Botox®, Dysport™, Xeomin®



    Botox (Allergan), Dysport (Medicis), and Xeomin (Merz) are all injectable neuromodulators, meaning they can temporarily alter the nerve impulses of targeted muscles, therefore reducing or eliminating contraction-induced wrinkles.

    Each brand has a slightly different formulation of the same substance, bacterium Clostridium Botulinum, or Botulinum Toxin A, but they all work the same way: they block the nerve impulses of the injected muscles to temporarily paralyze muscle movements that cause wrinkles. The most common targets are horizontal lines across the forehead and perpendicular frown lines between the brows (also called “The Elevens”), but many also rely on Botox, Dysport, and Xeomin for crow’s feet, nasal squint lines, lines around the neck, eyebrow lifting, and even profuse underarm sweating and migraines.

    “They are all very similar. In certain situations, one may get a slightly different reaction versus the other. I personally think Dysport has a little bit more diffusion, which is better for correcting a lot of little crow’s feet because it has a more even distribution. But if I need to make a small correction of a rogue wrinkle, I usually use Botox. In general, I use all three of them all interchangeably,” says Dr. Debra Wattenberg, who specializes in cosmetic dermatology in her New York City boutique clinic, SkincareRX, and is an associate clinical professor of dermatology at Mount Sinai Hospital.

    When administered properly, the effects are confined to the injection zone and do not affect the surrounding areas or travel around the body, as commonly feared.

    By reducing the intensity and frequency of contraction-induced wrinkles, these treatments also prevent the formation of deeper lines in the long run, making them an increasingly popular anti-aging strategy.


    Botox, Dysport, and Xeomin are safe for all skin types and skin colors. However, people who are pregnant, breastfeeding, or have any neurological diseases should not use these injectables unless approved by a qualified cosmetic doctor.


    During the treatment, a very fine needle is injected into each specific muscle for a few seconds with only the minor discomfort of a tiny pinch.  For ultra-sensitive types, topical anesthetic cream or ice can be applied beforehand if necessary.


    15 to 20 minutes


    You may experience slight redness or swelling at the injection sites, but only momentarily, so you can go about your normal activities immediately after receiving treatment.  You may also have slight bruising at the injection site, but nothing that a little concealer can’t hide.

    “Don’t believe any doctor who says you’re not at risk to get brow or eyelid ptosis, which is when your brow or eyelid droops because too much of the product drifted down or up in the eye area. This has happened in every doctor’s office, but the more qualified your doctor is, the lower the risk. Most adverse reactions are caused by the doctor who’s injecting it into you, not the product itself,” says Dr. Wattenberg. Fortunately, a drooping brow or eyelid can be somewhat corrected with Iopidine, prescription eye drops that stimulate surrounding muscles to contract and overcompensate for the laxity of the temporarily paralyzed muscles. The drops should be used until the injected Botox, Dysport, or Xeomin wears off. Other risks correlated to inexperienced practitioners include headache, rash, localized numbness, and flu-like symptoms.


    You should notice smoother, more wrinkle-free skin within 2 to 3 days post injection, but the full effects won’t appear for about 2 weeks. It may take as long as a month for results to peak on areas with stronger muscles, particularly in men.

    At full throttle, your skin will feel smoothed and lifted, with a more youthful and awakened appearance.  These results tend to last 4 to 6 months, at which point the muscle movement gradually returns and the wrinkles and lines start to reappear, but often less severe than before because the muscle is being trained to relax more.


    For optimal results, schedule touch-ups every 4 to 6 months, according to how your skin responds to the treatment. The good news: intervals between treatments may widen over time because your muscles will become more relaxed and require less maintenance.


    You should only visit an actively board certified dermatologist or plastic surgeon. Dermatologists should be certified by the American Board of Dermatology (ABD). Plastic Surgeons should be certified by the American Board of Plastic Surgery (ABPS). Both of those boards are part of the American Board of Medical Specialties (ABMS), a non-profit organization that is considered the gold standard of physician certification. Consult the Charlotte’s Book Premier Provider directory to find a doctor who meets these standards and specializes in this treatment. For more information about how we choose our providers, please read Credentials We Abide By.


    Usually costs average around $350 to $600 per area, while 2 areas may cost around $900, and 3 areas may cost $1200.


    Without solid evidence, it is recommended to stay upright for at least 2 to 4 hours post injection to maintain the cosmetic doctor’s placement of the injectable…let’s take the advice and stay on the safer side. Most cosmetic doctors will tell you to refrain from activities like yoga that involve potentially being upside down. Instead, sit up straight and have a glass of champagne to celebrate your treatment.

    First timer, anyone? Take baby steps with these injectables to see how you react. You can always add more, but you can’t undo a frozen expression. You actually have to wait until it dissipates naturally, which may take several months.

    “Wrinklerexia” is when the afflicted freeze frame junkie starts to inject wrinkles where there really are none, unless you’re making the slightest expression. So please don’t lose touch with reality—it’s unnatural to be 100% wrinkle-free 100% of the time.



    Disclaimer: As always, this information is provided to you for educational and/or informational purposes only, and should not be construed as an endorsement of any particular product, treatment, or procedure. This information is not a substitute for medical advice, diagnoses, or treatment by a doctor or other qualified health care professional. For medical concerns, including decisions about any procedure or treatment, users should always consult their doctor or other qualified health care professional. Please visit our Terms of Service to view our full disclaimers.

  • Natsuki Kiriyama

    Botox is super awesome when done by the right dermatologist. I use Dr. Ava in Los Angeles ( and I have never once left with an unnatural, frozen face. It smooths out wrinkles and leaves me looking younger in a very natural way.

  • Jane Lordwell

    I got Botox for the first time 2 years ago and came out looking like Dr. Evil! My eyebrows were so high…. That doctor was not listed on this site. The experience really scared me. But I am thinking of trying it again with a different practitioner. I tried all of these “natural” botox products on the market like bee venom and whatnot..but I think its all nonsense. I realized nothing can compare to medical grade Botox. I just have to muster up the courage!

  • Heather Amster

    Every time I saw a picture of myself the first thing that would stand out to me were the wrinkles around my eyes. I tried a lot of different creams both inexpensive and expensive but nothing seemed to really do the trick so I bit the bullet and went for Botox. I wish I did it sooner…I absolutely love how it works. Just the right amount around my eyes and the crow’s feet were gone leaving a completely natural look. I now can’t imagine living without it.

  • Robin Levine

    I started getting Botox when I turned 30. A very small amount to help prevent crow’s feet. I was very scared at first, having seen so many “bad botox” faces. But it was one of the best decisions I have made. I continue to get it every 6 months for the last 7 years. One of the best anti-aging treatments I have done (and continue to do). I didn’t tell my husband at first (he was against it), but he didn’t even notice. A small amount will go along way to preventing lines & wrinkles.

    • Eugenia

      Which is the anti-aging treatments, I want to know to buy, i am very worry about my wrinkles please I wait for you answer. Thanks