Botox, Xeomin and Dysport in Ashburn
When we make facial expressions, lines form around our features. Active facial muscles used for animation and expression, over time, will result in harsh lines on the face. These lines for men and women may include scowl lines, frown lines, crow’s feet and lines around the corners of the mouth. These expression facial lines will deepen and get worse with increase activity and aging. Some of these expressions may be subconscious and the person not even aware that they are scowling or turning their mouth down. With treatments that affect the muscle strength, these fine lines will soften.
There are two basic types of lines on the face. They are called dynamic lines and static lines. A dynamic line is the first type of line to appear on the face. Dynamic implies motion and these occur with a motion of the facial muscles. The dynamic lines go away once the motion stops. An example is a smile line that occurs on the check with a smile that goes away after the smile is gone or a squint line. No facial fine line fillers are needed for dynamic lines. The botulinum toxin products work best to prevent these lines from getting deeper.
A static line is a fixed line and implies that the line is there even if the face is not moving. These are the lines of overuse and age. They will take time to develop. A static line occurs after years of motion. So a line down the side of face that started by smiling but remains when not smiling is a static line. Static lines may be treated with Botox like products but will also benefit from a facial fine line filler treatment.
Dr. Michael J. Brown
These treatments are designed to stop a dynamic line from happening. If they stop them, then there will not be a static line. If a static line exists, it will soften over time with the treatments.
Treatment areas for Botox, Xeomin or Dysport
What are the differences between Botox, Xeomin and Dysport?
OnabotulinumtoxinA (BOTOX© by Allergan Inc.) is a sterilized extract from bacteria. It is marketed under two names but is the same medication. BOTOX and BOTOX© Cosmetic are the two names for the same medicine. The FDA has mandated this to assist the public in understanding what it has approved the medication for. BOTOX© Cosmetic has fewer approved treatments, it is FDA approved to treat the area between the aging eyes in a specific muscle area. It can also be used ‘off-label’ in other areas. Plastic surgeons and opthamologists have used it for years. It is used to treat various medical conditions, especially around the eyes. It is used to weaken overactive facial muscles. It is best to treat facial lines before the lines become too deep.
BOTOX© is FDA approved for blepharospasm, eye muscle problems, migraine headaches, urine incontinence, muscle stiffness associated with upper limb spasticity, cervical dystonia (abnormal head and neck positions), and overactive sweat production of the armpits and other treatments. It has the longest track record in the US.
XEOMIN® (incobotulinumtoxinA) for injection, for intramuscular use, is indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients. XEOMIN® has less approvals than Botox, but they are used to treat similar conditions in an ‘off-label’.
AbobotulinumtoxinA (DYSPORT™ by Medicis) has similiar approvals from the FDA. To avoid confusion, all of DYSPORT’s approval are under the name, DYSPORT™. It is more concentrated than Botox but works essentially the same way. There is a third product with FDA approval RimabotulinumtoxinB (Myobloc™) but it has less approvals and it does not have cosmetic treatment approval yet.
Botox treatment to forehead*
How do the botulinum toxins work?
These medicines work by weakening the muscles by blocking the conduction of ‘electricity’ from the nerve to the muscle. It actually does not harm the nerve or the muscle. BOTOX© Cosmetic, XEOMIN and DYSPORT™ work using very similar mechanisms of actions. Again, they work by not allowing muscles to contract. In the face, this means that the muscles are not able to cause the dynamic facial lines. So if there is no dynamic line, then a static line can not appear. These medicines are injected into the area of the muscles. The effects will occur in two to seven days. Over the following days, muscle will weaken and the facial lines will soften because the dynamic component is gone. The static lines can go away with repeated treatments. Since they are creases in the skin, the skin has to grow and shed the outer layer that has the creases in them. The timing to have the lines go away is based on the severity of the facial lines. The treatment results can be dramatic and will usually last 3 to 6 months. The length of time that the medication lasts also depends on other factors; the patient’s genetics, amount injected freshness of the product, and the skill of the injector.
Dr Michael J Brown
These treatments done in proper conditions will last longer each session because the muscles will atrophy over time. So a later treatment of the same dose will result in longer lasting provided the next treatment occurs before complete facial muscle activity returns. If the muscle activity returns completely, there will be no increase of the interval between treatments.
There is no limit to the number of injection treatments that you may have. If they are discontinued, there will be a return of your muscle activity.
Scowl line treatment using Dysport*
What are some of the side effects of Botox, Xeomin & Dysport?
The side effects and risks of botulinum toxins will differ depending on which area(s) are treated and how much of the product is injected. Side effects of the treatments to the face may include:
- temporary facial bruising
- tenderness at the injection site
- eyelid droop
- brow asymmetry
- forehead wrinkle asymmetry
- other facial asymmetry
These types of issues are also temporary and can usually be adjusted by a change the amount of product used during the next treatment. If eyelid droop was to occur, there is a short term antidote that can be used to elevate the lid until the medicine wears off.
George Washington University Professional Center
The Loudoun Center for Plastic Surgery
45155 Research Place, Suite 125
Ashburn, VA 20165