Lawrence G. Kass M.D.




St. Petersburg / Clearwater

Botox, Dysport and Xeomin Injectable Botulinum

Injectable Fillers & Wrinkle Treatment

FDA approved for wrinkle removal

Botox is widely used as a cosmetic wrinkle treatment to temporarily reduce wrinkles and fine lines in the face, banish neck bands and clear away crow's feet.


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Botox was approved by the FDA for non-cosmetic use in 1989 and approved for cosmetic use in 2002. Botox has been used to treat millions patients of worldwide.

When Botox Cosmetic is injected into facial lines, those muscles are paralyzed, making the wrinkles invisible. Results last for three to eight months and are visible a short while (usually just a few hours) after the Botox is injected into the affected area.

Botox relaxes facial muscles so that the overlying skin can remain smooth and unwrinkled.

Unfortunately, Botox injections are a temporary solution, the effects of the injections last from three to six months. Botox injections can be repeated two to three times a year as needed. Botox is not effective against all facial wrinkles. Rather, it is used for wrinkles caused by the muscles we use for facial expression, such as frown lines, crow's feet, worry lines, and smile lines. These type of wrinkles are often the first wrinkles to develop in young people.

Botox is a highly effective treatment for eliminating these wrinkles and restoring a relaxed and youthful appearance. It is a true "lunch-time procedure". No one but you and your doctor need to know.

FDA approves Botox to treat chronic migraine

The U.S. Food and Drug Administration today approved Botox injection (onabotulinumtoxinA) to prevent headaches in adult patients with chronic migraine. Chronic migraine is defined as having a history of migraine and experiencing a headache on most days of the month.

"Chronic migraine is one of the most disabling forms of headache," said Russell Katz, M.D., director of the Division of Neurology Products in the FDA's Center for Drug Evaluation and Research. "Patients with chronic migraine experience a headache more than 14 days of the month. This condition can greatly affect family, work, and social life, so it is important to have a variety of effective treatment options available."

Migraine headaches are described as an intense pulsing or throbbing pain in one area of the head. The headaches are often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraine is three times more common in women than in men. Migraine usually begins with intermittent headache attacks 14 days or fewer each month (episodic migraine), but some patients go on to develop the more disabling chronic migraine.

To treat chronic migraines, Botox is given approximately every 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms. Botox has not been shown to work for the treatment of migraine headaches that occur 14 days or less per month, or for other forms of headache. It is important that patients discuss with their physician whether Botox is appropriate for them.

Dysport Wrinkle Treatment Injections

FDA approved for wrinkle removal

Dysport is a prescription injection for temporary improvement in the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults less than 65 years of age.

Prescription Dysport is an injection used to temporarily improve the look of your moderate to severe frown lines without changing the look of your whole face. The untreated facial muscles still work normally, allowing you to freely show facial expressions, such as smiling, in untreated areas.

Though approved in the United States for aesthetic use in April 2009, Dysport has a history of use in other countries since 1991. Outside the U.S., it was first approved for aesthetic use in 2001. Dysport is a formulation that has been shown to deliver temporary improvement in moderate to severe frown lines, even with repeat treatments. So, the effect of repeat treatment with Dysport may be comparable to your first use.

Xeomin Injectable Botulinum Wrinkle Treatment Injections

FDA approved for wrinkle removal without using additives

One of the most common cosmetic procedures nowadays is the use of liquid injections to preserve the youthful appearance of facial skin. These liquid injections contain botulinum toxin type A, which is a by-product of the bacterium Clostridium botulinum. The main effect of botulinum toxin type A is to paralyze facial muscles by preventing the exchange of nerve signals between the brain and the muscles. By restricting the movement of facial muscles, the wrinkling of the skin is avoided.

Botulinum toxin injections were first made available commercially as Botox and Dysport. The latest variety is called Xeomin.

Xeomin is a botox alternative that was recently approved by the U.S. Food and Drug Administration. This injectable muscle relaxer has previously been sanctioned for use in European and Canadian markets. Botox, Dysport, and now Xeomin are the most common form of the botulinum toxin type A, and although they are similar they also have their differences. Merz Pharmaceuticals was able to develop a manufacturing technique to produce Xeomin au natural (which means that unlike Botox and Dysport there are no additives). This is especially important because it is believed that this special production process without additives may minimize the patient's possibility of developing antibodies to Xeomin. Hence, Xeomin may work in patients where Botox and Dysport fail to achieve their desired results.

Perhaps this is Xeomin's greatest advantage and should definitely be considered by any patient whose Botox or Dysport treatment has failed in the past.

Apart from the cosmetic benefits of Xeomin, it has several therapeutic uses as well. This botox alternative serves as remedy for cervical dystonia and blepharospasm.

Cervical dystonia is characterized by the spastic twists of the head and neck to one side. Blepharospasm, on the other hand, is the uncontrollable twitching of the eyelids. Both disorders are primarily found in adults. The muscle relaxants contained in Xeomin prevent the spasms from occurring, providing relief to people hampered by these kinds of conditions.

Due to its ability to control frequent spasms, the effect of Xeomin can possibly last longer than that of its counterparts, although this has yet to be proven of the substance. The reason for this potential longevity is the lack of certain proteins in its makeup. The missing proteins in Xeomin prevent the immune system from developing antibodies that would eventually wear down the effects of botulinum toxin type A. Another distinct characteristic of Xeomin that sets it apart from previous botox alternatives is its long shelf life. The Xeomin substance thrives in room temperature. Because it does not require refrigeration, it is considered to be the most environment-friendly botox variety available in the market today.

Xeomin injection procedures typically last thirty minutes, about as long as a Botox treatment would take. These cosmetic processes only require minimal recovery time. The results of Xeomin injections manifest within a week of the procedure and last for three to six months. Overusing the substance would diminish the effect it has on the muscles.

Before and After Xeomin Botulinum

The side effects and risks of using Xeomin are similar to that of other botox alternatives. It is common for the injection site to swell and redden immediately after the procedure. A less likely side effect is the development of short-term visual impairments. The body's condition should return to normal shortly after the injection. If the side effects persist, it would be best to consult a doctor.