Muscle relaxing proteins, also called neuromodulators are currently the most commonly used cosmetic tools for rejuvenation and enhancement. While Botox was the first FDA approved brand, Dysport, Jeuveau and Xeomin, 3 other similar products from different companies joined the market soon after. They each approximate 3 months longevity when used in recommended dosage, but our clinical experience shows that each patient can respond differently with varying longevity to the different brands. Therefore, a more personalized approach is always recommended.

Which areas can be treated with Botox?

Botox Cosmetic and Dysport are FDA approved purified proteins that are used to relax the facial muscles that cause frown lines. They can also be used off-label to lift brows, and decrease forehead lines, next to the eyes (crow’s feet), and on the nose (bunny lines). Other more advanced techniques can also be performed to decrease creases on lips, upturn corners of lips, decrease size of large masseters, and lift jowls to give the appearance of a mini face lift.

• frown lines (the vertical lines between the brows)
• crow’s feet (lines around the eyes), and
• forehead lines (horizontal lines in the forehead.)

Just as with Dysport and Xeomin, these agents can also be used off-label in upper half of face for:

• Lift brows up and outwards
• Relief an eye twitch
• Open up the eyes
• Decrease lines on the nose (bunny lines)​
​• Lift up an elongated nose tip

In the lower half of face, these agents can be used off label for:

• Upturn corners of the lips
• Lower the lips to reduce a gummy smile
• Decrease creases on the lips
• Relax and smooth out neck bands
• Lift jowls for a smoother jaw line
• Create a slimmer heart-shaped jawline

In the body, neuromodulators can decrease sweating:

• Decrease sweating of underarms
• Decrease sweating of palms of hands
• Decrease sweating of feet​

Aches, pains, and some medical conditions that can be improved with neuromodulators:

• Decrease Acne, sebum production, pore size
• Create symmetry after Bell’s palsy
• Decrease pain from migraine headaches and other nerve/muscle conditions such as trigeminal neuralgia
• Decrease teeth grinding and pain from TMJ
• Relax knots in muscles and at trigger points

What’s the difference between Botox and Fillers?

Botox and other neuromodulators relax muscles. As such, the weakened muscles no longer contract and don’t crinkle the skin into wrinkles. Fillers on the other hand “fill” the area under the skin. By volumizing a deflated or underdeveloped area, we can contour the face to decrease the shadows that make us look tired, lift the skin back up to its original position, and rejuvenate a droopy or flat structure.


Which product is right for me?

There’s no wrong or right choice and what worked for your friend might not have the same result for you. The only way to find out which product is best for you is to receive the comparable dose of each product in the same area by the same injector and note the result and longevity of each product. At our office, we charge the same price for the comparable dose used with each product. Let us know if you would like to try the different brands at each visit and decide for yourself which you like best!​


(onabotulinumtoxin A) by Allergan, same company that makes Juederm, Voluma, and Latisse) first earned Food and Drug Administration (FDA) approval for medical use in 1989. It has since received cosmetic FDA approval for use in frown lines (glabellar lines) and crow’s feet (peri-orbital rhytids).
Onset of results is usually about 7-10 days after injection into targeted muscles. When used in proper dosing recommended by the company (6 injection sites containing 20 units of Botox for frown lines, 3 injection sites containing 24 units of Dysport for crow’s feet), the duration of results usually lasts about 3-4 months. Some patients have more sensitive muscles and respond to fewer units, while others such as most men may require higher doses to achieve the same results.


(abobotulinumtoxin A) by Galderma (same company that makes Restylane, Restylane Silk, Restylane Lyft/Perlane, and Sculptra) was approved by the FDA in 2009. Each unit of Botox is equivalent to 2.5 to 3 units of Dysport in efficacy.
This does not mean that one is stronger than the other, only that the units of measurement differ. Dysport comes in 300 unit vials and like Botox needs to be refrigerated prior to and after re-constitution. Currently, it has FDA approval for treatment of frown lines (glabellar lines) in the amount of 50 units delivered in 5 injection sites. The most notable differences between Dysport and Botox is that Dysport has a quicker onset of result (3 days compared to Botox which is 7 days), and it diffused further surrounding the injection site.


(incobotulinumtoxin A) by Merz (same company that makes Radiesse and Belotero) was approved by the FDA in 2010. Its units of measurement are exactly like Botox. In other words, one unit of Xeomin is equivalent in effect to one unit of Botox. Xeoman has been FDA approved for use in the glabellar region (frown lines.) The only significant differences with Botox are that it does not need refrigeration and that it does not have the extra proteins that Botox carries. Some believe that Xeomin is a more purified version of Botox and is less likely to cause antibody formation in the body, while others believe that the extra protein within Botox makes Botox last longer. There are no studies to verify either theory at this time. Another key element with Xeomin is that it should be placed upside down for 1 to 2 minutes after reconstitution to ensure that all of the particles in the top of the vial also dissolve into the solution. Botox does not require this as all of its product is at the bottom of the vial.