Botulinum Toxins

Botulinum toxin is a neuromodulator that works by preventing your nervous system from telling certain muscles to flex. It is derived from the same bacteria that causes botulism. However,  it does not put patients at risk for botulism since the neurotoxin is diluted to less than 100 times the amount it would take to cause botulism. Furthermore, it is injected directly into targeted muscles with very little spread, so there is no systemic involvement. 

Botulinum toxin injections target specific muscles that cause lines and wrinkles near the injection site. It does not “freeze” your whole face or alter your facial expressions when administered by a trained professional. Any undesired effects from this treatment usually come down to too much being given, or placement in the wrong muscles. 

Currently, there are four FDA-approved varieties in the USA market. These are Botox, Dysport, Jeuveau, and Xeomin. 

Most of these toxins work very similarly, but some people do seem to get more mileage out of one type vs. another. Because the toxins have to be used relatively quickly after reconstitution to maintain efficacy, it is common for injectors to offer only 1-2 types, depending on what they think works best for patients. 

During treatment, a doctor injects tiny amounts of botulinum toxin into your skin using a small needle. Patients who have received injections describe the sensation as a small prick and do not experience much pain.

Dr. Wheeler frequently says that if it looks fake either too much was used or it was not injected correctly. The whole goal here is to give you as smooth and NATURAL look as possible. We are fairly conservative with our approach. It is always easier to give less and come back in for more if needed. To our patients who have never had botulinum toxins or who are nervous about looking fake, we strongly advise by starting low and going slow. This might mean treating only one area on the face before moving onto others, or it might mean injecting the lowest number of units we think will be effective. We sometimes liken this process to working with a hairdresser. Sometimes it takes us a few visits to learn exactly how you respond, which muscles are more difficult to soften, and how long it will last. Every single person is unique in these things. 

These are some of the most widely studied drugs in the world, with millions of patients using them for both therapeutic and cosmetic purposes.  injections are a safe FDA approved method for reducing lines and wrinkles in most patients. When administered by a trained profession treatment side effects are minimal.

The neuromodulator typically takes effect in 24-72 hours and lasts for 3-6 months. Initially after the procedure, you may have some redness, swelling, bruising, localized pain, or a headache which should resolve on its own after a few days. You should be able to return to work and your normal activities immediately following the injections.