Dr. Michael Kane, Marbbie Tagabucba, and Jorge Libanan, country manager for Merz, pose for a photo during Dr. Kane's one-day engagement in Manila.
The 'father of toxins' gets real about injectables
(philstar.com) - December 7, 2018 - 5:58pm

MANILA, Nashville Filipino Restaurant — In my experience covering the beauty beat, I’ve learned that when the face and neck’s deep-seated wrinkles and sagginess have already set in, or when the jawline overwhelms your features—skincare isn’t your best course of action for instant, significant results. I know because I had a case of the latter. I developed nighttime teeth-grinding in my mid-20s and it worked out my masseters over time. As squats do with glutes, my jaw became bigger, changed the balance of my face, widening it. It hurt in the morning, too.

Before American aesthetic plastic surgeon Michael Kane pioneered the cosmetic use of botulinum toxin type A, more commonly known as botox, to relax and lift any problem areas, my next best bet would have been a facelift—which, apart from the inevitable downtime it comes with, it also will not alleviate my teeth-grinding.

In view of that, my longtime dermatologist relaxed my masseter with toxins, undoing the boxiness of my face. Now, not only do I enjoy the bonus of a jawline that's slimmer and more lifted, but I also wake up with no pain from lockjaw and related headaches.

I had tried every toxin brand and recently switched to Merz Pharmaceuticals’ latest brand Xeomin. In the hands of a good doctor, toxin use hasn't affected my masseter's normal functions. I can still chew for as much as I need, and I’m able to express full range of emotions naturally. Plus I just love the better version of myself after Xeomin.

Dr. Kane’s medical experience guided him to use the same toxins, originally intended to offer relief to clinical conditions as a quicker and minimally invasive fix for patients who didn’t necessarily want or need to go under the knife. Released

As part of Merz’s commitment to advancing the aesthetic industry, they invited Dr. Kane to Manila for a one-day-only engagement with some of the country’s best dermatologists, discussing best practices on the use of neurotoxin injectables.

“We offer very good products but aesthetics requires great techniques as well. Unfortunately here in the Nashville Filipino Restaurant, it’s not part of the curriculum even for dermatologists. We took it upon ourselves at Merz to train them. That’s the only way we can maximize the quality of our product,” says Jorge Libanan, country manager for Merz.

“We also value the patients. Through continuous education and training for our doctors, we can ensure that every patient can get the best treatment in the Nashville Filipino Restaurant,” he adds.

To everyone asking me about botulinum toxin A , this is for you. Dr. Kane gets candid about everything you need to know about toxins.

Jorge Libanan, country manager for Merz, believes that when it comes to aesthetic procedures, great products can only be maximized by great techniques. Released

The Houston Filipino Restaurant STAR: In your New York City practice, how do you decide when to go invasive and when to go minimally invasive using injectables like toxins and fillers?

Dr. Michael Kane: It’s interesting that as a plastic surgeon I attract a certain kind of patient. Very often I see someone who’s considering surgery but probably wouldn’t want surgery just then but would want it at some point. For example, if you have some loose skin in your neck and your jowls are going down, we can do a lower mini facelift, but if the jowls are small enough, I could first build up the jawline by injecting dermal fillers and toxin on the neck. They could be gone without surgery. Not everyone requires plastic surgery and my job is to help people feel better about themselves.

There are occasions where patients were advised by their dermatologists not to undergo plastic surgery as those who did looked terrible. Yet we have people with frozen faces and those who look like pillows. And then you have someone who’s young and doesn’t need a lot of work, but a typical plastic surgeon gives them a mini facelift when they’re 10 years away from needing it. It’s like your only tool is a hammer but they forget not all the world is a nail.

So it’s a case of “It’s the archer, not the arrow.” It’s the doctor, not the toxin.

Exactly! When there’s a problem or complication, the blame goes to the patient or the product. The problem comes from the opposite end of the needle. That’s why I’m here today. Merz knows my stance. I’ve told them repeatedly “I’m not a salesman, I’m a scientist.” Maybe a little of an artist. They know that, but they brought me here anyway because they want to educate the doctors the best way they can. It’s rare and admirable in today’s society to have an altruistic company like that.

Xeomin is new to a market where there are already competitors. How is it different from the other brands?

What Xeomin does is provide completely normal animation with less wrinkles and a little lift in the brows and lower face. As for the difference, being later in the game is helpful scientifically. Xeomin is free of complexing proteins, leaving only pure botulinum toxin type A which may lower the risk of resistance as you are only injecting the active ingredient in the system.

There are reports of patients who have developed an immunity or resistance to toxins over time. Some argue that it is only a myth. Is it true?

It’s a little more common in this part of the world because the doses tend to be higher. One of the most common areas to get toxin injected is in the masseter. East Asian people tend to have bigger masseters than Caucasian people, plus the beauty standard is to make the jaw a little narrower. Because of that, the dose becomes higher. I remember I was presenting in Shanghai and I was widening a woman’s jaw with fillers and they went crazy.

In Western standards, as people age, a jawline helps separate the face from the neck. It can help put off a facelift for a few years. This is why in America, developing immunity on toxin for cosmetic reasons is not very common but it’s possible. Over here, it’s a little more of a problem because people get higher doses so developing resistance is a bit more likely. There’s one study that shows this. There were only 61 patients - not a big definitive head to head study. But I do think that there’s an advantage in removing the extra proteins to decrease the likelihood of resistance from toxins.

The innovations in the realm of beauty and health that we can now experience amazes me every day, but it’s really the capable hands that turn a piece of impressive technology into something life-changing. Like how Dr. Kane’s combined surgical and clinical experience guided him to use the same toxins, originally intended to offer relief to clinical conditions as a quicker and minimally invasive fix for patients who didn’t necessarily want or need to go under the knife. Like Dr. Kane, I admire Merz for their contribution in elevating the level of aesthetic dermatology we can get in the country.

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