Purified botulinum neurotoxin is available in three preparations in the USA, as the brands Botox, Dysport, and
Xeomin. These neurotoxins, also known as neuromodulators, help to block the transmission of nerve impulses to
muscles. Their effect is at the site where the nerve meets the muscle, with the first results seen within two days, and the maximum effect becoming apparent after 12 days. Each treatment can last for up to six months.
Many of the wrinkles and lines in the skin are due to muscle insertions into the skin, and temporarily weakening the muscles can treat those lines. If they are treated before they form an etched line in the skin, it can prevent this process. Existing lines, such as forehead furrows, can be improved by treatment.
The goal of treatment is to “smooth”, not “freeze”, the upper face, and leave enough activity to show emotion while easing muscle tone (and mass).

Common Areas to Treat with Botox, Dysport, and Xeomin
Treating frown lines, or “scowl lines”, or “11s”, with neurotoxins is fast, safe, and simple. As the action of these muscles is to lower the part of the eye brow that is closer to the midline, relaxing these muscles raises this part of the brow. Many patients feel “refreshed” after the muscles around their eyes relax and feel like a weight has been lifted off of their face. Another common area to treat are the horizontal forehead lines or furrows. These are caused by the action of the frontalis muscle on the skin, and selective paralysis of this muscle can prevent the furrows from pulling on the skin until it has permanent etching of lines into this skin.
Crow’s feet are the bunching of skin between the eyes and ears that get accentuated when you smile. The muscle responsible for the crow’s feet, the orbicularis oculi muscle, also depresses, or “pulls down”, the outer aspect of the eye brow. Selective paralysis of this muscle can both smoothe out the crow’s feet, and can also raise the eye brows.



Advanced Uses of Botox, Xeomin and Dysport

Though the most common use of neurotoxins is in the upper 1/3rd of the face, the power to selectively paralyze facial muscles and block nerve impulses gives it many uses that are outside of the mainstream.

  • Botulinum toxin has been extensively studied and proven to be a great treatment for medically refractory migraines.
  • The massater muscle is a very strong muscle that helps close your jaw when you bite. If you put your hands on the sidesof your face and bite forcefully, you will feel them contract. Treating these muscles can help slim your face from a front view, and also lessen symptoms of TMJ pain in people that suffer from it.
  • Hyperhydrosis, excessive sweating of the underarms, palms, or any other part of the body can be treated.
  • Vertical neck bands are caused by the platysma muscle, and selective paralysis of this can make them less prominent.
  • Some people have an overactive mentalis muscle in their chin. Look in the mirror and count to 10. If you have an “orange peel chin” look while you count, this can be treated.
  • The “gummy smile” that results from too much upper lip elevation with smiling can be made less “gummy”.
  • The depressor septi nasi muscle pulls the nasal tip down, and some people have an overactive nasal tip with too much vertical motion when they speak or chew.
  • “Bunny lines“, or diagonal nasal lines that some people have when they smile, can be treated
  • “Resting bitch face“, or a resting “angry” look, can sometimes be due to an overactive depressor angularis oris muscle that pulls the corners of the mouth down

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Nuance Facial Plastics
309 South Sharon Amity Rd.
Suite 202
Charlotte, NC 28211

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