Clarified: Neuromodulators, Neurotoxins, and Botox

In San Jose, CA

By Dr. Eric Li

To reduce the appearance of fine lines and wrinkles caused by the activity of the muscles of the face and neck, injectable neuromodulators (neurotoxins) are utilized. For more information, contact us or schedule an appointment online. We are conveniently located at 555 Knowles Drive, Suite 218 Los Gatos, CA 95032.

“I just got some Botox done!” is something you may hear a friend say after visiting a medical professional so that they can achieve a younger look or get rid of deepening facial lines. However, did you know that Botox is actually a brand, one of the four FDA-approved neuromodulators or neurotoxins which are available and can be used for aesthetic purposes? Each neuromodulator contains botulinum toxin type A as the active ingredient, and the end goal of each of these treatments is the same, which is to paralyze muscle activity and create various aesthetic benefits, whether that be a reduction in lines and wrinkles, a decrease in muscle volume for contouring purposes, or a reduction in muscle activity.

In honor of National Botox Day on November 16th, Dr. Eric Li, a double-board certified plastic surgeon, shares his insight on these four brands. Dr. Li has significant expertise in neuromodulators, fillers, and injectables as part of his private practice based in San Jose and Los Gatos Bay Area California.

Botox: The oldest in the game.

Developed by Allergan, this treatment was the first neurotoxin to be FDA-approved to treat frown lines, crow’s feet, as well as forehead lines. This neurotoxin contains protective proteins which are attached to it. Unfortunately, some patients may gradually develop an immunity to these proteins, which may make the medication less effective or ineffective over time, generally after many years of usage. Once injected, Botox typically works in 3-5 days with a peak efficacy at 1 month. Effects usually last for 3-4 months, and best results will come about for consistent, long-term usage.

2. Xeomin: The unique one in the game. 

Developed by Merz, this injectable does NOT contain the protective protein which is present in Botox. As such, it has the advantage in that it is the least likely product for patients to develop an immune resistance to. For larger unit treatment areas such as for jawline contouring with injections into the chewing muscles (masseters) or calf reduction with injections into the leg muscles (gastrocnemius), this is my preferred neurotoxin. Some clinical data suggests that less product may be needed to achieve comparable results with other brands. The onset and duration of action are similar to Botox.

Dysport: The skinny one in the game. 

Supplied by Galderma, this neurotoxin is less potent than other brands, as 3 units of Dysport is needed to have the same effect as 1 unit of Botox, however, clinically, this does not necessarily result in a different treatment effect, because providers generally use more of this product per treatment area as compared to the other brands. Of note, this product does tend to spread more easily to adjacent areas, which is particularly helpful when a larger area of effect is desired, but less ideal for injections targeted to very small areas. The onset and duration of action are similar to Botox, although some patients do report a slightly faster onset.

Jeuveau: The baby in the game. 

Supplied by Evolus, this is the newest neuromodulator on the market that has FDA-approval for treatment of glabellar lines, although it is used for other areas in an off-label fashion. It is also sometimes referred to as Newtox on social media. There is a proprietary technology that the company uses to prepare the product which is thought to make the neurotoxin more potent, but again, clinically, the onset, duration, and intensity of action are very similar to the other brands.

Now that we have clarified the different options to choose from, we invite you to book a consultation with us to see which neuromodulator can help you reach your beauty goals, whether that is defying age or enhancing your personal look.

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