Botox and other neuromodulators

Easy and effective solutions

BOTOX® Cosmetic is just one type of injectable botulinum toxin, or neuromodulator that is used primarily in a cosmetic practice for the reduction or elimination of dynamic wrinkles.

Other neuromodulator products that have also achieved US FDA approval include Dysport®, Xeomin® and Jeuveau®. All of these injectable neuromodulator drugs have also been shown to be safe and effective and are used very similarly to Botox® Cosmetic. The effects of these drugs are similar, and the choice usually depends on the patient’s unique individual situation.

To improve “dynamic” lines, including crow’s feet and forehead wrinkles, botulinum toxin is injected into specific muscles with a very fine needle. These injections relax the muscles within a week, in turn softening the appearance of lines in the skin.

BOTOX® Cosmetic, Dysport®, Xeomin®, and Jeuveau® are FDA-approved botulinum toxin based injectables. BOTOX® Cosmetic was the first to market in 2002 and it remains the most widely used worldwide. Although these products all act in a similar way, there are slight differences in dosing, how quickly results become apparent and how much they spread from the injection site.

BOTOX® Cosmetic is the most commonly performed non-invasive cosmetic treatment performed in the United States each year—and for good reason. This injectable has a decades-long safety record, and it provides visible wrinkle-smoothing results within three to seven days after treatment. Each patient responds differently, but results usually last for three to four months and can be repeated as needed to maintain the improvements achieved. On average, patients return three or four times per year for BOTOX® injections of the upper face.


Another injectable form of botulinum toxin A that works similarly to BOTOX® Cosmetic to improve frown lines, forehead creases and crow’s feet. Dysport® also limits muscle movement temporarily, which helps the skin appear smoother and less wrinkled.

In most cases, patients will see a visible improvement in the area treated within two to three days, and the full effects of Dysport will become more evident over the first week after treatment as lines and wrinkles continue to soften.

In addition, the effect of Dysport tends to spread over a wider area – this property can make Dysport® particularly useful in areas like the forehead. Each patient responds differently, but results usually last three to four months and can be repeated as needed to maintain the improvement.


Xeomin® is yet another botulinum toxin type A product that is FDA-approved for the treatment of severe frown lines between the eyebrows. One difference between Xeomin and BOTOX® Cosmetic is that it does not contain the additive proteins that BOTOX has.

Many physicians and researchers argue that removing these proteins prevents the body from becoming immune to the product (which can reduce results over time). However, despite a theoretic advantage, there has been little evidence to prove this as most patient’s experiences with Xeomin are similar to BOTOX® Cosmetic and provides similar results that last from three to four months.


Jeuveau® received FDA approval in 2019 for treatment of frown lines between the brows (glabellar lines). Perhaps the most similar to Botox® Cosmetic yet has shown to also have its unique profile. One difference is that the effects of Jeuveau tend to be seen sooner than BOTOX® Cosmetic and are often apparent within 48 – 72 hours.

In addition, Jeuveau® exhibits the least spread of effect (i.e. the drug works precisely where placed), which may be desirable in certain anatomic areas. Results typically last three to four months.



It is the first and only treatment FDA-approved to temporarily make moderate to severe frown lines, crow's feet, and forehead lines look better in adults. Treatment requires minimal downtime. It delivers predictable, subtle results, so you look like you, only with less noticeable facial lines.

BOTOX® Cosmetic targets one of the underlying causes of frown lines, crow’s feet and forehead lines — the repeated muscle contractions from frowning, squinting, smiling and raising the eyebrows over the years. Your specialist will inject these muscles with BOTOX® Cosmetic to temporarily reduce muscle activity. You will begin to notice your frown lines between your brows, your crow’s feet lines and your forehead lines temporarily look better.

BOTOX® Cosmetic is a technique-sensitive treatment. You can trust BOTOX® Cosmetic to deliver subtle results when you are treated by someone who is licensed, trained, and a medical expert in facial anatomy. So you’ll look like yourself—only with less noticeable lines. No one should be able to tell you’ve had anything done.

Three percent of patients experienced eyelid drooping in the frown lines studies, one percent of patients experienced eyelid swelling in the crow's feet studies, and one percent of patients experienced brow drooping in the forehead lines studies. Other possible side effects include: dry mouth; discomfort or pain at the injection site; tiredness; headache; neck pain; eye problems: double vision, blurred vision, decreased eyesight and dry eyes; and allergic reactions. These are not all of the possible serious side effects of BOTOX® Cosmetic.

Your specialist will discuss your treatment goals and perform a facial analysis to determine the appropriate treatment areas for you. If Dr. Fagien or Dr. Vaca deem you to be an appropriate candidate, the injection may take place on that same day. Some patients report that being injected with BOTOX® Cosmetic feels like a pinch.

You can return to your daily routine immediately after you leave your specialist’s office.