Yoon Jeongho, M.D.

Director

Jewelry Plastic Surgery, Korea

 

In the late 1960s, an American ophthalmologist Alan B. Scott was looking for a nonsurgical method of treating the imbalanced extraocular muscle contraction in strabismus. He injected different substances into the extraocular muscles. In 1971, he came across Drachmann’s paper on denervation of chicken hind limb using botulinum toxin. In 1973, Scott obtained surprising results using botulinum toxin in adult monkey extraocular muscle. In 1977, botulinum toxin was shown to be effective in blepharospasm and strabismus in humans. In 1989, botulinum toxin earned marketing approval from the US Food and Drug Administration. It was first approved under the trade name of ‘Oculinum’ but the manufacturer Allergan later changed the name to ‘Botox’.

 

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In 1982, Jean Carruthers, a Canadian ophthalmologist working in Scott’s research team had independently conducted clinical studies on botulinum toxin since 1983. In 1987, she found that injecting botulinum toxin into the eye area and forehead of a patient with blepharospasm had the unexpected effect of improved facial appearance. She told her dermatologist husband Alastair Carruthers who was looking for effective means to remove wrinkles. The Carruthers continued their research and published an important study on 18 cases of wrinkle treatment using botulinm toxin in 1992.

The long history of how botulinum toxin came to be used in aesthetic procedures can be summarized as following; Botulinum toxin was first discovered as the culprit behind fatal poisoning. Later, the bacterium that produces this toxin was identified as Clostridium botulinum. The technology of isolating and purifying the toxin from this bacterium developed as part of military research. An ophthalmologist fortuitously discovered the toxin’s aesthetic effects while using it in treatment of strabismus.

Botulism is known to be caused by ingesting contaminated canned foods. It came into being around the time canning developed as a way to preserve food. The canning method was first developed in the 19th century, under Napoleon-ruled France. Napoleon was seeking ways to preserve food to feed his soldiers in far away battle places. In 1809, he offered a large cash prize for a long-term food preservation method. Nicolas Apert’s method of sealing food in an air tight container was selected. This method involved steam sterilization and sealing, which are still the basic principles of canning.

In 1810, a British merchant Peter Durand developed and patented a tin container that improved on the shortcomings of a bottle. This patented container was named canister, which served as the origin of the word ‘can.’ Clostridium botulinum is common in the soil and water and can infiltrate into food during the process of canning. As it is anaerobic, it can proliferate in the vacuum conditions of the can. It also produces spores of high heat-resistance and is only completely destroyed by sterilization at 120℃ for over 4 minutes. Botulism was more common in the early days of canning due to incomplete technology and knowledge.

 

-To be continued-