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Wrinkles Wreaking Havoc? Botox®, Dysport®, and Xeomin® are Here to Save the Day!

Dermatologists and patients have been using neuromodulators like Botox® to smooth wrinkles and restore youthful skin for decades, but what exactly is a neuromodulator, and how does it work? This month, we’re sharing information about cosmetic injectables and how they can help smooth and refresh aging skin.


How do Neuromodulators Like Botox® Work?     

There are several types of neuromodulators, both natural and lab-made, that control nerve signals. Botulinum toxin type A is a bacteria-derived neuromodulator that temporarily inhibits nerve signals to the muscles where injected. There are several brands of neuromodulators available, including Botox®, Dysport®, Xeomin®, and Jeuveau®.

Repeated facial movements such as smiling, frowning, squinting, pursing your lips, and even chewing can cause wrinkles. When a neuromodulator is injected into a muscle used for one of these movements, it stops the muscle from contracting, which smooths the wrinkles over time.


Best Locations for Anti-Aging Injections

One of the most common areas of the face to develop wrinkles is between the eyebrows in the glabellar lines, commonly called the “11s.” Neuromodulator injections in these muscles make it difficult to frown, which smooths out the vertical lines over time. Other popular places for neuromodulator injections are the horizontal lines across the forehead and the crow’s feet around the eyes.

Some wrinkles around the mouth are also good candidates for neuromodulator injections. If the wrinkle developed from repeated muscle movement, such as those from pursing the lips, then an injection of Botox®, Dysport®, or another neuromodulator would be beneficial. Some wrinkles are caused by natural collagen loss and would be better addressed with a dermal filler rather than a neuromodulator.

Unwanted signs of aging like a pebbly chin or lines in the neck and décolletage are also good candidates for neuromodulators.


What to Expect at Your Appointment

At your appointment, the dermatologist will use a very fine needle to inject small amounts of botulinum toxin into very specific locations based on which wrinkles you’ve identified as problematic. A well-trained, experienced injector can pinpoint the precise muscle(s) responsible for specific wrinkles while preserving muscle movement in the rest of your face. The goal is to maintain as much natural facial movement as possible so that you don’t look frozen.

Most people tolerate the injections very well, so numbing the area is not usually necessary. Each individual’s dosage will vary based on the severity of the wrinkle, the location, and the strength of the muscles. Men, in particular, may require more product than women because their facial muscles are stronger. Appointments are quick, usually taking around ten minutes.


Injection Aftercare

Most patients tolerate neuromodulator injections very well with few side effects. Immediately following your appointment, you can expect slight swelling around the injection sites. Some patients may have very minor bruising, redness, or a headache.

There is minimal downtime following the appointment. You can resume normal activities as soon as you leave the office. It is advised that you not lie down for the first few hours, but you can resume exercise or any other activity within a few hours of your appointment. Those who wear makeup can safely apply it the day following their injection.

Do not rub or massage the treatment area, as doing so could cause the botulinum toxin to spread to other areas in your face.


Botox® Results

It can take up to seven days before patients begin to see results from their neuromodulator injection. Each person metabolizes the botulinum toxin at different rates, but the results typically last for three to four months.

Keep in mind that it may take several injection appointments to reach your desired smoothness. Your wrinkles took years to develop, so they take time to soften as well. Shallow wrinkles, like crow’s feet, smooth out quicker than deep creases, like those on the forehead.

The American Academy of Dermatology has a great before-and-after photo that demonstrates the effect of a neuromodulator and the results that you may be able to achieve.



Most people are good candidates for botulinum toxin injections, but the following individuals should avoid neuromodulators:

  • Anyone with an active infection
  • Persons with known neuromuscular disorders, such as ALS, Lou Gehrig’s, or Lambert-Eaton myasthenic syndrome
  • Persons with a known allergy to botulinum toxin type A
  • Women who are pregnant, think they could be pregnant, or those who are breastfeeding


Always disclose your medical history, prescription medications, and supplement usage to a physician before undergoing a neuromodulator procedure.


Other Botulinum Toxin Uses

Botulinum toxin is FDA approved for several uses other than wrinkle prevention. Physicians also have several “off-label” uses for the neuromodulator as well, including:

  • Gummy smile
  • Softening a square jaw
  • Hyperhidrosis (excessive sweating)
  • Migraines
  • Temporomandibular joint syndrome (TMJ)


Finding an Experienced Injector

Did you know that there are 43 different muscles in your face? Getting the outcome that you desire requires precision and a deep understanding of facial anatomy. Improper injection placement can create an imbalanced, unnatural result, as well as other undesirable side effects.

Cosmetic neuromodulators like Botox® are a very safe, well-researched treatment, but it’s very important that individuals see a Board-Certified dermatologist for the procedure. Board-Certified dermatologists have a thorough understanding of facial anatomy and are the best practitioners for successful neuromodulator placement.


Schedule a Consultation Today!

If you’re interested in learning more about neuromodulators, schedule a consultation with the dermatologists at Skin Surgery Center of Wilmington today. We love to help patients understand the treatments that we offer, so come with your list of questions ready! Every face is unique, and everyone has different needs and concerns. Being prepared for your consultation ahead of time will help you get the most out of your appointment and will help our dermatologists decide which procedure and placement locations will achieve your desired outcome.

Are you ready to recapture your youth? Then get in touch today!


Contact the Dermatology and Skin Surgery Center of Wilmington for all of your Mohs surgery, cosmetic, and general dermatology needs. Since 2001, Skin Surgery Center’s fellowship-trained Mohs surgeons and board-certified dermatologists have provided patients with exceptional treatment outcomes. Our professional staff is ready to provide you with the thoughtful, competent care that you deserve in our state-of-the-art facilities. Book your appointment today.

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