FAQ

Botox, Xeomin, and the like, are neurotoxins that lessen wrinkles, fine lines, and will lift or relax facial muscles (depending on the muscle treated) when injected. This occurs because the neuromodulator protein attaches itself to nerve endings in the muscle and prevents the release of the neurotransmitter acetylcholine (the chief neurotransmitter involved in muscle movement). By doing this, nerve signals are interrupted and the muscle(s) controlling the wrinkled skin is weakened thereby allowing for a rejuvenated appearance and significantly smoother skin.

Botox and Xeomin are very similar in that they both contain the same active primary ingredient (botulinum toxin A) and they are both used to reduce the appearance of fine lines and wrinkles caused by repetitive facial expressions, sun damaged skin, and the aging process.

The formulas, however, are slightly different based on some small differences in protein makeup. More specifically, there are accessory proteins in Botox that increase the chance of developing antibodies to the injectable, thereby decreasing the desired effect of the toxin over time. Further, because Xeomin is purified without extra proteins, there isn’t the chance that those additional antibodies will form, which is a good thing! Lastly, we’ve found that our clients like the lighter (not so heavy) feel that Xeomin promotes, and some studies have even found that Xeomin may last slightly longer than Botox, which is what we all want!

Botox and Xeomin are FDA approved for cosmetic use in areas of the face including the forehead, the Glabella Complex (over and between the brows), and the Crows Feet (around the eyes). Researchers and Healthcare providers have also recognized the benefits of treating other areas around the face and as such, these “off label” applications are readily sought out by patients and are utilized by practitioners when clinically appropriate.

So, besides treating those pesky forehead lines, frown lines, and crows feet, Neuromodulators can also be used to do the following:

Bunny Lines:
The Nasalis muscle is found in the nose and over time can create wrinkles on the bridge and sides of the nose. By injecting Botox or Xeomin superficially near the muscle, the product diffuses into the nasalis and relaxes these lines.

Gummy Smiles:
A “gummy smile” is seen when a person shows an excessive amount of gingival tissue underneath the upper lip when smiling. Many times, this is caused by an inherited hyperactive muscle called the LLSAN (Levator Labii Superioris Alaeque Nasi). This muscle is also known as the Elvis muscle (think snarl). The LLSAN is found alongside the nose and is responsible for lifting and everting the upper lip. When it is hyperactive, you get a “gummy smile”.  By relaxing this muscle you achieve a more harmonious and aesthetically pleasing smile.

Downturned Mouth and Lip Lines:
The Depressor Anguli Oris (DAO) muscle extends from the ring-like muscle surrounding the lips (Orbicularis Oris). This muscle works to pull the edges of the lips downward, forming a frown. Additionally, the Orbicularis Oris muscle, the muscle lying behind and surround the lips, creates lip lines above the top lip and below the bottom lip, due to the repetitive use of the muscle during talking, pursing, eating, and as part of the aging process.   

In treatment of these areas, a very fine needle is used to inject Botox or Xeomin into the muscle on each side of the mouth. By doing this, the corners are lifted turning that frown upside down. The same process is completed to treat the lines around the mouth, except the injections are placed strategically in the Orbicularis Oris muscle to weaken the force of contraction and reduce the appearance of lip lines.

Lip Flip:
By injecting a small amount of Botox or Xeomin into the muscle over the upper lip (Orbicularis Oris) the muscle is relaxed and provides a subtle enhancement to your upper lip. The lip will evert slightly and more red lip will show when smiling and at rest. Additionally, the cupid’s bow will appear slightly plumper and a ski jump-like aesthetic will define your existing vermillion border (the edge of the lip).

Chin Dimpling:
Another common problem area is the chin. As we age, the repetitive movement of the mentalis muscle causes dimpling in the chin and an orange peel appearance overlying the skin. By relaxing the mentalis muscle with Botox or Xeomin, the overlying skin of the chin will be smoother, less dimpled, and the relaxed mentalis muscle will allow for a more favorable contour to the lower face, both on frontal and profile views.

Jaw slimming and Jaw Pain (aka TMJ dysfunction):
The Masseter is a powerful muscle of mastication (muscle used to chew food). This muscle connects the lower jaw to the cheekbone and consists of three distinct layers which work with nearby muscles to move your Temporomandibular joint and jawbone (opening and closing your mouth). If the Masseter muscle is overworked due to clenching, chewing, etc., pain in the muscle and joints may occur. Many times, however, people do not realize that they are overusing this muscle because there is no overt pain. So, with continued overuse, the Masseter will enlarge creating a widened or square appearing jaw.

When seeking treatment for jaw pain, Botox or Xeomin is injected directly into the Masseter to weaken the muscle and a noticeable improvement in symptoms will typically begin in 1 week.

For jaw slimming, Botox or Xeomin is injected into the Masseter to weaken the muscle. Slimming results may become apparent as soon as 2 weeks and will continue to improve up to three months. With more frequent initial follow up treatments, the results will last longer and follow up may only be required every 6-12 months.

Neck Contouring:
As we age, neck bands (platysma muscles) become more apparent, neck lines increase, and the skin over the neck becomes looser. With the neck being a critical area of importance when communicating youth and beauty, it is often surprisingly overlooked.

To create a more youthful neck and contour of the lower face, Botox or Xeomin may be injected into the prominent platysma bands of the neck, the Depressor Anguli Oris (muscles that pull down the corners of the mouth), and the Mentalis (Chin Muscle). The results begin to show approximately three days after treatment and continue to improve over the course of 2 to 3 weeks. Results may last anywhere from 3 to 6 months.

Hyperhidrosis (Excessive sweating of the underarms):
In 2004, the U.S. Food & Drug Administration (FDA) approved BOTOX (onabotulinumtoxinA) for the treatment of axillary hyperhidrosis (excessive underarm sweating).  When Botox or Xeomin is injected just below the surface of the skin and sweat gland, it interrupts the chemical messages that cause sweating thereby “turning off” the sweating in the areas injected.

The full effect of treatment is appreciated in two weeks and can last from 6 to 12 months.

Those with one or all the following:

• If you have lines and wrinkles of the face or neck.
• If you are beginning to see line formation and want to prevent deeper lines from forming.
• If your skin appears to be loose and saggy.  
• If you desire subtle lip enhancement with or without filler.
• If you experience jaw pain from an overactive Masseter muscle.
• If you have a wide or square jaw due to an overactive Masseter muscle.
• If you experience excessive underarm sweating or excessive sweating under the breasts.

• Women who are pregnant.
• People with an anaphylactic egg allergy.
• People who have had an allergic reaction to Botox or Xeomin in the past.
• People who have trouble swallowing are not candidates for neuromodulators in the lower face or neck.

At Speak Beaty Studios we are proud to offer a variety of Hyaluronic Acid based and Biostimulator products. In the Biostimulator line, our favorite product is Radiesse, and for Hyaluronic Acid dermal fillers, we have a variety of options, including the more popular Restylane and Juvéderm family of dermal fillers, as well as newer products such as the RHA line of dermal fillers. After all, you need many paintbrushes when enhancing art.

A Biostimulator, such as Radiesse, is an injectable filler gel with tiny calcium microspheres called calcium hydroxyapatite. These tiny calcium microspheres are  similar to what is found in the bones and the teeth. When Radiesse is injected in areas where there is volume loss, the biostimulator activates fibroblasts to stimulate collagen production and create a more natural appearing restoration of deflated, saggy, or skeletal changes of the aging face. What is most impressive about Radiesse is that it is non-inflammatory, and instead works by embedding calcium particles in the skin which act as a scaffold that promotes the growth of new collagen and elastin.

Hyaluronic Acid, also known as hyaluronan, is a clear, gooey substance that is naturally produced by your body. The largest amounts of it are found in your skin, connective tissue and eyes. The main function of Hyaluronan is to keep the skin and tissues supple, plump, and well hydrated. As we age, the production of hyaluronic acid, along with collagen and elastin, decreases. As a result, our skin loses volume, hydration, and plumpness. By replacing volume loss and structural deficiencies with hyaluronic acid dermal fillers, you can redefine areas that have lost volume and structure, hydrate the skin, reduce lines and wrinkles, and redistribute the lights and shadows of your face to convey health, youth, and beauty.