The advent of injectable botulinum toxin (BOTOX, Dysport, Xeomin, and Jeuveau) has revolutionized the approach to wrinkle treatment. It is a quick, relatively straightforward, low-risk outpatient procedure which has now replaced many of the more traditional surgical approaches to treatingfacial aging. A more youthful appearance can be achieved in a single 15-minute session with no downtime.

Botox/Dysport/ Xeomin/Jeuveau can be injected to achieve a natural look.

How does BOTOX/Dysport/Xeomin/Jeuveau treatment eliminate facial wrinkles?

When BOTOX/Dysport/Xeomin/Jeuveau is injected into the superficial muscles of the face, it relaxes them and prevents skin wrinkling caused by squinting, frowning and raising of the eyebrows. Repeated muscle contractions lead to initial dynamic wrinkles followed by more permanent static lines. By inhibiting contractions of the muscle and stopping continuous creasing of the skin, lines gradually improve and disappear.  BOTOX®/Dysport/Xeomin/ Jeuveau injection is therefore a quick and easy treatment, ideal for improving and smoothing the skin between the eyebrows, the lines of the forehead and the crow’s feet area around the eyes.

Your skin will feel the same after BOTOX®/Dysport®/Xeomin/ Jeuveau and you will have normal sensation in all treated areas. Muscles not treated with BOTOX®/Dysport®/Xeomin/ Jeuveau will not be affected.

How is BOTOX®/Dysport®/Xeomin/ Jeuveau used?

A small amount of BOTOX®/Dysport®/Xeomin/ Jeuveau is injected into the muscle which creates clinically visible lines. BOTOX®/Dysport®/Xeomin/ Jeuveau works by blocking the nerve impulse from reaching the muscle fiber and leads to progressive weakening of that muscle.  As the muscle weakens, the BOTOX®/Dysport®-treated areas begin to relax and dynamic (motion related) and static (at rest) wrinkles soften and often completely disappear.

Results become visible in three to seven days and last for three to four months. Repeated Botox®/Dysport®/Xeomin/ Jeuveau treatments may last progressively longer as the facial muscles weaken and atrophy from non-use.

What areas can be treated with BOTOX®/DYSPORT®/Xeomin/ Jeuveau?

Currently, the FDA-approved use of BOTOX® is to “improve the look of moderate to severe frown lines between the eyebrows (glabellar lines).”

Current FDA-approved indications for DYSPORT® use are for the treatment of adults with cervical dystonia to reduce the severity of abnormal head position and neck pain in both toxin-naive and previously treated patients.

DYSPORT® might be used off-label for the treatment of facial lines and wrinkles in a fashion similar to BOTOX®.

Common off-label uses of BOTOX®/DYSPORT®/Xeomin/ Jeuveau include:

1. Forehead lines are caused by the contraction of the frontalis muscle, seen when eyebrows are raised. The treatment can also be used as an “injectable non-surgical browlift,” to slightly elevate the brow and eliminate horizontal lines across the forehead to help the upper face look younger and more relaxed. Many plastic surgeons consider Botox® to be an integral part of a surgical browlift, since its use before surgery can help relax the muscles and facilitate healing.

1. Smile lines (“crow’s feet”) around the eyes.  Squinting produces a gathering of the skin next to the eyes in the crow’s feet area caused by a portion of the orbicularis oculi muscles.
2. Neck rejuvenation by erasing wrinkles and tight cord-like bands are caused by protruding fibers of the platysma muscle.
3. Upper lip lines caused by pursing the lips.
4. Down-turned corners of the mouth.

6. Non-surgical rhinoplasty to relax the muscle that pulls the tip downward, creating a more upturned appearance, or to soften the “bunny lines” on the sides near the top of the nose.

1. Treatment of hyperhidrosis, or excess sweating of the hands, underarms, feet and face.

BOTOX®/DYSPORT®/Xeomin/ Jeuveau for Excessive Sweating

Excessive sweating (hyperhidrosis) of the palms, feet face, and underarms can be treated with a simple 15-30 minute outpatient session of BOTOX®/DYSPORT®/Xeomin/Jeuveau.

Anesthesia of the area to be treated is sometimes obtained with a topical anesthetic (applied at home a few hours before treatment) and/or local application of ice.

The effect of BOTOX®/DYSPORT®/Xeomin/Jeuveau injection begins to be apparent 2-3 days after the injection session, and lasts 6-12 months. Side effects are minimal to non-existent, and include injection related discomfort and minor bruising.

Can Botox®/Dysport®/Xeomin/Jeuveau Prevent Wrinkles From Forming?

Yes. Small amounts of Botox can be used to help break unconscious wrinkle-forming habits, such as frowning and squinting that lead to crow’s-feet.

Does a BOTOX®/DYSPORT/Xeomin/Jeuveau injection hurt?

Application of a topical anesthetic cream and/or ice compresses for several minutes prior to BOTOX®/DYSPORT®/Xeomin/Jeuveau treatment will effectively numb the area. When BOTOX®/DYSPORT®is injected, you may feel a slight stinging sensation that quickly subsides.

Is BOTOX® safe?

BOTOX®has an excellent safety profile. It has been used by neurologists and ophthalmologists for the past 17 years to correct facial tics and to relax the eye muscles responsible for lazy eye. No toxic effects of BOTOX®/Dysport®/Xeomin/Jeuveau have been reported.

Is There Any Danger of Botulism from Treatment?

Botulism occurs when large amounts of the toxin are ingested into the system, usually from eating contaminated food. Doses of about 3,000 units are considered highly toxic. For cosmetic treatment you will be receiving only about 10-200 units, far less than a toxic dose.

BOTOX®/Dysport®/Xeomin/Jeuveau Pregnancy and Breast-feeding.

BOTOX®/DYSPORT®/Xeomin/Jeuveau is classified as pregnancy category C.  Category “C” is classified as “animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks”.

There is a lack of controlled studies into the effects of BOTOX®/DYSPORT® on pregnant women and their unborn children, therefore it is impossible to say conclusively whether BOTOX®/DYSPORT® is safe. For the sake of erring on the side of caution, manufacturers of BOTOX®/DYSPORT® recommend that they notto be used on either pregnant women or nursing mothers. As with the effects during pregnancy, there is a lack of information on whether BOTOX®/DYSPORT® injections can pass the toxin into breast milk.

What are the advantages of BOTOX/DYSPORT/Xeomin/Jeuveau?

• BOTOX®/DYSPORT®/Xeomin/Jeuveau is a quick, non-surgical and effective way to remove wrinkles. A typical treatment takes 10 minutes. Results are seen within 4 to 7 days.
• Little discomfort
• There is no “down-time”. After the BOTOX®/DYSPORT®/Xeomin injection, you may resume normal activity.
• There is no physical evidence that you had a cosmetic procedure done
• There is no decrease in sensation or numbness of BOTOX®/DYSPORT®-treated areas
• The effect of BOTOX®/DYSPORT® is reversiblelasting between 3 to 6 months, depending on the number of previous treatments
• A memory response may develop with repeated BOTOX®/DYSPORT® injections if performed every 3 months for approximately 1year. So, although the effects are not permanent, there may be a gradual lengthening of the time interval between treatments. This will mean fewer BOTOX®/DYSPORT® treatments to obtain the same effect.

What are the Side Effects?

Side effects are minimal when properly administered. There is little discomfort as the solution is injected at the treatment site and there is a small chance of bruising. There have been no known reports of permanent side effects with BOTOX®/DYSPORT®. In very rare cases, there is a temporary, slight lowering of the eyebrow or eyelid.

Contraindications to BOTOX®/DYSPORT treatment:

• Allergy to any of the ingredients in BOTOX®/DYSPORT®or any other Botulinum toxin products including Myobloc®
• Skin infection at the planned injection site
• Neuromuscular conditions such as:

• Amyotrophic lateral sclerosis (ALS or LouGehrig’s disease)
• Myasthenia gravis or Lambert-Eatonsyndrome