Aesthetic services

NEUROMODULATORS: Botox, Dysport, Jeuveau, Xeomin and Daxxify

What are Neuromodulators?

Botox, Dysport, Jeuveau, Xeomin and Daxxify are the five commercially available brands of botulinum toxin type A, which are used for cosmetic purposes to reduce the appearance of wrinkles and fine lines. Botulinum toxin neuromodulators are strategically placed to target specific muscle groups, leading to temporary inhibition of the muscle movement.  The treatment is used to smooth and soften expression lines, creating a less tired and more refreshed appearance.  Botulinum toxin effects take about two weeks to fully develop.  While the specific duration of effects differ from person to person, and vary depending on dosage, treated area and an individual’s muscle activity and metabolism, neuromodulator results typically last between 3-4 months.   All botulinum toxin type A products contain the same active 150-kD neurotoxin molecule, but have unique manufacturing processes, excipients, formulations and units.  The general differences between the currently available brands are as follows:

  • Botox (onabotulinumtoxinA): Botox was the first neuromodulator on the market, approved by the FDA in 1989, making it the most well-known household name.  It is approved for both aesthetic and medical neurologic treatments. 
  • Dysport (abobotulinumtoxinA): Dysport received approval in 2009, as the second available neuromodulator.  The unit dose equivalence ratio of Dysport to Botox is approximately 3:1.  Dysport has been shown to have a faster onset of action.
  • Jeuveau (prabotulinumtoxinA): Jeuveau is known as “Newtox” and represents a newer product on the market, approved in 2019 and manufactured entirely for aesthetic purposes.  Jeuveau is nearly identical to Botox, resembling it in manufacturing process, equivalent units and duration of effect. 
  • Xeomin (incobotulinumtoxinA): Xeomin differs from other commercially available botulinum toxin type A preparations in that it is a pure neurotoxin, free from complexing proteins.  This purification process has led to Xeomin occasionally being referred to as a more “natural” toxin. While it provides similar results to Botox, Dysport, and Jeuveau, data has shown Xeomin to have a slightly shorter duration of action, leading to results that do not last as long.  In the rare instance where neuromodulator treatments stop producing an effect due to formation of antibodies against the product, the advantage of using Xeomin without any foreign protein is that it does not contain these potentially immunogenic excipients and may thus prevent treatment failure.
  • Daxxify (daxibotulinumtoxinA): Daxxify is the newest neuromodulator on the market, receiving approval in 2022.  Daxxify is uniquely formulated with a stabilizing peptide, making it a longer-lasting neurotoxin, with an average duration of 6 months.  Due to the prolonged effectiveness of the product, Daxxify is significantly more costly than other available neuromodulators

Are Neuromodulators safe for everyone?

  • Botox, Dysport, Jeuveau, and Xeomin, like any medical treatment, come with potential risks and considerations. While these treatments are generally considered safe, they may not be suitable for everyone. Here are some important factors to consider:

    • Allergies and sensitivities: If you have a known allergy to any ingredients in these products or have experienced adverse reactions in the past, it’s important to inform your healthcare provider. They can assess the risks and determine if an alternative treatment or product is more appropriate.
    • Medical conditions and medications: Certain medical conditions or medications may interact with botulinum toxin injections. It’s crucial to disclose your complete medical history, including any neuromuscular disorders, previous facial surgeries, or current medications. This information can help your healthcare provider make an informed decision about whether these treatments are suitable for you.
    • Pregnancy and breastfeeding: The safety of botulinum toxin injections during pregnancy and breastfeeding has not been established. It’s generally recommended to avoid these treatments during these periods to minimize potential risks.
    • Individual consultations: The decision to undergo botulinum toxin injections should be made in consultation with a qualified healthcare professional or cosmetic specialist. They can evaluate your individual circumstances, discuss potential risks and benefits, and determine if you are a suitable candidate for these treatments.

    It’s important to follow the guidance and recommendations of your healthcare provider and to disclose any relevant medical information to ensure the safest and most appropriate treatment plan for you. They will be able to provide personalized advice based on your specific situation.

Do the treatments hurt?

The sensation experienced during botulinum toxin injections can vary from person to person. Here are some factors to consider regarding the potential discomfort associated with the treatments:

  • Needle sensation: Since botulinum toxin injections involve the use of a fine needle, you may feel a slight pinching or pricking sensation during the injection process. Most individuals describe the discomfort as minimal or tolerable. However, pain tolerance and sensitivity can vary among individuals.
  • Topical anesthesia: To minimize any potential discomfort, your healthcare provider may apply a topical anesthetic to the treatment area before the injections. This can help numb the skin and reduce the sensation during the procedure.
  • Cold compresses or vibration: Some clinics or healthcare providers may use cold compresses or vibrating devices on the skin before or after the injections. These techniques can help distract from or alleviate any discomfort associated with the procedure.
  • Individual perception: Everyone’s pain threshold and sensitivity can differ. What one person may perceive as uncomfortable, another may find relatively painless. It’s important to communicate your concerns or discomfort level with your healthcare provider, as they can take steps to make you more comfortable during the treatment.

Overall, many individuals find botulinum toxin injections to be relatively tolerable and not excessively painful. If you have specific concerns about pain or discomfort, it’s best to discuss them with your healthcare provider or the specialist administering the treatment. They can address your concerns and provide appropriate measures to ensure your comfort during the procedure.

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Frequently asked questions

  • The duration of the treatment and the ability to resume normal activities afterward can vary depending on the individual and the extent of the treatment. Here are some general guidelines:

    • Treatment duration: The actual injection process typically takes only a few minutes. However, it’s important to note that the overall appointment duration can be longer due to consultation, preparation, and any additional discussions with your healthcare provider. The total time spent at the clinic or office can range from 15 minutes to an hour, depending on various factors.
    • Returning to work or home: In most cases, you can resume your daily activities immediately after the treatment. Since the injections are minimally invasive, there is usually no downtime required. Some individuals may experience mild redness, swelling, or bruising at the injection sites, but these side effects are typically temporary and resolve within a few hours to a few days. You may choose to apply cold compresses to the treated areas to help reduce any swelling.
    • Post-treatment considerations: After receiving botulinum toxin injections, it’s generally advised to avoid rubbing or massaging the treated areas for a few hours to prevent the product from spreading to unintended muscles. Your healthcare provider may also recommend avoiding strenuous exercise, extensive sun exposure, saunas, or steam rooms for at least 24 hours after the treatment.

    It’s important to follow the specific aftercare instructions provided by your healthcare professional, as they may vary depending on the brand of botulinum toxin used and the treatment area. If you have any concerns or questions, it’s best to consult with your healthcare provider or the administering specialist.

  • The onset and visibility of results after receiving botulinum toxin injections can vary from person to person. However, in general, you can expect to start noticing the effects within a few days to a week after the treatment. Here are some key points to keep in mind regarding the timeline of results:

    • Initial changes: The initial effects of botulinum toxin injections may become noticeable within a few days after the treatment. However, it’s important to note that these changes are usually subtle during the early stages.
    • Full results: The full and optimal results of the treatment typically become evident within 1 to 2 weeks. At this point, you should notice a significant reduction in the appearance of wrinkles and fine lines in the treated areas.
    • Individual variations: The time it takes to see results can vary depending on factors such as the specific brand of botulinum toxin used, the dosage, the treatment area, and individual variations in metabolism and response to the treatment. Some individuals may experience results earlier or later than the general timeframe mentioned above.

    If you have any concerns about the progress or timing of the results, it’s best to discuss them with your healthcare provider or the specialist who administered the treatment. They can provide you with more personalized information based on your specific circumstances.

  • Botulinum toxin injections, such as Botox, Dysport, Jeuveau, and Xeomin, are designed to relax targeted muscles temporarily. While the treatments can reduce the appearance of wrinkles and fine lines, they do not completely restrict your ability to make facial expressions. Here’s some information to consider:

    • Natural-looking results: When administered correctly by a skilled healthcare professional, botulinum toxin injections aim to achieve natural-looking results. The goal is to soften the appearance of wrinkles and lines while preserving your ability to make normal facial expressions.
    • Targeted muscle relaxation: Botulinum toxin works by temporarily blocking the nerve signals to specific muscles. This relaxation of the muscles helps reduce the appearance of wrinkles caused by repetitive movements. However, it does not completely immobilize the muscles or hinder your ability to express emotions.
    • Customizable treatment: Your healthcare provider can tailor the treatment to your desired outcomes. By adjusting the dosage and injection sites, they can ensure that the treatment focuses on the intended areas while maintaining a natural range of motion in other facial muscles.
    • Temporary effects: The effects of botulinum toxin injections are not permanent. Over time, the muscles gradually regain their function, and the wrinkles may gradually return. Typically, the results of a single treatment last around 3 to 6 months. Subsequent treatments can be scheduled to maintain the desired appearance.

    It’s important to communicate your expectations and desired outcomes with your healthcare provider before the treatment. They can provide guidance and ensure that the injections are administered in a way that allows for a balance between wrinkle reduction and maintaining natural facial expressions.

  • No, Botox, Dysport, Jeuveau, Xeomin, and dermal fillers such as Restylane and Juvéderm serve different purposes and work in different ways.

    • Botulinum toxin (Botox, Dysport, Jeuveau, Xeomin): Botulinum toxin injections temporarily relax specific muscles, reducing their activity. This helps diminish the appearance of dynamic wrinkles, which are caused by repetitive facial movements, such as frown lines between the eyebrows and crow’s feet around the eyes. Botulinum toxin injections primarily target muscle activity rather than adding volume to the skin.
    • Dermal fillers (Restylane, Juvéderm, and others): Dermal fillers are gel-like substances that are injected into the skin to restore volume, fill in wrinkles and folds, and enhance facial contours. They work by physically filling in areas that have lost volume due to aging or other factors. Dermal fillers can be used to address static wrinkles, which are visible even when the muscles are at rest, as well as to add volume to areas such as the lips or cheeks.

    In summary, while both botulinum toxin injections and dermal fillers are used in cosmetic treatments, they have different mechanisms of action and target different concerns. Botulinum toxin injections primarily relax muscles to reduce the appearance of wrinkles caused by muscle activity, while dermal fillers add volume to specific areas to address static wrinkles and enhance facial contours. The choice between these treatments depends on the specific concerns you wish to address and can be discussed with a qualified healthcare professional or cosmetic specialist.

  • As of my knowledge cutoff in September 2021, there are no topical creams or over-the-counter versions of Botox, Dysport, Jeuveau, or Xeomin available on the market. These products are currently administered through injections by qualified healthcare professionals or cosmetic specialists.

    The active ingredient in these products, botulinum toxin type A, needs to be injected directly into the muscle to achieve the desired effects. Topical application of botulinum toxin is not effective because the molecules are too large to penetrate the skin and reach the underlying muscles.

    While there are various skincare products available on the market that claim to have “Botox-like” effects, it’s important to note that these products typically contain different ingredients that may help with skin hydration, firmness, or the appearance of fine lines, but they do not provide the same muscle-relaxing effects as botulinum toxin injections.

    If you are interested in receiving treatments with Botox, Dysport, Jeuveau, or Xeomin, it’s recommended to consult with a qualified healthcare professional or cosmetic specialist who can assess your suitability for the injections and provide the treatments in a safe and effective manner.

  • Botox, Dysport, Xeomin, and Jeuveau are all brands of botulinum toxin type A, used for various cosmetic and medical purposes. While they share a similar mechanism of action, there are some differences between them, primarily in terms of formulation, dosing, and onset of action. Here’s a breakdown of the differences:

    • Formulation: Botox, Dysport, Xeomin, and Jeuveau each have their own unique proprietary formulation of botulinum toxin type A. While the active ingredient is the same, the surrounding proteins and additives may vary, which can affect how the product is prepared, stored, and administered.
    • Potency and dosing: The potency of the different brands can vary. For example, Dysport is reported to have a lower protein load and may be dosed differently compared to Botox. This means that the units used to measure the dosage of each brand are not equivalent. Your healthcare provider will be familiar with the appropriate dosing and conversion factors for each brand.
    • Onset of action: The time it takes to see the onset of action may differ between these brands. Some individuals may experience results sooner with one brand compared to another. For example, some studies suggest that Dysport may have a faster onset of action compared to Botox.
    • Duration of effects: While the general duration of effects for Botox, Dysport, Xeomin, and Jeuveau is similar (around 3 to 6 months), individual experiences may vary. Factors such as metabolism, muscle activity, and the specific treatment area can influence how long the effects last.

    It’s important to note that the choice between these brands often comes down to the preferences and expertise of the healthcare provider, as well as individual patient considerations. Your healthcare provider will be able to recommend the most appropriate option based on your specific needs and desired outcomes.

  • The choice between Botox, Dysport, and Jeuveau depends on various factors, including individual preferences, the expertise of the healthcare provider, and the specific treatment goals. It’s important to note that what may be considered “better” can vary from person to person. Here are some points to consider:

    • Effectiveness: All three brands, Botox, Dysport, and Jeuveau, have been approved by regulatory authorities and have demonstrated efficacy in reducing the appearance of wrinkles and fine lines. The effectiveness can vary from person to person, and individual experiences may differ.
    • Formulation and dosing: While the active ingredient, botulinum toxin type A, is the same, the formulations, dosing, and potency of each brand differ. The choice of brand may depend on the healthcare provider’s experience, familiarity, and personal preference.
    • Onset and duration: The onset of action and duration of effects can vary between brands. Some individuals may experience faster onset or longer-lasting results with one brand compared to another. However, individual responses can differ, and it’s best to consult with a healthcare provider to determine which brand may be most suitable for you.
    • Personal considerations: Factors such as allergies, sensitivities, medical history, and individual preferences can influence the choice between these brands. It’s essential to discuss your specific needs and goals with a qualified healthcare provider who can provide personalized advice.

    Ultimately, the decision between Botox, Dysport, and Jeuveau is best made in consultation with a healthcare professional or cosmetic specialist who can assess your individual circumstances, discuss the available options, and recommend the most appropriate treatment for you. They can consider your desired outcomes, medical history, and their own experience to help guide your decision.

  • Both Botox and Jeuveau are botulinum toxin type A injectables that are used to temporarily reduce the appearance of wrinkles and fine lines. While the duration of their effects can vary between individuals, in general, Botox is known to have a longer track record and established duration of action compared to Jeuveau.

    Botox: On average, the effects of Botox injections typically last around 3 to 6 months. However, individual experiences may vary, and some people may observe longer-lasting results, particularly with repeated treatments over time. It’s important to note that the muscle activity gradually returns, and subsequent treatments are typically needed to maintain the desired appearance.

    Jeuveau: Jeuveau is a relatively newer brand of botulinum toxin type A, and its duration of effects is reported to be similar to Botox. Clinical studies have shown that Jeuveau can provide results lasting around 3 to 6 months. However, as with any botulinum toxin treatment, individual responses may vary.

    It’s important to remember that the duration of results can depend on various factors, including the individual’s metabolism, the specific treatment area, and the dosage administered. Additionally, the longevity of the effects can also be influenced by the expertise of the healthcare provider performing the injections and their knowledge of optimal dosing and injection techniques.

    To determine the most suitable option and expected duration for your specific situation, it’s recommended to consult with a qualified healthcare provider or cosmetic specialist who can assess your needs and provide personalized advice. They will be able to discuss the potential duration of effects and help you make an informed decision based on your individual circumstances.

Botox (botulinum toxin type A) is considered highly effective in reducing the appearance of wrinkles and fine lines for several reasons:

  • Long-standing track record: Botox has been used for cosmetic purposes for many years and has a well-established track record. Its effectiveness has been extensively studied and documented, leading to its widespread use and recognition as a reliable treatment option.
  • Extensive research and clinical studies: Botox has been extensively researched and evaluated in clinical trials, demonstrating its efficacy in reducing the activity of targeted muscles and smoothing out wrinkles. The results of these studies have contributed to its approval by regulatory authorities for cosmetic use.
  • Precise muscle targeting: Botox works by temporarily blocking the nerve signals that stimulate specific muscles, leading to muscle relaxation. This targeted action helps reduce the appearance of wrinkles caused by muscle activity, such as frown lines and crow’s feet. Skilled healthcare providers or cosmetic specialists can administer Botox injections with precision, ensuring that the intended muscles are targeted effectively.
  • Customizable treatment: Botox treatments can be customized to meet individual needs and desired outcomes. The dosage and injection sites can be adjusted based on factors such as the treatment area, muscle activity, and patient preferences. This customization allows for tailored treatments that address specific concerns, optimizing the effectiveness of the treatment.
  • Longevity of effects: While individual experiences may vary, Botox treatments typically provide results that last around 3 to 6 months. This duration allows for long-lasting wrinkle reduction, although subsequent treatments are generally needed to maintain the desired appearance.

It’s important to note that the effectiveness of Botox can also depend on the expertise of the healthcare provider performing the injections. A skilled and experienced professional will understand optimal dosing, injection techniques, and the unique considerations of each patient, maximizing the effectiveness and safety of the treatment.

When considering Botox or any other cosmetic treatment, it’s advisable to consult with a qualified healthcare provider or cosmetic specialist. They can assess your specific needs, discuss expected outcomes, and determine the most appropriate treatment plan for you.

  • Botox (botulinum toxin type A) can be used in various areas of the face to target specific wrinkles and lines caused by muscle activity. The most common areas where Botox is used and considered effective include:

    • Glabellar lines: These are the vertical lines that appear between the eyebrows, often referred to as “frown lines” or “11 lines.” Botox can help relax the muscles responsible for creating these lines, resulting in a smoother and more youthful appearance.
    • Forehead lines: Horizontal lines that appear on the forehead due to facial expressions and muscle movement can be treated effectively with Botox. The injections help relax the muscles, reducing the visibility of these lines.
    • Crow’s feet: These are the fine lines and wrinkles that radiate from the outer corners of the eyes. Botox can be used to relax the muscles around the eyes, softening the appearance of crow’s feet and providing a more rejuvenated look.
    • Bunny lines: Bunny lines refer to the wrinkles that appear on the sides of the nose when certain facial expressions are made. Botox injections can help minimize the appearance of these lines by targeting the underlying muscles.
    • Lip lines: Botox can also be used to reduce the appearance of vertical lines that form around the lips, often referred to as “smoker’s lines” or “lipstick lines.” By relaxing the muscles in this area, Botox can help smooth out these lines.

    It’s important to note that the effectiveness and suitability of Botox in specific areas of the face can vary from person to person. The expertise and experience of the healthcare provider or cosmetic specialist administering the treatment play a crucial role in achieving optimal results.

    During a consultation, your healthcare provider can assess your facial anatomy, discuss your concerns, and recommend the most appropriate treatment plan, including the specific areas to be targeted with Botox, based on your desired outcomes.

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