What is BOTOX®?
BOTOX® is a trade name for a refined version of the botulinum toxin type A, originally isolated and refined by researchers seeking to help people with eyelid and facial spasms. It has been safely used for this purpose since the 1980s. Dr. Fante is the author of scientific articles on the medical uses of botulinum toxin type A and has vast experience with this medication.
We’ve all heard that botulism is a form of food poisoning. Yikes. How can a poison be used therapeutically?
Well, not to worry. It’s only poisonous in a large dose, about 100 times what will be used cosmetically because then it paralyzes muscles. For cosmetic treatments, BOTOX® injections have been approved by the FDA. Injected precisely into specific muscle areas in tiny doses, it relaxes the muscle and relieves it from unconscious and unnecessary movement, thus preventing it from making wrinkles.
Alternative brands of botulinum toxin type A, such as Dysport® and Xeomin® are also available at our office. We will explain the differences below.
What is Xeomin®?
Xeomin® is an injectable composed of botulinum toxin type A, a naturally occurring protein that is produced by the bacteria Clostridium botulinum. When Xeomin® is injected into the muscles it reduces their activity and the result is a smoother and less noticeable wrinkle. Xeomin® does not stop the muscle from moving entirely; instead, it modifies the contractions. This is achieved by inhibiting a body chemical called acetylcholine from signaling all of the nerves within the muscle to contract.
The number of injections necessary will vary from patient to patient, depending upon the area of concern. The results of treatment with Xeomin® are usually seen after one week and last, on average, up to 12 weeks.
What is Dysport®?
Dysport® is an injectable that is FDA approved. It temporarily lessens or eliminates moderate-to-severe frown lines between the eyebrows. Dysport® is made from a neurotoxin produced by the bacterium Clostridium botulinum; it is the same neurotoxin used in BOTOX® Cosmetic.
Similar to BOTOX® Cosmetic, Dysport® injectable is placed directly into the muscle underneath a furrow, weakening the muscle to the point where it cannot contract.
What is Jeuveau®?
Jeuveau® is a newly FDA approved neurotoxin intended to reduce facial lines from chronic muscle contraction. It Is also an acetylcholine release inhibitor and a neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients.
Jeuveau® is an alternative neurotoxin that appears to work as well as Botox® in most people and may be more effective for certain individuals, including those who have developed immune resistance to other types of botulinum toxin. It is difficult to measure the potential effect of neutralizing antibodies in individual patients on the effects of particular brands of botulinum toxin. Instead, a treating physician may try one of the other brands to see if effectiveness can be enhanced. Like Botox®, Dysport®, and Xeomin®, Jeuveau® may have advantages for particular patients.
Am I a Candidate For Cosmetic Injections?
The best candidates for these drugs are adults who are in good physical health and who wish to temporarily smooth dynamic lines and wrinkles. Treatment should be postponed in the event of skin infection in the proposed injection sites. Use of neurotoxins such as Botox®, Dysport®, Jeuveau®, and Xeomin® is also not suitable for women who are pregnant or breastfeeding.
How Do Neurotoxins such as Botox®, Dysport®, Jeuveau®, And Xeomin® Work?
We tend to learn facial habits as we grow up. Facial expressions that become habitual, and over the years start creating permanent lines. BOTOX®, Xeomin®, and Dysport® injections don’t completely stop all muscle movement; they just relax the muscles and allow the skin to become smoother. This gives us a refreshed look as if we had a good night’s sleep and feel in a good mood.
Jeuveau® Before & After
What Can I Expect During My Cosmetic Injection Treatment?
Using a very fine needle, the injectable is placed directly into facial muscles that are causing furrows and lines. No anesthetic is required, but some doctors numb the area to be injected with ice packs or topical anesthetic cream. Patients can usually see results within a few days and typically last up to 4-6 months. In some cases, areas that are treated on a regular basis may retain results longer.
- Beforehand, several photographs will be taken of your face, from different angles, so that you can compare your new look with this previous look.
- The injections take only a few minutes and are done with a very fine, tiny needle. There’s not much pain, but some people feel minor, temporary discomfort.
- There’s no recovery time necessary. Most people go right back to work or their normal activities after treatment.
Are Cosmetic Injections Painful?
Neurotoxin injections with drugs such as Botox®, Dysport®, Jeuveau®, and Xeomin® are among the most popular treatments performed today. One reason is that injectable treatment is only minimally uncomfortable. Patients tolerate multiple injections very well without the need for any type of anesthetic. The only discomfort that is associated with this treatment is the minor sensation that occurs when the tiny needle touches the skin. The introduction of Botox® into the muscle causes no sensation. Patients also quickly recover from injections without any post-treatment soreness or tenderness.
Benefits of Neuromodulators
The benefits of neurotoxins such as Botox® extend beyond the anti-aging effects this treatment achieves. Patients appreciate that neurotoxin injection is a quick and convenient treatment that does not require downtime. Though results are not immediate, they appear gradually over just a few days, making wrinkle-reduction possible even when a special event is on the horizon. The fact that Botox® provides temporary cosmetic improvement is also a benefit; this characteristic helps those who are new to this treatment try facial rejuvenation without committing to permanent changes to their appearance.
How Many Botox® Treatments Will I Need?
Typically, the BOTOX® is injected in 4 or 5 areas on each side of your forehead, and 2 or 3 at each eye area. Other areas around the mouth and neck can also be treated. But of course, each face is unique. So we will work with you to use the right number of small injections to make for you, in just the right places, to give you optimal results. Dr. Fante has vast experience with these treatments.
What To Expect After Treatment
- Avoid rubbing the injected areas for 3 or 4 hours
- We will have discussed bruising with you, and if it’s a concern, avoid taking any aspirin or ibuprofen (Advil) for a day or two.
- You’ll see the results anywhere from 2 to 7 days later.
- You’ll notice that deeper wrinkles will become lighter and light ones will almost disappear.
- Some people go on to have injections of a filler substance, such as Restylane® or Juvéderm®. This fills out the skin that was furrowed and is now smoother.
- If you have several deeper wrinkles, you might decide to have further Botox® injections on them, to achieve your best results.
Side Effects Of Neuromodulators
The worst that people generally experience is some pain at the injection sites and/or headache, and maybe some symptoms of a cold or upper respiratory virus. We will prescribe pain medication if necessary. Bruising is uncommon but possible. Even more rarely, there could be some temporary eyelid drooping. If you were to notice that, immediately let us know because there is a treatment for it.
Are Neurotoxins Such as Botox®, Dysport®, Jeuveau®, And Xeomin® Safe?
Botox® has a long history of use in both clinical settings and in aesthetic medicine. Between 1989 and 2003, the FDA received only 36 reports of adverse reaction. Of those, 13 cases were confirmed to be related more to the underlying condition being treated than to the drug itself. Furthermore, reports suggest that reactions to Botox® are typically associated with therapeutic injections. This is likely due to the fact that a higher dose is used therapeutically than what is needed to achieve cosmetic benefits.
Typically, the side effects of neurotoxins such as Botox®, Dysport®, Jeuveau®, and Xeomin® are limited to transient redness and swelling. These side effects are hardly noticeable and are usually gone by the time that patient returns to their normal activities. Though much less common, some patients develop a mild headache after getting injections, and yet fewer explain post-treatment side effects as “flu-like.” Again, side effects usually last no more than a few hours.
It is important to receive neurotoxins such as Botox®, Dysport®, Jeuveau®, and Xeomin® injection treatment from a licensed, experienced professional. In our office, Botox® injections are prepared and administered by board-certified physicians according to FDA standards.
How Long Does Botox® Last?
Effects last for 3 or 4 months. Gradually your muscles return to their normal state, and repeat treatments can maintain them in their more relaxed state. After 18-24 months of continuous treatment, some people will have retrained certain facial muscles (especially between the eyebrows) and will need less Botox® after that. Also, there is a “frequent flyer” program for Botox® and other products made by Allergan called Brilliant Distinctions. We will help you enroll and will be sure that you receive credit for any treatments received through our office. The makers of Dysport® and Xeomin® have similar programs.
How Long Do Jeuveau® Injections Last?
Jeuveau® has a similar duration of action to Botox®, averaging 12 weeks.
How Much do Neurotoxins Such as Botox®, Dysport®, Jeuveau®, And Xeomin® Cost?
Every case is unique. The overall cost of facial rejuvenation using these drugs is determined by several factors, including areas needed to treat and the degree of facial rejuvenation required. Many patients have multiple concerns, such as crow’s feet at the outer corners of the eyes and also drooping or heavy eyebrows. To address both areas of concern, more units of treatment are needed. Furthermore, treatment with neurotoxins such as Botox®, Dysport®, Jeuveau®, and Xeomin® is often combined with dermal fillers to achieve the best results. During our consultation with each patient, we discuss their broader objective in obtaining treatment and develop a recommended treatment plan based on their goals. At that time, we can provide a detailed list of costs.
How Are Neurotoxins Such as Botox®, Dysport®, Jeuveau®, And Xeomin® Different From Dermal Fillers?
Both Botox® and dermal fillers fall into the category of injectable wrinkle-reducers. However, neurotoxins and dermal fillers are very different products. Botox®, Dysport®, Jeuveau®, and Xeomin® are each neuromodulator, that smooth lines, and wrinkles by diminishing muscle contractions. They are the injectable that we turn to when lines are caused by muscle movements. Examples include frown lines and worry lines on the forehead. Dermal fillers do not affect the muscles, they affect the skin itself. These products contain ingredients that build volume beneath the epidermis. By adding volume, a dermal filler plumps tissue so a crease is brought up to the surface of surrounding skin for a smoothing result. Because neuromodulators such as Botox®, Dysport®, Jeuveau®, and Xeomin® and dermal fillers work differently, they make very nice partners in the improvement of facial contours.