lift
• lip augmentation
• filling scars and depressions

When used for filling out the face, scars, and depressions, transplanted fat can last longer than facial fillers, which often (depending on the type) need to be applied every six months to 1 year.

With this new fat bank, patients can have their fat retained for future use, instead of having it extracted repeatedly for different procedures over time. In the video above, Tina LeBoeuf, a breast reconstruction patient and mother of 3, is having fat taken from her lower body. Her surgeon will be using some of it to reconstruct her breast, and the rest will be mailed to BioLife Cell Bank, ready to be withdrawn at any time. Future procedures would require office injections rather than a stint in the O.R.

The stored fat may also have important applications in the future, since stored fat contains a high concentration of stem cells, which have been shown to have a number of medical applications.

Facelifts, injectables, and body contouring are three of the procedures where they are predicting growth.

As the economy improves, the demand for facelift surgery will increase, as those who have been putting off the surgery may be more likely to get it in 2011, according to the society.

Already the most popular non-surgical procedure according to ASAPS’s 2009 statistics, injectables (such as Botox, Juvederm and Restylane) will continue to grow in popularity as they evolve and new products become available on the market.

Body contouring procedures will also be on the rise as more obese people may turn to weight loss surgery given the health dangers of obesity. That will lead to an increase in body contouring cosmetic procedures to tighten and remove excess skin after dramatic weight loss.

The society also predicts that more patients will be seeking “posterior body lifts, buttock lifts and surgical and nonsurgical buttock augmentations to shape and augment their buttocks” thanks in part to celebrities like Kim Kardashian and Beyonce who have made it a “must-have accessory.”

The society sees change ahead in fat reduction techniques. While liposuction will remain the standard in surgical fat reduction, new non-surgical techniques will continue to be developed, including freezing, zapping and lasering fat, as possible alternatives to surgery.

Unfortunately, the society also sees consumers looking for bargains on cosmetic procedures. Procedures, such as “discount injectables” bought overseas and cosmetic procedures performed by untrained practitioners will lead to an increase in cosmetic surgery “horror” stories. Always research your cosmetic surgeon to ensure he or she is well-trained in cosmetic surgery.

Read the full list of predictions at surgery.org.

Dr. Steven H. Dayan, of the Chicago Center for Facial Plastic Surgery, conducted the study on 100 participants who received either Botox injections or a saline placebo for facial wrinkles between the eyebrows, on the forehead and around the eyes.

Participants took a quality of life enjoyment and satisfaction questionnaire before the injections and two weeks and three months after the injections.

The researcher found that Botox injections result in improvements in quality of life and self-esteem. Those who were treated with Botox showed statistically significant improvements in answers to many quality of life questions, including those pertaining to physical health, mood, overall life satisfaction, body satisfaction, self-consciousness, self-worth, appearance, weight satisfaction, attractiveness and sense of well-being. Additionally, increases in overall self-esteem and appearance-, social- and performance-related self-esteem were observed in those who received Botox.

The study also revealed that patients who received Botox for the first time demonstrated a greater improvement in quality of life and self-esteem when compared to participants who had previously received Botox.

“The findings in this study ask us to think much differently about Botox treatments,” says Dr. Dayan. “We have long known the physically enhancing benefits of Botox treatments, but to now have data that indicates Botox also improves one psyche, self-esteem and quality of life is very significant. The question now has to be asked is if getting Botox makes people feel better about themselves, could this translate into them being more productive in their professional lives and happier in their personal lives?”

Learn more about Botox at Advanced Cosmetic Surgery.

Statistics compiled by the American Society for Aesthetic Plastic Surgery (ASAPS) show that for those in the 51-64 age range, the number of facelifts dropped from over 75,000 in 2008 to just under 55,000 in 2009. On the other hand, for this same age group, the number of Botox procedures jumped from 672,840 in 2008 to 734,751 in 2009.

“If you are a woman who has to come back to work full-time or a man who isn’t going to be able to retire any time soon, you’ve got to look like you can compete,” says Wendy Lewis, a New York–based plastic surgery and skin care consultant. “And if you are working in a field like media where everyone is really young, you don’t just want to look good for your age, you want to look good, period.”

Overall stats from ASAPS showed that the number of facelifts in the U.S. dropped 29 percent from 2008 and eyelid surgeries declined 23 percent during the same time frame. On the other hand, Botox and Dysport injections rose 3.8 percent from 2008 to 2009, with 2.6 million injections performed last year.

Less invasive procedures not only have less recovery time compared to surgery, but they also generally cost less than cosmetic surgical procedures. However, Lewis does point out that minimally-invasive treatments can be overdone. “There is a point at which you are going to have a better result and spend less money if you just have a facelift,” she says. In addition, there are some problems that can only be fixed by surgery, such as sagging jowls. A cosmetic surgeon can help select the best procedures to address a patient’s concerns.

Advanced Cosmetic Surgery offers a number of non-surgical procedures, including Juvederm, Radiesse, and CO2 Laser Resurfacing.

The aesthetic laser and light therapy markets for skin resurfacing, hair removal and laser lipolysis will be the fastest growing segments, according to the report, and the market for botulinum toxin-A drugs, such as Botox, is estimated to grow to $543 million by 2017.

“Allergan has had a monopoly on botulinum toxin A drugs since 2002, but now faces competition from Dysport by Medicis as well as other new competitors expected to enter the market,” said Dr. Kamran Zamanian, CEO of iData. One of those future competitors may be a botulinum toxin called PurTox by Mentor. PurTox is now in Phase III clinical trials in the U.S., according to Mentor’s website.

The use of botulinum toxins is also expected to increase due to an increasing number of therapeutic treatments, such as upper limb spasms, neck malpositioning and certain types of eye muscle disorders. The FDA is also currently evaluating Botox as a treatment for severe migraines.

“A growing number of doctors are looking at the therapeutic potential of Botulinum-A. There are more cosmetic procedures performed using Botulinum-A than therapeutic, however therapeutic procedures use higher doses of the drug, therefore these two markets are similar in value,” said Dr. Zamanian.

The report, titled “Markets for Cosmetic Surgery, Facial Aesthetics and Medical Laser Devices 2011,” states that the U.S. market for injectables is valued at almost $860 million. The three-report series includes data, analyses, and competitor profiles for botulinum toxins, dermal fillers, breast augmentation implants, liposuction aspirators, laser/light devices, and microdermabrasion.

One case recently in the news was a woman, nicknamed the “Beauty Bandit”, who received over $3,000 worth of Botox and dermal fillers in a Fort Lauderdale cosmetic dermatology center and then disappeared after saying she had to get cash at an ATM.

The suspect was arrested recently and is just one in a line of “cosmetic criminals” who undergo beauty treatments and then leave without paying, according to msnbc.com. Others such crimes have been reported in Newport Beach, Calif.; Port St. Lucie, Fla.; Tampa, Fla.; Brisbane, Australia and Kenton, England.

A spokesman for the American Academy of Cosmetic Surgery, Jeff Karzen, says that from talking with their doctors, it’s a problem that’s occurring from coast to coast.

Some surgeons speculate it’s the bad economy and the perceived “necessity” of procedures like Botox that are the motivating factors behind these crimes.

“Botox is no longer a luxury,” says Dr. Jon Grazer, a Newport Beach plastic surgeon who was hit by a beauty bandit last year. “It’s something people have to have, and if they can’t afford it because of the economy, I think it’s going to push them to get it by whatever means they can.”

Cosmetic surgeon Dr. Samir Pancholi says that  it’s happened three times at his cosmetic surgery practice in Las Vegas. He recounts: “The first time, it was a woman in her 50s who came in and got treatment, then said, ‘My purse is in the car, I’ll go grab it and be right back.’ Then she was gone.”

These “beauty bandits” have forced some cosmetic centers to change payment rules—one now requires all new patients pre-pay.

Juvederm XC, Restylane-L, and Perlane-L are three injectables that won FDA approval in February 2010 for lidocaine versions in the U.S.

Dr. Michael H. Gold, a clinical assistant professor of dermatology at Vanderbilt University School of Medicine and School of Nursing, says the products performed similarly to their lidocaine-free predecessors in terms of safety  and efficacy.

Furthermore, in the clinical trials, he says, “The incorporation of lidocaine has surely provided a higher comfort level for patients.”

In the 72-patient trial of Juvederm XC, patients were blindfolded and their nasolabial folds were treated with either Juvéderm or Juvederm XC. Patients assessed pain levels during treatment and then 30 minutes and 24 hours post-treatment. In the study, 93 percent reported less pain when treated with the lidocaine formulation versus the non-lidocaine formulation of Juvederm.

Dr. Gold says that, based on his clinical experience, when a patient receives an injection that includes even a small percentage of lidocaine, “Most patients say they barely feel the second stick. To me that is the home run of lidocaine in these fillers.”

The FDA also cleared a method for physicians mixing lidocaine with Radiesse last year. “Originally, I was against doctors mixing a lot of fillers because I was afraid of potential changes in the products themselves,” says Dr. Gold. But once the FDA clears these products, especially those premixed by manufacturers, “I’m pretty comfortable with it.”

Juvederm, Restylane, and Radiesse are performed at Dr. Frenzel’s Arlington, Texas office.

The full story, “Fillers with lidocaine among latest injectable advancements,” is available online at Modern Medicine.

A study found that patients with thoracic outlet syndrome (TOS)—a debilitating and painful nerve compression disorder—who received a single, low-dose injection of Botox in a neck muscle reported a significant reduction in short-term pain.

This suggests, the researchers say, that Botox could be an alternative to the invasive rib-removal surgery that is used to treat the syndrome as a last resort.

“There haven’t been many alternatives to the use of surgery to treat this syndrome,” says the study’s lead author Paul J. Christo, M.D., M.B.A., an assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. “Botox seems to be an effective treatment that avoids surgery’s obvious drawbacks, such as its invasive nature and long recovery time.”

As with treating wrinkles, the effect from Botox on TOS patients lasts only a few months, so repeated injections would be necessary to maintain the results. Dr. Christo says some patients could develop antibodies to the compound with excessive use, which would mean the toxin would no longer block pain.

Botox’s use as a cosmetic procedure shows no signs of slowing. In the latest statistics from the American Academy of Cosmetic Surgery it was the number one less-invasive cosmetic procedure performed in the United States in 2009. Dr. Frenzel performs Botox in his Arlington, Texas office.

For the full release on how Botox eases nerve pain in TOS patients, visit the Johns Hopkins Medicine website.

In a study funded by Allergan Inc, Roger A. Dailey M.D. F.A.C.S. analyzed the results of 50 patients undergoing Botox injections for temporary correction of their glabellar lines.  He concluded that after using Botox every four months for two years, the injection frequency could be extended to 6 months while still remaining effective.

In addition, his research indicates that Botox may have work as a preventive measure against wrinkles.  You can read more details in the official online press release from the Oregon Health and Science University.