“Aging is inevitable, looking younger is a choice.”
Wrinkles form with constant movement thus, by relaxing the muscle & causing atrophy the mountains flatten out. Tox℠ is used in areas such as the frown, forehead, crows feet, neck bands, and several small custom areas. Medical use for migraines, hyperhidrosis (severe sweating in the underarms) and Temporomandibular joint dysfunction (TMJ). Technically all botulinum toxins function the same way by medically treating certain muscular conditions and cosmetically to remove wrinkles by temporarily paralyzing facial muscles. Read below about the three FDA approved neuromodulators.
What is BOTOX® Cosmetic?
“BOTOX® Cosmetic was the first FDA-approved prescription product that temporarily improves the appearance of both moderate to severe frown lines between the brows and moderate to severe crow’s feet in adults.
Wrinkles result from a combination of many factors. It’s not just about cellular changes, collagen depletion, or damage caused by free radicals. When you frown or concentrate, the muscles between your brows contract, causing your skin to furrow and fold. And when you squint, the muscles around your eyes contract and cause crow’s feet.
BOTOX Cosmetic works beneath the skin’s surface and targets the underlying muscle activity that causes frown lines and crow’s feet to form over time.
How does it work?
BOTOX is injected into the muscles that cause frown lines and crow’s feet lines, temporarily reducing the activity of those muscles. The result is a reduction in the appearance of those lines. Botox blocks the release of a substance called acetylcholine. This reduces muscle activity that causes moderate to severe wrinkles to form.
What is Dysport?
“Dysport™ is an FDA-approved wrinkle relaxer. From frown lines to crow’s feet, it can lift your spirits and improve your wrinkles at the same time. With a few tiny injections Dysport™ will take effect over a period of days to banish frown lines and many other telltale signs of aging.
Dysport™ (pronounced DIS-port) is a new form of botulinum toxin A, similar to Botox, but slightly different in several ways. It takes effect quicker and lasts longer and, for the time being, is priced at a very attractive cost to the consumer.”
What is Dysport used for?
“Dysport™ is used to smooth frown lines and wrinkles between the eyebrows and on the forehead, known as glabellar lines. Dysport™ can also smooth crow’s feet around the eyes.
What is Xeomin®?
XEOMIN® is a prescription medication used in facial aesthetics to temporarily improve the appearance of moderate to severe glabellar frown lines between the eyes (glabellar lines) in adults. XEOMIN® contains botulinum toxin type A, a protein purified from the bacterium Clostridium botulinum. XEOMIN® is also sometimes referred to as incobotulinumtoxinA.
How Does it Work?
When you squint or frown, the muscles between your brows contract, causing the skin to furrow and fold. These lines that occur due to facial mimics are referred to as dynamic lines. 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® – is used in facial aesthetic treatment to treat dynamic lines like glabellar frown lines. It acts on nerve endings in muscles to prevent muscle fibers from contracting. By reducing these contractions, XEOMIN® can temporarily reduce the frown lines on your forehead between your eyes.
Indications and Useage
XEOMIN® (incobotulinumtoxinA) for injection, for intramuscular use, is a prescription medication that is injected into facial muscles for the temporary improvement in the appearance of moderate to severe glabellar lines (frown lines) in adult patients.
XEOMIN® should be administered no more frequently than every three months.
Some of the unique areas that we can treat:
Q. What is the difference between tox and fillers?
A. The easiest way to visualize the difference between Botox referred to as ‘TOX’ and dermal fillers is to think of mountains and valleys. Tox flattens and smooths the mountains created by excessive muscle movement/expressions and prevents them from being pushed together, while dermal fillers fill & lift the crevices & valleys.
Q. How Does TOX Work?
A. TOX is formulated from botulinum toxin, which is a neuromodulator. When used as a cosmetic treatment, tox is injected in very small amounts, temporarily blocking the chemical transmitter acetylcholine which signals the brain to contract the muscle in the target area. The effect of the neuromodulator allows the muscles to relax and skin to smooth, eliminating fine lines and dynamic wrinkles caused by repeated muscle movement. There are 3 FDA-approved Tox’s for cosmetic use on crow’s feet (wrinkles at the outside corners of the eyes) and vertical frown lines between the brows, just above the bridge of the nose but are also widely used on several other muscles in the face & neck. Other medical uses for tox include hyperhidrosis (excessive sweating), TMJ (clenching of the jaw), migraines, bladder spasm, cerebral palsy, torticollis, esophageal stricture/spasm as well as other medical uses.
Q: Will Tox℠ get rid of my wrinkles I see on the surface?
A: Not exactly. Botox, Dysport or Xeomin injections treat muscles that repeatedly contract, creasing and damaging the overlying skin and creating those lines and wrinkles. These products are injected into specific muscles where, within about 2 -10 days, they act to block the muscle’s contractions. The muscle quits pulling on the skin and begins to thin out or atrophy. The surface layer of skin sheds with time (quickly when we are young, not so quickly when we age i.e.. 7-8 weeks vs. a baby sheds skin almost weekly!) The new skin doesn’t have accordion effect of the push/pull of the muscle and appears smooth. This effect on the muscles lasts about 3 months, after which the normal muscle movement resumes and the creasing/damaging/wrinkling cycle restarts. This is it is recommended to retreat these areas about every three – four months to see continued skin improvement and prevent the damage cycle from restarting.
Q:Do men receive Botox Cosmetic treatments?
Yes. BOTOX® Cosmetic has also been clinically evaluated in male patients. In clinical studies for moderate to severe frown lines, 17.5% of patients treated with BOTOX® Cosmetic were men. In the clinical studies for moderate to severe crow’s feet, male patients comprised approximately 10% of patients treated with BOTOX® Cosmetic.
According to the American Society for Aesthetic Plastic Surgery, 10% of all cosmetic procedures performed in the United States in 2014 were on men—that is more than 1 million cosmetic procedures. The number of cosmetic procedures for men increased by 273% from 1997 to 2014.
Q. Do TOX Injections Hurt?
A. The majority of patients feel little to no discomfort during treatment. Ice is used to constrict the blood vessels & freeze the muscle prior to injection. However, patients who are extremely sensitive may use a topical numbing cream prior to their session.
Q: How long does the Tox treatment take?
A: Your specialist will discuss your treatment goals and perform a facial analysis to determine the appropriate treatments for you. The actual injection process takes about 10 minutes.
Q. When Will I See Results for TOX & how long does it last?
A. Your final results may be noticeable within a few days after your session, or may take up to 10 days to become visible. The effects are long-lasting, and many patients find they can go between 3 to 5 months between treatments. With continued regular treatments you may achieve longer lasting results. Initially if you have strong muscles it may take several treatments to eliminate the visible lines and/or deep valleys.
Q: “My wrinkles aren’t that deep… am I too young to start getting Botox, Dysport, Xeomin, or Jeuveau?”
A: A common misconception is that you should wait until you have wrinkles, then start treating them. Not the case! Truth is, once the skin has been damaged enough to form deep-set wrinkles, it becomes much more difficult to smooth and repair them. Some of these deeper lines may not fully improve, even after treating the area with Tox℠. This is where being proactive really pays off. By preventably treating the wrinkle-prone areas of your face before you start seeing deep creasing, you can prevent these deep wrinkles from ever forming or worsening. People often ask at what age they should start using Tox℠. There really is no magic number–I’ve seen patients in their 20s with deep lines & extremely strong muscle activity, as well as patients in their 40s with only fine wrinkles & not much movement. There is no one-size-fits-all when it comes to antiaging treatments. Each person’s face is unique! If you look in the mirror & it bothers you or if your friend/colleague asks what’s wrong (you LOOK mad or tired) but you feel just fine then it might be time to get treated.
Q: How come I still see lines around my eyes when I smile after treating my Crow’s Feet?
A: Botox , Dysport, Xeomin has been used to soften “crow’s feet,” or wrinkles at the outer corners of the eyes, but you still need to blink & smile so you can’t relax all of the muscles around the eye. The muscles that mechanically lift the lip when you smile also pulls up the cheek which may accentuate the wrinkles around the eye. So if you “wink” you will see the smoothing out affect from treating the crow’s feet. Filler may help occupy the lost volume which lessen the appearance of the cheek wrinkles along with the Tox℠.
Q: What happens with the side effect of “droopy eye” from Tox℠ treatment?
A: There is lid ptosis (droopy eye) and brow ptosis (droopy brow) that can occur from treatment. If the eyelid muscle is affected then the lid closes & it is difficult to open it. It will improve with time or an antihistamine eye drop may be needed (either over the counter or prescription eye drop may be indicated). A brow ptosis may be too much Tox℠ in the forehead causing a “heavy feeling” of not being able to “lift” your forehead. This will ease up with time. Possibly a Custom “brow lift” extra treatment may be needed. By following the post treatment “rules” usually most side effects can be avoided. (i.e.. no rubbing/manipulation of the treated areas, no lying down or heavy workouts for 4 hours after treatment). Also side effects are rare with experienced Practitioners that know the anatomy & have the skill of how much & where to treat.
Q: Will Tox℠ freeze my face and make me look “done”?
A: A skilled injector places Botox, Dypsort, Xeomin to relax only the targeted muscles that are causing wrinkles to form, while avoiding certain other muscles that we need for natural facial expressions like smiling. After the product takes effect in the targeted area, those wrinkle-causing facial expressions (think: scowling) will be softened, giving you a smoother, more youthful, but still natural look. When Botox first came out it was promoted that way, but not only is it impossible to “stay frozen” it is unrealistic. When it first was introduced we were treating & pricing by the area, then encouraged to treat by the unit and people were giving more & more…thus the body was requiring more to get the desired result. A drug like alcohol is a prime example that when a person keeps drinking more then they will require more to achieve the original “buzz.”
Q: Can you become resistant to Tox℠?
A: It is possible, but if treated with therapeutic dosing on regular intervals (not sooner than 3 months apart) then you should be fine. Sometimes when re “treating” with a touch up then there is also a possibility of “immunogenicity” by reintroducing the Tox℠ 2 weeks later. Once in awhile a touch up is required especially to correct asymmetries but it is not good to get into the habit of it.
Q: Does it Hurt & how long does it take?
A: Just a few “pinches” like a mosquito bite, but with adequate ice numbing much of it isn’t even felt. It only takes a few minutes.
Q: Will it be obvious when I leave the office, does it show right away?
A: A few red marks which diminish in 10 minutes after treatment. Possibility of bruising (stop blood thinners a few days before) can cover with makeup & take Arnica if proned to bruising. It takes 2-10 days to take effect. Most show no evidence and it eases on & eases off so other people won’t even notice. You will just look more refreshed, youthful and awake.
Q:How long is the recovery time after treatment?
After your treatment, you can resume your day. There is minimal downtime and you will be given specific aftercare instructions that include: no bending over or heavy exercise for several hours after treatment. No same day massages or facials after the treatment.
Q:What is the average treatment cost?
Your cost not only includes the price of the product, but more importantly, the skill and expertise of the healthcare professional who is administering your treatment. Tox is a technique-sensitive treatment—look for someone who is licensed & trained and has experience treating patients with BOTOX® Cosmetic/Dysport/Xeomin. Be wary of discount products or “cheap” BOTOX® Cosmetic—if it sounds too good to be true, it probably is. Having to fix or redo a bad botox isn’t worth it.
It is more important to find an experienced specialist who will take the time to understand your treatment goals and develop a treatment plan that is right for you.
Q: Can I can get my Botox, Dysport, Xeomin treatment done anywhere?
A: These days you probably can get Tox℠ just about anywhere–the dentist, your OBGYN, your hair salon. So how to choose? A great Botox, Dysport, Xeomin result requires knowledge of the facial anatomy and aesthetic judgment in order to avoid a potential mis hap like lowered brows or uneven features. If not properly getting into the desired muscles the effect may not work or last as long. The best provider for your cosmetic and skin goals will have a natural eye for facial aesthetics as well as specialized training in cosmetic injection techniques with toxins. Experience trumps price & convenience so be sure your provider not only has the proper medical license credentials (M.D., PA or NP in the State of Florida) but specializes full time in aesthetic treatments for best results.