Inside Aesthetics Ep 230 The Tox Talks (Chapter 7): We've Been Doing Toxins Wrong for the Past 35 Years | Dr John Joseph
Episode 230 hosts Dr John Joseph (Plastic Surgeon from California, USA)
In this mini series 'The Tox Talks', we feature expert injectors who have significant experience in using botulinum toxins. These episodes explore our guests experiences using particular brands, the evolution of their injecting techniques and we get special insights into the subtle nuances of getting the best out of toxins.
In chapter 7 John shares his experiences as a lead clinical study investigator and tells us why he believes we've been doing toxins wrong for the past 35 years. We dangle the possibilities of longer lasting results, less complications, increased patient satisfaction, more time and how to revolutionise the world of toxin treatments.
00:00 Introduction 01:04 Miami Conference Teaser 02:02 Meet Dr John Joseph 02:20 Early Botox Adoption 07:51 Building a Botox Practice 09:00 Why 2.5 mL Became Standard 11:15 Inside Clinical Trials 15:55 On Label vs Off Label 19:20 Eureka on Dose Duration 23:44 Galderma Study and Bias 28:41 How Longer Duration Works 32:28 Measuring Duration and FDA 40:22 Why He Pushed the Science 45:32 Allergan Plateau Findings 46:56 Why Duration Plateaus 47:51 Trial Design and Patient Expectations 50:28 Safety and Field of Effect 52:54 Concentrate to Extend Duration 56:34 Cold Versus Old Data 61:50 90 Units in the Lip 66:06 AccuTox Syringe Prototype 72:04 Running Multiple Dilutions 77:11 Pricing and Practice Economics 81:29 Which Toxin to Stock 83:22 Future Adoption and Consumer Pull 84:54 Resistance and Type E Antidote 90:43 Wrap Up and Next Steps