Frown Lines (dynamic wrinkles).
What causes frown lines, you may wonder? Frown lines occur when the facial muscles underneath your facial skin contract, (when directed to contract by chemicals released by the nervous system), to cause different facial expressions. As we grow older, with aging skin, these repeated facial expressions leading to lasting frown lines that persist with normal facial expressions as the underlying muscle contrast, and they are called dynamic wrinkles.
What is Botox Dysport® or Xeomin® and how does it work?
Botox®, Dysport® and Xeomin® are FDA-approved neuromodulators. When injected into the muscle, these neuromodulators work by blocking the release of the neurotransmitter chemicals from the nerves that feed that muscle, therefore blocking the muscle contractions that are normally caused by the neurotransmitter chemicals. The injected neuromodulator, therefore, leads to relaxation of the skin overlying the now-relaxed muscle, and therefore softening and smoothening of the wrinkles. The relaxation effect of the neuromodulator on muscle is temporary and lasts for a few months (3-5 months).
How are Xeomin®, Dysport® and Botox® different?
Unlike Botox and Dysport, the therapeutic component in Xeomin® does not contain complexing proteins which, theoretically, makes it less likely to induce antibody response to itself. Studies have however not been done to determine if this lack of complexing proteins has any long-term effect on safety or efficacy.
The results of Dysport are noticed in the quickest at 2-5 days as opposed to 4-7 days for Botox and Xeomin. Dysport is composed of a diluted solution that spreads more quickly to a wider area so it’s able to treat a broader area with fewer injections. Patients may find the efficacy of Dysport to be more potent than Botox, creating a cost-saving solution over other popular neuromodulators. The duration of action for Dysport may be a little longer than Botox at 4 months. In addition, the effect of Dysport is known to drift/spread from the site of injection. Therefore, the effect of injection may spread to unwanted areas and result in complications such as eyebrow or eyelid drooping. On the other hand, spreading effect on the forehead or crows’ feet may be desirable for optimal cosmetic results. Dysport also contains protective proteins, similar to Botox. Therefore, patients who have no response to Botox and are suspected to have antibodies will also have a poor response to Dysport. On the other hand, Xeomin is a “naked” Botulinum toxin A formulation. As a result, patients with antibodies to Botox can be successfully treated with Xeomin.
At Glo & Spa-rkle Aesthetics and Medical Spa, a provider will advise you on the best neuromodulator for you.
What is the neuromodulator injection procedure like?
At Glo & Spa-rkle, the procedure is performed by first cleaning the area to be injected. This is done after your provider has assessed you and determined, with you, what the best neuromodulator treatment plan is. Once the face is cleaned, the target muscles are then injected with a precise dose of the neuromodulator using a very fine needle. This injection often feels like a minor sting. As a result, local anesthesia is often not needed. Multiple injections are usually needed for different facial muscles. After the procedure, pressure is applied to avoid bruising.
What aftercare do I need?
Once all target areas are injected, you can leave the office and resume your daily activities. We recommend avoiding heavy and strenuous activities for the first 24-48 hours. Injection site swelling and bruising usually resolves within 24-72 hours. Cold compresses may help these resolve faster.
How long do the effect of neuromodulator last?
The muscle relaxation and wrinkle smoothening effect last about 3-4 months. Subsequent repeat injections will be necessary to maintain the effect. Schedule follow ups with your Glo & Spa-rkle provider for repeat injections to maintain and enhance the wrinkle clearance and smoothening effect as desired.
How do I know if I should get a neuromodulator treatment or dermal filler?
Neuromodulators are used to soften and smoothen dynamic wrinkles that arise from muscle contractions during facial expressions.
On the other hand, static wrinkles result from loss of volume under the skin, that arises from age-related loss of fat, muscle or bone under the skin. These static wrinkles are treated by dermal fillers to restore volume. Some people may have both types of wrinkles, and therefore may need neuromodulators and dermal fillers.
How should I prepare for the injection?
Will Botox, Dysport or Xeomin treat all my wrinkles? Neuromodulators are used to treat wrinkles that are caused by muscle activity (dynamic wrinkles). Dysport, Botox or Xeomin can only treatment the frown lines and wrinkles that come from muscle contractions under the skin during a facial expression (dynamic wrinkles). This is because they work by relaxing the muscle and stopping it from causing the skin above to wrinkle. Any lines that are present without any facial expression are not due to muscle activity (static wrinkles, and will not usually respond to Dysport, Botox or Xeomin. These need a volume restoration treatment like fillers, microneedling with/without platelet-rich plasma, PDO threads or laser skin rejuvenation.
Before you get any neuromodulator injection, including Botox or Xeomin®, make sure to let your Glo & Spa-rkle provider know if you have any of the following conditions:
- have a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig’s disease], myasthenia gravis or Lambert-Eaton syndrome)
- have had any side effect from any other botulinum toxin in the past
- have a breathing problem such as asthma or emphysema
- have a history of swallowing problems or inhaling food or fluid into your lungs (aspiration)
- have bleeding problems
- have drooping eyelids
- have plans to have surgery
- have had surgery on your face
- are pregnant or plan to become pregnant.
- are breastfeeding or plan to breastfeed.