Candidates for Botox & Other Neuromodulators
Candidates for neuromodulator treatment include individuals who want to reduce facial wrinkles at the forehead, glabella (the region between the eyebrows), and sides of eyes (crow’s feet). Neuromodulator treatment can also be performed off-label to treat wrinkles of the nose (bunny lines), lips (smoker’s lines), and chin. In addition to treating wrinkles, neuromodulator treatment can help improve asymmetry, alter the shape of the eyebrows, and slightly lift the corner of the mouth.
How Botox & Other Neuromodulators are Performed
Your initial visit may take 30 to 60 minutes. This visit is important to review all relevant information, understand your goals, answer all your questions, and formulate a plan. Your face will be mapped out to determine the pattern and number of units that will be used. This information and measurements are recorded in your chart for future reference. During the procedure, the neuromodulator (either Botox, Dysport, Xeomin, Jeuveau, or Daxxify) is injected at the regions of concern. Subsequent visits usually take 5 to 15 minutes to perform the treatment.
We highly optimizes the neuromodulator treatment for each patient, ensuring an exceptional experience and excellent results. We are very meticulous during the injections and only use high-quality, delicate needles. Pain is minimal due to the combination of our extremely small needles and careful technique. If desired, topical numbing creams are available to further help reduce discomfort. In addition, we offer the Zimmer Cryo Chiller device to cool the skin, which improves comfort and can decrease the risk of bruising.
How to Prepare for Botox & Other Neuromodulators
It is recommended to avoid medications and supplements that thin your blood in order to reduce the risk of bruising. Ensure to consult with your prescribing physician before stopping any medications. Schedule your filler treatment for a time that it is OK if you happen to develop bruising.
We are conveniently located to serve Beverly Hills, West Hollywood, & Los Angeles. However, we are available to help with coordinating your stay if you are an Out-of-Town Patient.
What to Expect After Botox & Other Neuromodulators
It usually takes 1 to 3 days to start noticing the effect of neuromodulator treatment, and the maximal effect can take 1 to 2 weeks. Some wrinkles that are still present at rest may continue to further soften over months and with additional future treatments. The expected improvement largely depends on the severity of the wrinkles and consistency with treatment.
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Fillers faq
How long does it last?
Neuromodulator treatment usually lasts 3 to 4 months using traditional dosing but varies from person to person. Based on our extensive experience, we have seen treatments lasting between 1.5 and 9 months. Although we have a very lucky patient who benefits from Botox lasting 9 months, this is extremely rare.
Neuromodulator dosing will likely change in the future, and this will increase how long the treatment lasts. For example, using 4 times the amount of units will significantly make the treatment last longer. There are currently several investigations regarding this topic, and Dr. Foulad is highly active in such research. The key is using micro-focused droplets of highly concentrated neuromodulators to achieve a very natural, but long-lasting effect. At this time, high concentration neuromodulator treatment is not feasible because of the high cost. However, this will likely change; it is just a matter of time as a result of competition between various manufacturers.
What are the different types of neuromodulators for treating wrinkles?
Botox was the first FDA-approved neuromodulator for cosmetic use and has become a very popular brand.
Dysport is another type of neuromodulator that has a similar effect as Botox, but requires different dosing. Approximately 3 units of Dysport is equivalent to 1 unit of Botox. This conversion is factored into pricing, and thus 3 units of Dysport is usually a similar cost as 1 unit of Botox. Typically, you may notice the results take effect sooner with Dysport as compared to Botox. This makes Dysport especially useful in situations that require quicker onset of results.
Xeomin is made with botulinum toxin type A, the same purified protein that is used in Botox and Dysport. However, unlike Botox and Dysport, Xeomin can be thought of as being “purer” because it leaves out various accessory proteins. This may reduce the risk of your body forming antibodies to the product. Many of our patients describe treatment with Xeomin as feeling relatively “lighter” compared to other neuromodulators. Occasionally, some patients will have a short period of headaches or a feeling of tightness after Botox treatment to the forehead. Many of these patients have noted that Xeomen is less likely to cause those symptoms. However, this “lighter” product may not last as long as the other neuromodulators.
Jeuveau is the newest neuromodulator that has been FDA for wrinkles and is very similar to Botox.
Which neuromodulator product is best for me?
Each neuromodulator product has its specific advantages and disadvantages. Based on your goals, we can determine the best neuromodulator product for you.
What are the post-procedure instructions?
• For the first several hours after the treatment (ideally until the next day), avoid applying pressure to the treated areas. For example, you should avoid massaging or resting your head on treated areas. When cleansing your face or applying makeup, perform this gently. This is to avoid pushing the neuromodulator treatment to other areas.
• Ideally, do not perform strenuous exercise until the day after the treatment.
Associated Articles & Videos
- Article: What is botulinum toxin resistance?
- Article: Why didn’t my Botox work well?
Case samples
Crow’s Feet Treatment
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Botox treatment was performed to reduce the wrinkles around her eyes.
Dynamic wrinkles are formed during facial expression, such as smiling. Muscle contraction creates grooves in the skin, which can lead to permanent wrinkles over time. The goal of neuromodulator treatment is to weaken the muscle contraction that causes wrinkles. Although the effect of neuromodulator treatment is most noticeable during facial expression, wrinkles visible at rest can also be improved to a certain extent. In the before and after photographs, the wrinkles around the eyes have significantly improved both during smile and at rest.
Forehead Wrinkles Treatment
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This lovely patient desired to treat her forehead wrinkles that have started to become more prominent. A touch of Botox was all that was needed.
Gummy Smile Treatment
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Our beautiful patient simply received 4 units of Botox to treat her gummy smile. The appropriate muscles associated with the upper lip must be targeted properly in order to reduce the amount of gingival display, while maintaining a beautiful and natural appearing smile.
Identifying the cause of the gummy smile is important when determining whether Botox or other neuromodulators are an appropriate treatment option. Gummy smile, also referred to as excessive gingival display, can be due to soft tissue and/or bone related reasons. For example, gummy smile can be caused by hyperactivity of muscles that control the upper lip, a short upper lip, overgrowth of the jaw, and/or excess gingival tissue. Although Botox is FDA approved for various cosmetic conditions, it is not approved specifically for the treatment of gummy smile and is considered off-label use in this situation.
Chin Treatment
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Botox was used for this lovely patient to improve the contour of her chin, reduce chin dimpling, and soften the mental crease (the indentation between the chin and the lower lip). She was a great candidate for this treatment considering her extremely hyperactive mentalis muscle. The before and after photographs were taken with her at rest and demonstrate the dramatic improvement that can be achieved with proper injection technique.
Neuromodulators such as Botox®, Dysport®, and Xeomin® can be a great option for select patients to improve the appearance of the chin without the use of surgery or fillers. The treatment works by targeting and relaxing the mentalis muscle. Although Botox is FDA approved for various cosmetic conditions, it is considered off-label use in this situation.
