Wrinkle smoothing Botulinum Toxin A injections are the most common non-invasive aesthetic procedure in the US, and while they are colloquially called “Botox”, there are actually four different FDA approved Botulinum Toxin A injectable products for cosmetic use. Each one is made by a different manufacturer and has different cost, potencies, formulas and trademarked names. Because Botox®️ was the first FDA approved neurotoxin on the market, for many people the name Botox®️ has become synonymous with Botulinum Toxin A just as Kleenex has with tissues.
All four contain the same active ingredient, a very small dose of the potent Botulinum Toxin A which has the ability to temporarily paralyze muscles for cosmetic effect thereby reducing the appearance of fine lines and wrinkles caused by facial expression.
Botulinum Toxin A works by preventing muscle contraction. After injection into the target muscle (forehead, “elevens”, Crow’s Feet), the product travels to the junction of the motor nerve ending and the muscle. There, it attaches to the nerve ending and prevents the nerve from releasing the chemical messenger (acetyl choline) that normally travels to the muscle cell with the signal to contract or shorten. Without this signal to contract, the muscle remains relaxed, and wrinkle free.
Each of the four neurotoxins have similar safety and efficacy profiles but subtle differences do exist. Dosing is similar for Botox®️, Xeomin®️, and Jeuveau®️ but Dysport®️ dosing is more than double the units per area. Onset for Botox®️and Jeuveau®️ is 3-5 days, 5-7 for Xeomin®️ and 24 hours for Dysport®️. Results last an average of 3-4 months for all four but vary for individuals. The most common side effects are redness or bruising at the injection site, headache, nausea, temporary facial weakness and, rarely botulism-type symptoms.
Botulinum Toxin in its natural form is considered one of the most lethal substances known to man. I marvel that scientists have been able to harness, purify and dilute Botulinum Toxin A to create a product that is both safe and aesthetically useful.
