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MODERN-day fountain of youth or dangerous toxin whose health hazards are yet to be fully revealed?

If its popularity is anything to go by, judgment appears to be firmly in favour of Botox.

Growing numbers of patients and medical experts are embracing the drug as a safe and effective weapon against wrinkles.

Australians spent about $300million on non-surgical cosmetic procedures, such as Botox, in 2007.

And doctors say our appetite for Botox or botulinum toxin A is only growing, despite the global financial gloom.

Toorak plastic surgeon Dr Chris Moss says his patient list has increased about 20 per cent every year for the past 10 years, with his Liberty Belle Medical Skin Rejuvenation Centre now performing about 30 Botox treatments a week.

But he says Botox has more on its side than just popularity, with more than 50 trials testing the safety of the drug.

“It has an extremely high safety profile,” Moss says.

“This is a product that has been used safely for 20 years now.

“More than a million patients have had these cosmetic treatments worldwide since its approval and in more than 10 years of experience in our clinic we haven’t received evidence of any medical disease being caused by the drug.”

South Yarra dermatologist Associate Prof Greg Goodman agrees, saying adverse reactions to Botox are very rare.

“It’s a compound that’s taken up by nerve endings very quickly and avidly,” Dr Goodman says. “And once you’ve gone through three or four months those nerve endings are replaced and repaired and you’re back to where you were.

“It’s not as though it stays in the body and does terrible things.”

But Australian Medical Association national president Dr Rosanna Capolingua is not convinced.

“At the moment there doesn’t seem to be a body of accumulated evidence around long-term effects, but there is still a possibility something may emerge over time,” she says.

“We may discover that there are harms from accumulated utilisation of Botox, but maybe we haven’t seen those yet.”

Australia’s drug watchdog, the Therapeutic Goods Administration, has received 45 reports of adverse reactions to botulinum toxin A, which is sold as Botox and Dysport, over the past 14 years. More than a third relate to cosmetic uses of the drug.

The most common problems were muscle weakness, rashes and other allergic reactions, double vision and fatigue.

“Most adverse effects with botulinum toxin appear to be non-serious, of mild to moderate intensity and transient,” it found in its February 1 report.

It found rare serious adverse reactions usually related to “leakage” of the toxin after too much was injected or it was injected incorrectly.

The TGA called for extreme care when administering the toxin after deaths occurred overseas.

This was mainly children being treated for cerebral palsy.

Cosmetic Physicians Society of Australasia public relations officer Dr Gabrielle Caswell says her organisation is extremely worried about a boom in beauty-salon Botox treatments.

“Generally nurses at the salons work for a doctor, but they’re not on the same site as the doctor,” she says.

“So it’s a bending of the rules but a totally inappropriate bending of the rules.”

Caswell says the TGA requires Botox to be prescribed by a doctor and the CPSA recommends it also be administered by a doctor or by a nurse under a doctor’s direct supervision.

Victoria’s Health Services Commissioner Beth Wilson says she is more concerned about inappropriate marketing of the drug, such as the trend of a few years ago of Botox parties.

“Alcohol and medical services should never be mixed,” she says.

Wilson says her office receives fewer than five Botox complaints a year, the main gripes being about treatments not working as well or for as long as expected.

Goodman says prices range from about $100 to treat lines around the mouth, about $400 for the frown lines between a woman’s eyebrows and a little more for men, about $200 for forehead lines and $600 to $800 for a lower facelift. Treatments around the eyes at Moss’s clinic cost $350, and between $100 and $200 for other areas.

Goodman says treatments are needed every three to four months to keep up appearances.

BOTOX is produced from the lethal botox protein, a nerveblocking toxin that causes the disease botulism. It’s used to treat several medical conditions, but is better known as a cosmetic treatment.

In cosmetic surgery, a small amount of the substance is injected under the skin, paralysing facial muscles.

Moss, who has had Botox, says between 20 and 40 units of the toxin are injected in cosmetic procedures, about 10 per cent of the proven safe levels of the drug.

But he says it’s possible patients can experience mild reactions, highlighting the need for treatments to be done by skilled practitioners.

“There can be bruising, there can be tenderness, there can be some weakness in the immediate area of less than 1cm around the injection.”

Caswell says a good Botox outcome is one that’s barely noticeable.

“Really you shouldn’t see the practitioner’s handiwork,” she says. “In other words, if . . . you look as though you’re stuck in a wind tunnel, then technically I’d say that’s not a very good Botox job.

NICOLE KIDMAN: The Aussie actor is rumoured to be a Botox devotee. It seems a good explanation for such a complexion at the age of 41. But it’s just sunscreen and a bit of TLC, according to the new mum herself. “I am completely natural. I have nothing in my face or anything. I wear sunscreen and I don’t smoke. I take care of myself, and I’m very proud to say that,” she told Marie Claire magazine late last year.

COURTENEY COX (FAR RIGHT): The former Friends star, 44, admits trying Botox but says she hated it because she couldn’t move her face.

KYLIE MINOGUE (RIGHT): The 40-year-old pop princess is widely considered by cosmetic surgeons to be a Botox babe.

DANNII MINOGUE: Little sister Dannii, 37, freely admits she’s been Botoxed, but said late last year she’d sworn off the jabs because they were affecting her judging on Brit TV talent quest The X Factor. “The job I do now I need to express myself, so I’m not having that anymore,” she said.

ELLE MACPHERSON: The 44-year-old model dubbed The Body is another tipped by cosmetic surgeons to be turning back the clock with Botox.

MADONNA:The Material Girl, 50, has been a longtime client of highprofile cosmetic dermatologist Frederic Brandt, known as the Baron of Botox.

SAM NEWMAN: The Footy Show buffoon had a Botox touch-up live on TV in 2007. It wasn’t the 53-year-old’first and probably not his last.

ANNA BLIGH: The 48-year-old Queensland Premier confessed late last year that Botox had been part of her beauty routine. “Like most women, I care about my appearance. I dye my hair and I do other things, so what?” she said.

NEVIN Guner’s youthful looks can be put down to good genes and a needle point.

Guner, 50, has been getting Botox injections from plastic surgeon Dr Chris Moss every five months for the past four years.

She estimates she’s forked out $3200 on the wrinkle treatment, but says it’s money well spent.

“I don’t drink, I don’t smoke and I don’t go out very much, so I don’t spend a lot of money on myself in other ways,” she says.

“I spend $400 or $500 every fi ve months on my face and I’m getting a lot of very positive feedback. So it’s worth it.”

Turkish-born Guner, a supervisor at her brother’s cleaning business, is far from the stereotypical Botox patient, but says as with other women she is conscious of looking her best.

“Like every female I want to like what I see in the mirror,” she says.

“The Botox treatments freshen up my face and prevent lines from getting deeper.

“They make me feel happy because I look fresh and young.”

The single Sydenham woman gets Botox injections around her eyes and to her forehead.

The regular jabs are part of her skincare routine, which also includes moisturiser, facials and peels.

“But the Botox is more effective because you can see the difference straight away,” she says.

Guner says there is a little discomfort during and after the treatments, but she is usually back at work within a couple of hours.

And she would not hesitate recommending others drink from the Botox fountain of youth.

Younger brother Ismail says his sister looks 10 to 15 years younger than her 50 years.

“She has good genes, but you put the Botox on top of that and you get a great result,” he says.

• IMMEDIATELY reduces facial lines and wrinkles
• NON-INVASIVE cosmetic treatment
• EASILY and quickly administered
• LITTLE, if any, recovery time required
• CUMULATIVE benefi t from repeated treatments
• STRONG safety record
  (serious side-effects are extremely rare)

• CAN cause mild reactions such as bruising, tenderness and weakness in the immediate area around the injection site
• SERIOUS adverse reactions are rare but can occur when too much of the drug is injected or the drug is injected incorrectly
• CAN be expensive, with treatments typically ranging from $100 to $400
• EFFECTS typically last three to four months