What Are Neuromodulators (NM)?

Neuromodulators are injections of botulinum toxin that are used to relax wrinkles. Commercially known as Botox®, Dysport®, Xeomin® or Jeuveau®.

How Are NMs Used?

A very small amount of the substance is injected into the underlying muscle which subsequently causes it to relax. This smooths out the appearance of the overlying skin that typically lasts about 3 months but can last up to 6 months in some cases. NM’s can be used for other “off-label” treatments (BOTOX® is the only FDA-approved NM for treatment of most “off-label” treatments) and we currently offer injections for crow’s feet, masseter injections for TMJ/headaches related to clenching/jaw slimming, brow lifts, bunny lines, and lip flips. We plan to offer treatments for neck lines, trapezius muscles, and migraine headaches in the future.

Which NMs Do We Use In Our Office?

We use Xeomin® and Dysport®.

Xeomin® is an NM with no additives and is marketed as “pure botox.” In the office, Xeomin® is used for masseter injections and for people seeking “baby botox.” Baby botox is a term that has become commonplace over the last few years resulting in a softer or “less frozen” effect. Another benefit of its additive-free constitution is few people become resistant to Xeomin® after multiple treatments.

Dysport® is a NM with similar properties to what is commercially known as BOTOX. In general, more Dysport® units are required to obtain the same effect due to the size of the molecule and its carrier proteins. In the office Dysport® units are converted to relative botox units to achieve equivalent pricing.

What Should I Expect During My NM Treatment?

First, we will discuss goals of your treatment (cosmetic, functional, softer effect, etc.) and ensure that you are an appropriate candidate to receive NM treatment. If not already done prior to your arrival, the toxin will be reconstituted with bacteriostatic saline which causes less burning when injected. The medication will then be drawn up into insulin syringes, the skin will be cleaned with an alcohol swab, and the medication will be administered in the areas discussed.

You will not see effects of the NM right away. Generally, it takes 10 days-2 weeks for the full effects of the NM to be seen. If you would like to make an appointment for a NM touch-up this will not be scheduled until the 2 week mark and not after the 3 week mark.

Frequently Asked Questions About Neuromodulators

  • Pregnant or breastfeeding women
  • People with Neuromuscular disorders such as ALS (Lou Gehrig’s disease), Lambert-Eaton Syndrome or Myasthenia Gravis
  • People who are allergic to NM: allergic reactions are extremely rare, but not unheard of.
  • Allergic reactions (anaphylactic reactions to NM have been reported)
  • Pain, swelling, or bruising at the injection site
  • Headache or flu-like symptoms
  • Droopy eyelids
  • Crooked smiles
  • Eye dryness or excessive tearing
  • Upset stomach
  • Numbess
  • Malaise
  • Drooling

For most people, Botox® is considered safe. Botox® is a neurotoxin created from a bacterium, Clostridium botulinum, that is found in many environmental settings. This neurotoxin is responsible for botulism, which is a rare illness that occurs when a large amount of the toxin is produced and weakens important muscles that control the body. Manufacturers of the NM use a very small amount of the botulinum toxin to temporarily relax the muscles it its injected into without the lethal effects. For example, in a 150 lb person, it would take between 2500-3500 units to produce a lethal effect.

If you decide that NM treatment is not for you, that’s ok! We are currently offering microneedling in the office as well. We hope to offer chemical peels in the future to assist with whatever aesthetic needs you may have.