FAQs Botox®

What are Botox®, Dysport®, Jeuveau® and Xeomin®

Botox®, Dysport®, Jeuveau® and Xeomin® are all neuromodulators that improve lines and wrinkles of the forehead, brow (frown lines) and crow’s feet areas. This medication relaxes the muscles that cause these lines, smoothing deep furrows that can make you look angry and tired. In many patients the eyebrows are subtly raised by the procedure, often called the “nonsurgical brow lift.” In select patients, they may be used in the upper lip to relax vertical lines, along the jawline, to improve the corners of the mouth, and in the neck to relax vertical neck bands. Results are more variable in these areas. The Botox® brand of neuromodulator has been used in medicine for almost 2 decades on millions of patients with an excellent safety profile. The newer brands Dysport®, Xeomin® and Jeuveau® have gone through years of testing and use outside the U.S. before being approved by the FDA and have similar results and potential side effects as Botox®.

When will I see results?*

It takes 2 to 4 days for the frowning, squinting and forehead muscles to start to relax after the initial injection. At 14 days the results are complete. Although fine lines often disappear quickly, deeper furrows may take longer to fade away. In older patients or very deep wrinkles, lines will be improved but not completely eradicated.

How long will the results last?*

Benefits initially last about 3 to 4 months initially. With continued treatments, the duration of muscle relaxation generally becomes longer. Some patients can eventually wait 6 months or longer between treatments. How frequently you are treated is entirely up to you. If the duration of action of the treatment is shorter than expected, or decreases with subsequent treatments, changing brands (for example from Botox® to Dysport®) may be helpful.

Are there risks to the procedure?

Transient bruising at injection sites can occur, particularly if you have had aspirin or ibuprofen (Advil, Motrin) within 1 week, or alcohol within 48 hours of treatment. Occasional brief tenderness or headache may result for a few hours, and rarely longer. Mild, temporary eyelid or eyebrow drooping can last 2-3 weeks or rarely months and may occur in about 1 percent of patients and is never permanent. Extremely rare side effects
include temporary double vision, reduced blinking resulting in corneal injury, allergy and development of antibodies which may decrease the duration of results for future neuromodulator treatments

Who should not be treated with Neuromodulators (Botox®, Dysport®, Xeomin®, Jeuveau®)?

You may not be treated with neuromodulators if:

• You are pregnant or nursing.
• You are allergic to benzyl alcohol or botulinum toxin.
• You have a neuromuscular disease (such as myasthenia gravis).
• You are taking aminoglycoside medications (Streptomycin, Neomycin, Gentamycin)

Pre-Treatment Instructions

1. If possible, discontinue aspirin for 10 days, ibuprofen (Motrin, Advil) and Vitamin E for 5 days prior to the procedure. These medications make you more likely to bruise. If you have been prescribed one of these medications, ask your doctor before you stop taking it.
2. Tylenol is preferred for the week prior to treatment as it will not increase your chance of bruising. Bruising is generally not a serious issue with neuromodulator injections, so we can still treat you if you were not able to avoid these blood thinners.

Post-Treatment Instructions

1. Do not lie down or bend over (such as in yoga) for 4 hours after Botox treatment.
2. Refrain from vigorous exercise for the rest of the day (walking is okay).
3. Utilize the muscles injected every few minutes for 30 to 45 minutes to enhance neuromodulator absorption and action. Do this by squinting, frowning, and/or lifting the eyebrows (depending on the area treated).
4. Do not massage or manipulate the treated area on the day or evening of treatment. You may wash your face normally.
5. If you experience a headache, you may take Tylenol (acetominophen) or Advil/Motrin (ibuprofen) immediately after the procedure. Wait until the next day to take aspirin to minimize bruising.
6. The results from your procedure may start to become evident at 2-3 days but it takes 14 days to reach the maximum effect. Sometimes certain muscles such as those of the forehead may try to compensate for the areas being relaxed by the Botox. This can lead to a “quizzical” or “Jack Nicholson” appearance with raised eyebrows that are too angled or high. This can be easily treated at the 2 week point, or later,
   with a brief complimentary touch up in our office. Please call us if this is the case but please wait until 2 weeks after your treatment as it sometimes corrects on its own before day 14.
7. Slight bruising and minimal tenderness may occur at the treated areas. However if the treated areas are very tender, or have significant bruises, or you feel there is heaviness in the eyebrows, eyelids or other areas, please call the office. Also call if you have a serious headache, visual changes, worsening eye dryness or any other eye symptoms.

*Individual Results May Vary*