Botulinum Toxin A

(Botox®️, Xeomin®️, Dysport®️, Jeuveau®️)

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.

How They Work

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.

Dosing, Duration and Side Effects

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.

Nuances

  • Botox®️ is tried and true but does contain complexing proteins which may lead to antibody formation and resistance over time.
  • Xeomin®️ is a pure product with no complexing proteins which may prevent the development of resistance to the product over time.
  • Dysport®️ may not be suitable for people with dairy allergies as it contains milk proteins.
  • Jeuveau®️ is the new guy on the block and is a Botox®️ look-alike. Time will tell.

Conclusion

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.

Dr. Tara Wegryn is a board-certified Neurologist and Electrophysiologist whose current area of concentration is Aesthetic Medicine. She has extensive training in the latest aesthetic medical techniques and is a member of the International Association for Physicians in Aesthetic Medicine. Dr. Tara Wegryn is the sole owner and operator of Refresh Medispa, the only dedicated medical spa in Galveston, TX. Refresh Medispa offers a variety of services and products including Botox, fillers, PRP hair restoration, Kybella, skin resurfacing, hydrafacials, ZO Skin Health, and Colorescience.

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