Archive October 2018 XIX, No. 10

Ideas That Work: Off-Label Use

Botox for Hernias? Yup!

Shirin Towfigh, MD, FACS
BOTOX FOR HERNIAS? Botox isn't just for wrinkles. One off-label use you might not have heard of: treating large hernias.

Botox is not just for smoothing out wrinkles. Believe it or not, it can help with giant hernias. By giant, I mean at least 20-cm-wide defects with retracted muscles that would otherwise be impossible to close. For these challenging cases, I inject Botox into the abdominal wall around 4 weeks before surgery. This paralyzes and relaxes the muscle, letting it stretch out and elongate, giving me a longer stretch of muscle to work with so I can reconstruct and close the abdominal wall. I do maybe 4 Botox hernia repairs a year. Insurance doesn’t cover the Botox. The out-of-pocket charge to the patient is $2,000.

Shirin Towfigh, MD, FACS
Beverly Hills (Calif.) Hernia Center

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