Botox, Dysport, Xeomin & Jeuveau
When you look in the mirror, are you beginning to see facial lines or wrinkles? While this is a completely normal aspect of aging, it can cause many individuals to feel self-conscious. A great treatment option to soften these lines are injections of a medication known as neuromodulators (Botox, Dysport, Xeomin, Jeuveau). This procedure is minimally-invasive and requires no downtime. Dr. Thomas Walker has significant experience with injectable treatments and can help you achieve your individual aesthetic goals for a more confident you.
What is Botox?
Botox is an FDA-approved treatment that weakens muscle movement and thereby has many cosmetic applications and even functional ones. For cosmetic purposes, Botox is very popular to treat and prevent lines and wrinkles on the forehead, upper face, crow’s feet, and more. This facial rejuvenation procedure provides incredible, natural results and is popular among both men and women.
Botox can create a dramatic yet natural enhancement to dynamic facial wrinkles (wrinkles caused by repetitive movement). To diminish the appearance of these dynamic lines and wrinkles, Botox is injected to relax muscles and soften the overlying skin. This injection is most commonly placed between the eyebrows to treat the “11” lines, on the crow’s feet at the corner of the eyes, and throughout the forehead for horizontal forehead lines. The injections may also be performed in underarms, palms, or soles for excessive sweating. Other common uses are for chronic migraine headaches, amongst other applications.
Neuromodulator injections such as Botox are individualized to every client, depending on your needs and desires. These treatments cannot stop the aging process. However, they can temporarily diminish the appearance of wrinkles caused by certain muscle groups. In fact, neuromodulator injections such as Botox are best begun in the early 20s to prevent wrinkle formation. Botox injections may be performed as an isolated procedure or as an adjunct to a non-surgical or surgical intervention (dermal filler injections, browlift, facelift, etc.).
What Types of Neuromodulators are there?
Botox is classified as a medication called “neuromodulators” and has become perhaps the most popular cosmetic treatment worldwide today. There are multiple neuromodulators available on the market today with Botox being the first and most recognized one. Other similar neuromodulators are Dysport, Xeomin, and Jeuveau. All four neuromodulators work via the same mechanism with very similar clinical effects even though subtle differences exist between the four compounds. Even though the FDA-approval varies slightly among these medications, they are often used interchangeably for the same purpose. Should you want to learn more about these products, please discuss with Dr. Walker what the differences between these compounds are and which substance may be best suited for you.
Botox Cosmetic is FDA-approved for the treatment of crow’s feet, frown lines between the eyebrows (commonly called the “11 lines”), and forehead lines. Not only do injections in those areas decrease wrinkles, but they also lead to a subtle but favorable brow elevation if administered properly, contributing to a more refreshed look. All other areas of the face and neck, such as the lower eyelids or neck bands, may be treated safely with Botox in an “off-label” fashion. Botox is also approved by the FDA to treat many other conditions involving excessive sweating of the underarms and hands (hyperhidrosis), chronic migraine headaches, crossed eyes (strabismus), eyelid spasm (blepharospasm), cervical dystonia (stiff neck), musculoskeletal pain disorders, motor disorders of the facial nerve (VII cranial nerve), and most recently, urinary incontinence.
Dysport is FDA-approved to treat moderate to severe frown lines between the eyebrows and cervical dystonia (neck stiffness). Other areas of the face and neck, such as crow’s feet wrinkles, forehead lines, and neck bands, may be treated with Dysport in an “off-label” fashion.
Xeomin is FDA-approved to treat moderate to severe frown lines between the eyebrows and cervical dystonia (neck stiffness). Other areas of the face and neck, such as crow’s feet wrinkles, forehead lines, and neck bands, may be treated with Xeomin in an “off-label” fashion.
Jeuveau is FDA-approved to treat moderate to severe frown lines between the eyebrows and cervical dystonia (neck stiffness). Other areas of the face and neck, such as crow’s feet wrinkles, forehead lines, and neck bands, may be treated with Jeuveau in an “off-label” fashion.
Who is a Good Candidate for Neuromodulators such as Botox?
Botox is used for adult individuals who desire to diminish and soften the appearance of dynamic wrinkles, lines, and many facial expressions. Even if dynamic wrinkles have not yet formed, please keep in mind how often we tend to make facial expressions.
Popular treatment areas (FDA-approved and off-label uses):
- Frown lines (11-lines).
- Crow’s feet.
- Forehead lines.
- Jelly roll under eye (to open the eye with smiling).
- Non-surgical Brow lift.
- Lines around the mouth with puckering.
- Peau d’orange (orange peel skin).
- Gummy smile.
- Platysmal neckbands.
- Jawline narrowing (masseter hypertrophy).
- Excessive sweating in underarms, palms, or soles.
If you have deeper lines, a combination of Botox and a filler may be a better option for you.
Botox for cosmetic purposes can only be utilized in adult patients. Anyone with a known hypersensitivity to botulinum toxin should not undergo any neuromodulator injection. Women who are nursing or pregnant should not undergo these treatments as the safety is unknown. Caution is advised in individuals with difficulty swallowing (dysphagia) and breathing difficulties in the treatment of Cervical Dystonia. Caution is advised in people with pre-existing neuromuscular disorders.
How Are Botox Injections Performed?
Dr. Walker is typically able to perform your Botox treatment at the time of your initial consultation. You will be asked to make various facial expressions, which will allow Dr. Walker to see where the injections need to be placed. Your skin will be cleansed with alcohol, and a cold compress will be applied to prevent any minor discomfort and minor bruising. Although available, a numbing cream is typically not used, as icing has been found to be more effective for Botox injections than numbing creams. Botox will be injected just under your skin using the smallest possible needle. Dr. Walker advises his clients to refrain from strenuous activities and alcohol consumption for the rest of the day to minimize the risk of bruising. You will also be asked to sleep with your head elevated if possible, for the first night. It is important to understand that there is always a slight risk of a tiny bruise, especially when taking blood thinners such as aspirin, ibuprofen, Advil, Motrin, and Aleve.
Botox is a quick in-office procedure that typically lasts 10-15 minutes, requires no anesthesia, and is associated with no downtime. It can often be done at the beginning or end of your workday, or even during your lunch break. There will be a slightly raised area at the injection site similar to a mosquito bite for 5-10 minutes following injection. Makeup can be immediately reapplied and nobody would know you had these treatments done once the small bumps subside after a few minutes. Discomfort is usually minimal or absent. Very few clients may experience some injection site redness, minimal bruising, and on occasion, a minor headache at the injection site which may last up to 24 hours. These reactions are usually minor and clear up quickly. Most patients can return to normal activity immediately after receiving the injections. It is important that you do not massage the area in which the injections were administered because you can cause the medication to spread and affect other muscles other than the ones that were targeted.
Even though slight differences exist between the various neuromodulators, you can begin to see results followinginjections within 48-72 hours with the full effects within 10-14 days. This is typically the time when Dr. Walker asks his clients to return for re-evaluation and for a possible minor enhancement to make sure you have the best and most natural result. Treatment results usually last three months.
Schedule Your Consultation
If you are looking for a more youthful, fresh-faced look without invasive surgery, then Botox injections may be right for you. To learn more about this treatment option or to schedule a consultation appointment, contact Atlanta Facial Plastics today.
Frequently Asked Questions
How much does BOTOX® cost?
The cost of BOTOX® and other neuromodulators such as Dysport®, Xeomin®, and Jeuveau® depends on how much product is and what areas are treated. This will vary based on your goals. During your consultation, Dr. Walker will establish a customized treatment plan with you to determine what areas should be treated and how much BOTOX® would be utilized. An estimate will then be given to you. Although BOTOX® treatment may seem like a simple procedure, it should only be performed by a qualified provider for various reasons including obtaining the best possible results, safety, and avoiding knock-off injections. Dr. Walker has an account with the various manufacturers and only uses fresh and authentic products that has been properly shipped and stored. Allergan (BOTOX®, Juvéderm®, Kybella®, SkinMedica®, Latisse®, and CoolSculpting®) and Galderma (Dysport®, Restylane® and Sculptra®) also offer a rewards program called “Brilliant Distinctions” and “Aspire”, respectively, which helps you save money by earning points that can be used for any future product or treatment from a given manufacturer. To learn more about these rewards program, contact us today.
How can I avoid a frozen face” and is BOTOX® safe?
A common misconception about neuromodulator injections is that they lead to a frozen, expressionless face. The key to avoiding this lies in the skill of the injector and not in the product itself. By using microdroplet injections targeting specific muscles and by avoiding certain areas, a natural result can be obtained without looking artificial or “overly done”. Since there is no reversal agent to BOTOX® injections or its relatives (Dysport®, Xeomin®, or Jeuveau®), Dr. Walker places emphasis on conservative injections. This is particularly true for clients who are new to him or new to BOTOX® or Dysport® altogether, as the results can always be enhanced with more product at the two-week follow-up.nEven though neuromodulator injections appear to be relatively minor procedures, they are often misconceived as a procedure without side effects or risks. The human face contains over 43 muscles, and it is important to understand which muscles may be safely injected and which muscles ought to be avoided. It is very important that you only allow an experienced and trained injector to perform this procedure. As a fellowship-trained and dual board-certified facial plastic and reconstructive surgeon who performs a vast array of facial surgeries (both cosmetic and reconstructive), Dr. Walker possesses the necessary knowledge of facial anatomy and skill set to safely administer BOTOX® injections.nA misplaced injection can result in a very unnatural look, asymmetries, blurry vision, mouth drooling, and other side effects depending on which muscles were inadvertently injected. In rare instances, the injected substance may migrate away from the injection site and cause slurred speech or even breathing problems.
What is the right age for BOTOX® injections and does the amount injected differ by age group?
All individuals must be above the age of 18 years. Other than that, there is no right or wrong age for injections. Even though younger patients tend to have fewer skin creases, neuromodulator injections help prevent the formation of wrinkles if started at a younger age. Dr. Walker believes is it important to always start with the lowest possible dose of BOTOX® regardless of your age.
Is BOTOX® toxic?
BOTOX® is a safe and FDA-approved medication for many medical treatments beyond cosmetic purposes. Like any medication, BOTOX® can have rare side effects if administered at doses that are too high or if used in patients who should not receive BOTOX®, as is true for any medication on the market, including non-prescription drugs. Tylenol, if taken incorrectly or in conjunction with alcohol consumption, can lead to liver failure. Aspirin, Motrin, Advil, Aleve, and other NSAIDs can lead to gastrointestinal bleeds that can be life-threatening to a certain patient population. Although BOTOX® naturally occurs as a bacterial toxin that can cause botulism, the dosage used for medical purposes is approximately 1% of toxic levels. To put things in perspective, penicillin is also derived from microbes (common molds) and can cause life-threatening side effects in patients who are allergic to penicillin. The side-effect profile of BOTOX® is extremely small considering the number of treatments performed every day worldwide.
How long do my BOTOX® results last?
Results from BOTOX® and other neuromodulators typically last 3 months, rarely longer. Most patients come in every three months for maintenance of treatment. If you are getting preventative BOTOX® at a younger age, you may be able to space visits further apart. After considering your goals and postulating your treatment plan, Dr. Walker will advise your recommended treatment intervals.
What is the difference between BOTOX® and fillers?
The difference is simple: BOTOX® prevents and treats wrinkles you get with repetitive facial movement (dynamic wrinkles) such as the frown lines or crow’s feet by relaxing the underlying muscles. Fillers are used for wrinkles present at rest (static wrinkles) such as the smile lines between your nose and mouth (nasolabial folds) or to volumize the face by filling hollows under the skin. BOTOX® and fillers work complementary to each other and address different parts of your face. In fact, they are often used in conjunction for a “liquid facelift”. While BOTOX® is classified as a medication by the FDA, fillers are considered a liquid implant.
What is the difference between BOTOX®, Dysport®, Xeomin®, and Jeuveau®?
BOTOX®, Dysport®, Xeomin®, and Jeuveau® are brand names of injectables that weaken muscles to relax wrinkles. The active ingredient in all four brands is botulinum toxin type A. They all relax facial muscles to soften dynamic wrinkles by the same mechanism, but each formula is designed to suit specific areas and needs. There are subtle differences between them, including the amount in each dose, treatment spread, the onset of results, and the duration of results, although the difference is quite small and frankly negligible. Similarly, Motrin and Advil are different brands of the same medication (ibuprofen), just like BOTOX®, Dysport®, Xeomin®, and Jeuveau® are different brands of the same ingredient. Dr. Walker will be happy to go over the differences and similarities with you and choose the best treatment option with you and for you.