Richmond’s Laser Skin Care Specialists

Botox and Xeomin

“I’m too young to have wrinkles on my face!”

-Katherine Bevington

Pre- and Postoperative Gallery

Botox and Xeomin injections are the most popular cosmetic procedures in the United States. The beauty of Botox and Xeomin is that treatment can be tailored to your goals, whether you just want a subtle reduction of frown lines, or a complete relaxation of the muscles that make wrinkles. Botox and Xeomin can also be used to reshape the lower face and lips, reduce the appearance of bands in the neck, treat headaches or help with excessive underarm sweating.

Frequently Asked Questions

How is Botox or Xeomin helpful?

Botox is commonly used to improve wrinkles around the eyes, to shape the mouth, and to alleviate the pain of migraine headaches and temporomandibular joint spasms.

Around the eyes:

Botox is most commonly injected into the corrugator muscle, which creates the vertical frown lines in the glabella, the region between the eyebrows and above the nose. Botox is also approved for injecting the orbicularis muscle around the corner of the eye, where squinting and smiling create radial creases called “crow’s feet.” With skilled injection of the procerus muscle and other eyebrow depressors, the physician can encourage unopposed upward movement of the eyebrows. This is sometimes referred to as a chemical eyebrow lift.

In the forehead:

Botox can be used with caution to relax the horizontal creases across the forehead. Excessive treatment can cause flattening of the eyebrow arch, or even sagging of the brow. Complete elimination of forehead muscles is usually not desirable, as it creates an expressionless “mask.” This is considered an “off-label” use.

In the lips:

A popular site for Botox injection is into the corner of the mouth muscle, called the depressor anguli oris (DAO). DAO injections improve the shape of the mouth, reducing frowns and elevating the corners of the mouth. Very tiny doses of Botox may be injected into lip lines to relax the vertical creases or “smoker’s lines” in the lip skin. Botox injections around the mouth can be especially effective when combined with injectable fillers.

For migraine headaches:

Botox can be extremely helpful for some patients with migraine headaches, offering 3-4 months of relief to patients who have averaged over 15 headaches per month despite medical management. Typically, we inject the forehead and around the eyes, as well as the temples and back of the skull.

For temporomandibular joint pain:

Botox can be helpful for patients with excessive jaw clenching and tooth grinding, relieving the pain caused by excessive muscle activity.

What is Botox or Xeomin?

Botox® Cosmetic is FDA-approved for temporary cosmetic improvement in the vertical wrinkles between the eyebrows and the “crow’s feet” creases at the corner of the eyes. Botox is a “neuromodulator,” a prescription drug that decreases muscle activity by controlling the transmission of nerve signals to the muscle. The benefit of Botox typically lasts 3-4 months, but the treatment may be repeated.

XEOMIN® (incobotulinumtoxinA) is a prescription medicine that is injected into muscles and used to temporarily improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults. The benefit typically lasts 3 months but the treatment may be repeated.

Is Botox or Xeomin right for me?

You should not receive Botox or Xeomin if you are allergic to any botulinum toxin product (including Dysport), if you have certain neurologic diseases, including amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), myasthenia gravis or Eaton-Lambert syndrome, or if you have an infection near the injection site.  It is not known whether Botox or Xeomin can affect an unborn fetus or a breastfeeding infant. 

What can I expect after Botox or Xeomin injection?

Be patient.  It takes 3-5 days for Botox to reach maximum effect, and the improvement will last 3-4 months.  Avoid vigorous exercise for four hours after treatment, and do not massage the area.  You may drive yourself home and return immediately to work.

What are the risks of Botox or Xeomin injections?

Allergic reactions, unintended spread of toxin effects, and other serious complications have been reported following Botox or Xeomin injections.

If you have any difficulty speaking, swallowing or breathing at any time (hours to weeks) after injection, seek medical care immediately.  

Botox or Xeomin has been safely used for over 25 years without any confirmed cases of botulism when used as recommended for wrinkles around the eyes. Over 11 million patients have been treated. The most common complications are bruising at the site of the injection, undertreatment, and overtreatment.  With cosmetic injection.2ns, incorrect treatment may lead to drooping eyelids, double vision, or distortion of the mouth muscles. These side effects are infrequent and temporary, but may last 3 weeks to 3 months. With larger doses, and especially with injections in the neck, there have been reports of difficulty speaking, swallowing or breathing, which may be life-threatening.


What is Dysport?

Dysport® (previously known as Myobloc®) is an alternative brand of botulinum toxin that is similar to Botox, widely available and similarly effective.

Read more on Dysport