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Prick to perk up raises doubts
Botox is used to push out, lift chest

Some doctors find use questionable

DAVID BRUSER
LIFE WRITER

Could sagging breasts be fixed, not with a nip or a tuck, but with an injection of Botox?

Some doctors are dubious about the treatment that's popping up in southern Ontario, saying it's a faddish and questionable use of the toxin used for relaxing wrinkles and other medical purposes.

But at least one Ontario dermatologist, Kevin Smith of Niagara Falls, is now offering Botox injections as a way to push the breast up and out.

It takes five to seven days for the $500 treatment to have its desired effect which lasts about two to four months, Smith said.

"They're looking to see if they can make a good thing better," he says of the handful of women he's treated so far. "The effect is to improve the appearance of the breast."

In Oakville, dermatologist Dr. Sheetal Sapra is testing it on staff and volunteers, and says he is considering the injections as a posture treatment.

"This is the edge," Sapra says. "This is really interesting. I'm excited by it. We're testing it on ourselves."

When injected, the Botox deadens the pectoralis minor muscles in the chest, forcing the rhomboid muscles in the back near the shoulder blades to compensate, Sapra says. The result is better posture and pushing out and lifting of the chest.

"It just weakens the muscles that pull your shoulders in. What happens then is the muscles that pull your shoulders back and straight work harder because they're unopposed now," Sapra says.

"Pull your shoulders back, what happens? Your breasts kind of lift, your nipples separate and you get a pointing out."

Sapra, who recently tested the drug on himself, says the drug could help men as well.

"If you walk into a room and see a guy slouched over, not standing tall, what's your impression? When you're tall and straight, you look more confident," he said. "Appearance matters in this world. Studies show this ... There's some improvement in me and I'm happy with that."

But Toronto plastic surgeon Dr. Trevor Born doubts Botox can bring about better posture.

"Just weakening the pectoral (minor) muscle doesn't mean the whole shoulder will go backward," he says. "If people are really looking for a breast lift, they're not going to find that."

When asked about such skepticism, Sapra says, about the treatment, "I'm still testing it out. There's obviously some lifting going on, so where's that coming from? ... I'm not strong on it. I think it does this, but I'm not sure."

Born also says better posture doesn't guarantee a more youthful looking bust.

"If you ask any person to sort of stand at attention, watch their chest go up. It's normal. So it doesn't physically do a breast lift. There's nothing pulling the breast up," he says.

"If someone has any hang in their breast, a fold in their breast, that won't really change all that much."

Smith agrees. "This is not a significant breast lift. If the breasts are hanging down or distended, if they need a breast lift, they need a breast lift."

That's why Smith recommends the shot will work best for women between the ages of 30 to 55 with an A- or B-cup breast. Another effect of the treatment is erect nipples, which lasts about three to four weeks.

Botox, made by Allergan, is a diluted formulation of botulinum toxin, a poisonous bacterium that immobilizes. The product, which is used to relax stiffened muscles in children with cerebral palsy and adults who have had strokes, can also treat back spasms, migraines and excessive sweating. But it is commonly used for the "off-label" purpose of smoothing out facial wrinkles.

Product information lists possible side effects, including headache, nausea, respiratory infection and drooping eyelids.

Ali Adibfar, a Toronto plastic and reconstructive surgeon who uses Botox, dismisses this new use of the toxin.

He and others question whether it's merely an attempt to capitalize on Botox's popularity.

"(The) pec minor is such a small muscle ... (the freezing of it) would not cause any breast lift or any major movement of the shoulder backward," he says.

"I think it's just a little hocus-pocus thing ... Let's not try to get carried away with this Botox bandwagon. Before you know it, people are going to say, ` I can make you look taller with Botox.'"

Mississauga plastic surgeon Hugh McLean also worries Botox is being overused.

"In my opinion it's part of the pendulum swing in the use of Botox that perhaps is going a little farther than it should go," he says.

"If what you have is a hammer, all the world looks like a nail. If you have a technique, you want to use it for as many things as you possibly can. It doesn't sound to me like something that will become widely adopted."

To such skepticism, Smith responds, "They'll draw their own conclusions after they treat their own patients ... People being treated have a reasonable expectation of what can happen."

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