Botox and Xeomin are two types of neurotoxins we use to treat dynamic wrinkles. Dynamic wrinkles are formed as a result of repeated facial muscle contraction, which damages the skin’s dermis, and occur naturally around the eyes, mouth, forehead and between the eyebrows (“11’s”). These wrinkles become more pronounced with age due to not only repetition of facial expressions, but also due to normal collagen and elastin loss in the skin’s dermis (1% loss per year after the age of 30). Sun damage and sleep deprivation expedite this loss. Neurotoxin injections relax the muscles near these wrinkles to prevent over-pronounced facial expression formation. In conjunction with regular use of topical moisturizing creams and sunscreen, sleep hygiene, and hydration neurotoxins allow the body to naturally heal the skin’s dermis and eliminate the appearance of said wrinkles.

Neither Botox nor Xeomin is used for fine, superficial, adynamic lines as these are caused by chronic skin aging and associated collagen/elastin wasting and breakdown. These types of wrinkles are treated with other modalities such as topical moisturizers, radiofrequency skin tightening with microneedling, and chemical peels just to name a few.

Typically, it takes 7-10 days from injection to get the final result on the muscle. This effect lasts roughly 3 months. Repeated toxin dosing is extremely important, as it can take much longer for the dermis/wrinkles to fully heal.

Dermal Fillers:

Dermal fillers (gel-like material) can also sometimes be used to treat wrinkles on the face. In addition, they are often used to replete areas of age-related volume loss to restore or enhance the desired youthful “heart-shaped” face. Fillers come in various forms, based on overall “stiffness” of the gel. This “stiffness” scale is called G-Prime. Low G-Prime fillers are low in stiffness, and can be used superficially to treat wrinkles. Mid G-Prime fillers are a bit stiffer, and are used in deeper areas such as large smile lines, lip enhancement, and areas of wasting/volume loss that occurs in areas such as the cheeks and under the corners of the mouth. High G-Prime fillers are the most stiff, and are injected deep (next to facial bones) to enhanced a desired overall structure. This filler is used mainly for the cheek bones and along the jawline and chin.

Results differ depending not only on the type of filler used but also where the filler is injected. Areas of the face that are frequently mobile, such as the lips and smile lines, will get processed/broken down sooner than filler injected in adynamic areas such as the cheeks and jawline/chin. Higher G-Prime fillers typically last longer than lower G-Prime fillers. That being said, filler lasts between 6-12 months depending on these criteria.

Extremely rare, less than 1%, but include:

  • Bruises at the site of injection (neurotoxin and dermal fillers)
  • Vascular occlusion with associated tissue necrosis (dermal fillers)
  • Chronic inflammatory response/granuloma (dermal fillers)
  • Anaphylactic response (neurotoxin)
  • Cold sores in lips (dermal fillers)
    We recommend patients stop taking blood thinning medications 2-3 days before injection date to help minimize bruising.

We recommend patients who get cold sores to take an antiviral 2 days before injection and 2 days after (ask injecting provider for prescription if needed).

We recommend against injecting pregnant patients (breast-feeding is just fine) and patients with history of allergic reaction to these products.

We recommend a full consultation with our medical professionals prior to being considered for any injectables.

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