Neurotoxins (eg Botox)
The 3 major neurotoxins used in the US market are Botox® Cosmetic, Dysport®, or Xeomin®. Botox® Cosmetic was the first to market, but since its release Dysport® and Xeomin® have been used for the same purposes. Dr. Blyer has experience with all three and there are small nuances where one may be favored over another.
People are often confused whether they need "Botox" or filler. As I explain during consultations, Botox and the other neurotoxins work by decreasing the strength of the muscles of facial animation. This results in a decrease in wrinkles. Fillers are used to restore volume.
There are generally 2 types of wrinkles:
- dynamic wrinkles: which are wrinkles as a result of animation and
- static wrinkles: which are wrinkles that are still present even when not animating
A dynamic wrinkle over time will usually turn into a static (or imprinted) wrinkle. Botox® Cosmetic, Dysport®, or Xeomin® work well for dynamic wrinkles. They do not work well for static wrinkles. When a wrinkle is present even without motion these neurotoxins will prevent the wrinkle from worsening but laser, filler, or Dr. Blyer's threading technique may be considered to address the wrinkle.
Am I too young to start with Botox?
'An ounce of prevention is worth a pound of cure". Botox® Cosmetic, Dysport®, and Xeomin® all work great as a preventative measure. Treating an area with a neuromodulator when it is a small dynamic wrinkle can prevent its evolution into an imprinted one.
A well known study published in the Archives of Facial Plastic Surgery compared two identical twins. One twin received Botox injections 3 times per year over a 13 year period (on right), while the other did not (on left). Comparing the twins' photos, it is clear how regular Botox treatments help prevent the aging process, evident in the right twin's face. This nicely demonstrates the benefits of preventive Botox treatments.
Neurotoxins like Botox® Cosmetic, Dysport®, or Xeomin® are best used in the upper third of the face . The more common areas treated include:
|commonly referenced names||avg. "units' needed*||anatomical area|
|glabella, frown line, "elevens", angry lines||20-30|
|crow's feet, smile lines||10-15|
* The units shown are the average units for Botx or Xeomin, Dysport is different
Picture yourself with Botox!
All 3 neurotoxins although different create the same clinical effect.
Aside from a small chance of bruising, risks and complciations are few and rare. Ptosis (brow drop) is the main adverse event patients are concerned with, and both Dysport and Botox had ptosis occur in 3% of patients during FDA phase 3 trials.
This was the first to market in the treatment of dynamic wrinkles on the forehead (glabellar area).
Everyone loves perks: For our Botox patients we participate with the Brilliant Distinctions program. For Allergan products such as Juvederm or Botox, you generate points that are redeemable to discounts on future Botox or Juvederm treatments.
There is some evidence that Dysport may diffuse more compared to the other neurotoxins. Some doctors believe this creates a smoother look, while others fear spreading in undiserable areas. While Botox and Xeomin's unit equivalent can be compared to each other as equivalent, Dysport does not follow the same unit requivalents.
Everyone loves perks: Love It or Money Back guarantee from the company (I was unable to find this on their site but heard about this offer from Dysport)
The newest neurotoxin on the markert and does not require refirgeration. It is believed to be a "purer" form of neurotoxin in that there are no proteins attached to the molecule. Is is believed that because of this, one cannot develop antibodies (or an immunity) to Xeomin while with its competiitors, it is possible.
Everyone loves perks: For Xeomin patients, we offer a $50 VISA gift card that can be used for any product or treatment in our spa or office.
There is essentially no downtime to this treatment but after your injection t is advisable for patients to avoid lying down for 4 hours after a treatment, as well as avoiding vigorous exercise. It takes about one week to start to see the effects of this treatment.
Beware of Botox scams or as Dr. Blyer refers to in a recent news article "Faux-Toc". Click here for more information on the scams where below cost neurotoxins are being offered disingeniously..