If you’ve found that frown lines, forehead creases or other facial-expression lines are preventing you from looking as good as you feel, cosmetic denervation with botulinum toxin (Botox or Xeomin) injections may be a good option for you. Botulinum toxin is a purified therapeutic agent that removes lines and creases in the upper part of the face by inactivating specific muscles that pull on the skin. It works to eliminate the face’s dynamic wrinkles—those wrinkles that are caused not by aging or sun exposure, but by years of facial movement, such as laughing, smiling or frowning. Cosmetic injections are tailored to the unique contours of your face for maximum results and flexibility. Treatment in the affected areas causes the underlying muscles to relax, giving the skin a smoother, more refreshed appearance. Botulinum toxin can also lift eyebrows and make one’s eyes appear more open. The result of neurotoxin injections is that you look more relaxed, fresh, and youthful.
What is Botox or Xeomin?
FDA-cleared brands of botulinum toxin that are available at Indian Lake Medical include Botox Cosmetic and Xeomin. These products have EXACTLY the same active ingredient, botulinum toxin. They differ only in the proteins that surround that ingredient. All are very effective, although one may work better than the other for different individuals. Xeomin and Botox both have an onset of about 3-5 days.
BOTOX® Cosmetic: Botox is a prescription medicine that is injected into muscles and is used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in people 18 to 65 years of age for a short period of time.
Everything you need to know before your first treatment
WHAT IS XEOMIN®?
Xeomin® (incobotulinumtoxinA) is a prescription medication injected into muscles and used to temporarily improve the appearance of moderate to severe frown lines between the eyebrows (glabellar lines) in adults. Xeomin® contains botulinum toxin type A, a protein purified from the bacterium Clostridium botulinum.
HOW DOES XEOMIN® WORK?
When you squint or frown, the muscles between your eyebrows contract, causing the skin to furrow and fold. Over time, as your skin ages and loses some of its elasticity, these repeated contractions can cause persistent frown lines. Botulinum toxin type A – the active ingredient in Xeomin®– acts on nerve endings in muscles to prevent muscle fibers from contracting. By reducing these contractions, Xeomin® can temporarily reduce the lines between your eyebrows.
IS XEOMIN® PROVEN?
Xeomin® was proven effective in two randomized, double-blind, multicenter, placebo-controlled clinical trials of 547 healthy, adult patients. The average age of patients in the study was 46 years. Patients received 20 Units of Xeomin® and were classified as responders if they had a 2-grade improvement on a 4-point scale as assessed by the physician and patient. Using these criteria, treatment success was higher with Xeomin® than placebo on Day 30 in both studies (60% and 48% vs. 0% for placebo in both studies). Based on these trials, Xeomin® received FDA approval for use in glabellar lines in 2011.
HOW DO I KNOW IF XEOMIN® IS RIGHT FOR ME?
If you are an adult with moderate to severe glabellar lines, Xeomin® may be right for you. Talk to your doctor to discuss the benefits and risks of treatment. Do not use Xeomin® if you are allergic to botulinum toxin or any of the other ingredients in Xeomin®. You should also not use Xeomin® if you have had an allergic reaction to any other botulinum toxin product or have a skin infection at the planned injection site.
WHAT SHOULD I TELL MY DOCTOR BEFORE TREATMENT?
Before receiving treatment with Xeomin®, you should tell your doctor about all of your medical conditions, including whether you have a disease that affects your muscles and nerves, have allergies to any botulinum toxin product, or have experienced any side effect from any other botulinum toxin in the past. In addition, tell your doctor about your medical history and all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you have received any other botulinum toxin product in the last four months or in the past. Be sure your doctor knows exactly which product(s) you received and when you received them.
WHAT CAN I EXPECT DURING TREATMENT?
During treatment, which usually takes about 10-20 minutes, your doctor will inject Xeomin® into the muscles in your forehead that cause frown lines between your eyebrows. No anesthesia is required; however, your physician may use a topical anesthetic or cold pack to reduce any discomfort.
WHEN CAN I EXPECT TO SEE RESULTS?
You may begin to see visible smoothing as early as 3-4 days after injection. The median first onset of effect was less than a week. The maximum effect occurred at 30 days. The typical duration of effect was up to 3 months in clinical trials but may last significantly longer or shorter in individual patients.
Is Neurotoxin Injection treatment right for me?
Neurotoxin Injection is most commonly used to treat adults 18 and older. However, patients of any age can benefit from treatment. You may be a good candidate for Botox or Xeomin if you have any of the following conditions:
Frown lines (vertical wrinkles between the eyebrows)
Forehead creases (horizontal forehead lines)
“Crow’s feet” near the eyes
A personal consultation is the first step for new patients considering this type of treatment. During this meeting, we will assess your physical and emotional health and discuss your specific treatment goals. You should arrive at the consultation prepared to give complete information about:
Past and present medical conditions (If you’re a woman, we must know if you are pregnant or are nursing a child)
Medical treatments or recent psychological counseling you may have received
Medications that you take, including nutritional supplements and herbal remedies
Any allergies you may have
During your physical evaluation, we will assess your bone structure, the texture and elasticity of your skin and the muscle activity of your upper face. We may explain additional procedures that can be performed in combination with Neurotoxin Injections to better meet your appearance goals.
How is a treatment performed?
Injections are quick and associated with very little pain. Often, patients remark that the ultra-thin needle that is used makes the injections far less uncomfortable than expected. The simple office procedure typically takes 10 minutes or less and the actual injections take only seconds. No anesthesia is required. However, if you are especially sensitive, we may elect to use a topical numbing cream. The number of injections you’ll need depends on the areas that are affected. For forehead, you can probably expect about 8-12 injections; for frown lines between the eyebrows, 5-7 injections; and for lines around the eyes, 2-3 injections for each eye. We target the hyper-kinetic muscles, that is, the over-active muscles that are responsible for movement and expression.
Are there other treatment options?
If the wrinkles on your face are mainly caused by sun damage or aging and are not concentrated to the upper third of your face, we may recommend a skin-resurfacing technique, such as chemical peel or dermabrasion, to shrink the wrinkles and create a smoother appearance.
How will I look and feel right after the injections?
Though it is unusual, you may experience some mild discomfort, bruising and/or swelling at the injection site. If any of these side effects becomes bothersome, we may give you medication or suggest that you apply ice to the affected area. You may return to work or your normal daily activity immediately after the treatment. However, for the first 3 to 5 hours after the injections, you’ll be advised to avoid bending or straining. Exercise or facial massage may spread the medication to an area where it is not needed. The goal is for the toxin to be taken into the muscle at the place where it was injected. After a few hours have passed, you may resume any activity or exercise.
What should I know about my results?
The effect may take several hours or even several days to develop. The duration of the results may vary. However, in general, you can expect your results to last for three to five months. If you find that your treatment did not produce the look that you had hoped for, we may recommend a repeat treatment. Patients are typically quite pleased with the results of this quick outpatient procedure. Most are surprised at how simple it is to maintain the results with regular treatments.
How long before I need repeat treatment?
To maintain your softer, more relaxed appearance, you will need to see us every 3-6 months for repeat treatments. You may find that as the muscles gradually weaken from lack of use, you repeat treatments will become less frequent. However, it’s important to be aware that if you discontinue your treatments altogether, the botulinum toxin will leave your body entirely and your appearance will return to its earlier state. At your return visits, we will assess your results, modify your treatments if needed and address any questions or concerns you may have.
Botox $12 per units
Xeomin $10 per unit