Finding the needle in a haystack of unsafe injections Q: I know that you're against Botox, and I read your letter about collagen injections the other day. But I'm wondering if there are any cosmetic procedures that you do find okay? JVW: If you're interested in these sorts of cosmetic injections, there's only one that gets my conditional approval. It's actually another form of collagen, but this time I'm referring to actual human collagen. Two products containing it were approved in 2003: Cosmoderm for superficial lines and Cosmoplast for deeper lines and wrinkles. Since they're made from real human collagen, it's highly unlikely that they would ever cause any problems, so I consider them the safest of the cosmetic injections available. But I still can't give them my unconditional approval for two reasons. First, the collagen is combined with lidocaine, a local anesthetic frequently used in dental work. Lidocaine allergy is rare, but if you don't know for sure whether you're allergic to it or not, it's a very good idea to check this aspect before trying Cosmoderm or Cosmoplast. Second, the collagen in these products is cloned from human newborn foreskin. Your opinion of this may vary according to religious persuasion, but from a strictly medical point of view, newborn and infant circumcision is an extremely unnecessary amputation of a normal, functional part of male human anatomy. But even with the possible ethical arguments against it, if you're thinking of having "cosmetic injections," then this is the only kind presently available that I think is OK in terms of safety. | 
