What Is Botox® (botulinum toxin)?

Botulinum toxin is a type of toxin that is made by the bacterium Clostridium botulinum. This bacterium produces a neurotoxin that can be injected into specific muscles to weaken or paralyze them in a controlled fashion. There are several neurotoxins available including Botox® by Allergan, Dysport® by Galderma, Xeomin® by Merz or Newtox® by Jeveau. At Refine Dermatology, we carry both Botox®️ and Dysport®️ and can talk to you about which treatment might be right for you.

How Do Neurotoxins Work?

Botox® and Dysport®️ both work by interfering with neural transmission at the neuromuscular junction. When injecting botulinum toxin into muscles, the toxin inhibits the release of acetylcholine from presynaptic motor neurons to the postsynaptic motor neurons resulting in paralysis of the affected muscles. This blockage is irreversible; however, neural function recovers by sprouting new nerve terminals and forming new synapses. This process of recovery takes approximately 2-3 months.

What Can Botulinum Toxin Be Used For?

• Facial Expression Lines: Temporary improvement in the appearance of moderate-to-severe frown lines (glabellar lines/eleven lines) crow's feet (around the eyes), and forehead lines in adults.
• Lips and Mouth: Used around the mouth to soften the lines, reduce a "gummy smile” or to increase lip fullness (lip flip). A downturned mouth can also be improved by injecting the DAO's (depressor anguli oris’).
• Jawline: Used to relax the masseters, which are the muscles used with those affected by bruxism (teeth grinding). People affected by bruxism often develop enlargement of the masseters, leading to a square jaw. The use of neurotoxin can decrease the size of these muscles and results in a slimmer jawline.
• Neck: Used to treat the platysmal bands of the neck that become more prominent with aging. By treating and relaxing these bands, we can improve the contour of the neck resulting in a more youthful appearance.

What To Expect With Neurotoxin Treatment?

Treatment is quick and discomfort is minimal. Dr. Salyards will clean your face and mark your treatment areas prior to injection. The visit usually takes only a few minutes. You will start to see a decrease in muscle activity in about 24-72 hours with maximum effect at 10-14 days. You typically will have a follow up appointment at this time with Dr. Salyards to review symmetry and make minor adjustments as necessary.

Botox® and Dysport®️ effects typically last around 3 months due to the process of neural recovery. Patients who use neurotoxins regularly may notice that they can go longer between treatments due to muscle atrophy. Neurotoxins do not wear off overnight and muscle function will increase slowly over time.

What Are The Possible Risks With Neurotoxins?

The most common side effects include temporary bruising, pain or swelling around injection sites, or headaches. Less common side effects include flu-like symptoms or upset stomach.

Side effects related to technique that can occur include eyelid droop and crooked smile. It is important to have an experienced injector because risks of these side effects can be minimized when treated by professionals with advanced understanding in facial anatomy.

How Much Does Botox® or Dysport®️ Cost?

At Refine Dermatology, we do not charge by the unit. We find that charging by unit devalues the treatment you are receiving and can lead to subpar results. Instead, we charge for how many areas you would like to have treated. This allows us to use as many units as we need to give you the results you want and includes an additional touch up. Dr. Salyards recommends a follow up visit 2 weeks after your treatment to ensure you are happy with your results can add to your treatment if needed.

If you’d like to discuss cosmetics further, please feel free to give us a call or contact us by filling out our cosmetic survey and we’ll reach out to you by the next business day to schedule you with Dr. Salyards.