The name BOTOX® is synonymous with non-surgical rejuvenation: For many years, BOTOX® was the only injectable treatment for dynamic wrinkles. Most people still automatically turn to this compound when they want to smooth away crow’s feet and frown lines, but today, their options are more varied. Similar injectables, like Dysport®, Xeomin®, and now Jeuveau, allow patients to experiment with multiple neuromodulators. Though all of these products share the same basic mechanism of action, they have some important differences. Knowing the pros and cons of each product can help you achieve the results you want while working within your budget.
What is Jeuveau (AKA “NewTox”)?
Jeuveau, like BOTOX®, uses purified botulinum toxin to temporarily relax the small muscle groups that cause dynamic wrinkles. When these compounds are injected into muscle tissue, they block nerve signals so that the brain can no longer instruct treated muscles to move.
Though they work similarly, Jeuveau and BOTOX® are made by different manufacturers and produced in different countries. BOTOX® is made by Allergan and manufactured in Ireland, whereas Jeuveau is made by Evolus and produced in South Korea. Jeuveau also uses a slightly different form of botulinum toxin than BOTOX®: BOTOX® contains onabotulinumtoxinA and Jeuveau contains prabotulinumtoxinA. According to clinical trials, both compounds share a similar safety profile and are equally effective for treating dynamic wrinkles.
What is a Neurotoxin? Is it the Same Thing as BOTOX®?
One of the main concerns patients have when trying BOTOX®, Dysport®, Xeomin®, or Jeuveau is their potential toxicity. All of these compounds are derived from a potent neurotoxin that, when consumed orally, can cause illness. Neurotoxins are compounds that alter the function of nerve tissue by destroying nerve cells. Neurotoxins can be chemical (e.g., ethanol) or, like BOTOX®, they can be produced by bacteria.
Nerve tissue can regenerate itself, so the effects of neurotoxins are seldom permanent. After BOTOX® or Jeuveau eliminate nerve cells in specific areas, the cells slowly grow back on their own; that’s why the effects of most neuromodulators only last about three months. Likewise, cosmetic neurotoxins like BOTOX® don’t harm skin or muscle tissue, so patients don’t have to worry about permanently altering their appearance when they try a neuromodulator. The idea that BOTOX® and similar compounds can permanently “freeze” the face is an urban myth. If you don’t like the way BOTOX® looks on you, all you have to do is wait four to six months and your face will return to normal.
While we certainly recommend caution when trying these compounds (i.e., patients should always research their chosen injector carefully and have BOTOX® administered in a clinical setting), there’s no reason to fear the word “neurotoxin.” When used correctly, neurotoxins actually have a number of medical benefits. In fact, these compounds were first investigated by medical researchers in the late 1800s, when it was discovered that neurotoxins could reduce muscle spasticity. Today, neurotoxins are used to treat a wide range of medical conditions, including involuntary facial spasms (such as facial tics and uncontrolled blinking), migraine headaches, limb spasms, excessive sweating, strabismus (crossed or lazy eyes), bruxism, and TMJ pain.
How Often Do You Have to Get BOTOX® or Jeuveau to Get the Full Benefits?
Generally, we recommend having a second round of injections three or four months after your first appointment. After you’ve had two or three treatments, however, you may only need to have “top up” injections once every three to six months. Repeated BOTOX® or Jeuveau injections may gradually train targeted muscles to remain in a more relaxed state, making results potentially more long lasting.
Can I Make BOTOX® or Jeuveau Last Longer?
Though there’s no way to make any neuromodulator last forever, there are several things you can do to extend your results:
- Set up a long-term treatment plan. Having injections regularly will keep your muscles and skin smooth, preventing “rebound wrinkles.”
- Follow proper aftercare protocol. Don’t vigorously scrub or massage your face for 24 hours after having BOTOX® or Jeuveau injections. Don’t have skin tightening or laser treatments that heat the skin for at least 3 days after the injection, as heat can make the medicine less effective.
- Stay out of the sun. Sunlight doesn’t destroy BOTOX® or Jeuveau, but it does speed up the aging process. Sunlight breaks down collagen and elastin, making the skin thinner, weaker, and more prone to developing new wrinkles.
- Prepare for your treatment correctly. To decrease the risk of bruising, you should avoid using alcohol the day before or blood thinners for about two weeks before having BOTOX® injections (or any other cosmetic injections).
Can Starting and Stopping Neuromodulator Treatment Cause Problems?
One of the best things about neuromodulators is the flexibility they offer patients: you can start or stop BOTOX®, Jeuveau, or Dysport® whenever you want, without worrying about adverse effects. You may notice that your wrinkles gradually return within six months of stopping treatment, but your creases will probably be less noticeable than they would be if you never had BOTOX®. Researchers believe that having regular neuromodulator injections reduces stress on the skin, potentially slowing wrinkle formation.
What is the Difference Between BOTOX®, Dysport®, Xeomin®, and Jeuveau?
BOTOX® was the first injectable neuromodulator approved for cosmetic use by the FDA. BOTOX® was granted FDA approval for the treatment of glabellar lines (vertical lines between the eyebrows) in 2002, but it has been used medically since the 1970s. BOTOX® has a proven history of producing effective results, which makes it most patients’ first choice. Many people have been receiving BOTOX® injections for almost 20 years without experiencing adverse health effects, so we know this compound is generally safe for long-term use.
BOTOX® is often used “off label” to treat other wrinkles around the eyes and brows, such as crow’s feet and frown lines. Some clinicians also use BOTOX® to target certain wrinkles on the lower face, like smile lines, and to slim the jawline.
Dysport® is BOTOX®’s most well-known competitor. Unlike BOTOX®, which takes five to seven days to act, Dysport® can create visible results in as little as two days. The active ingredient in Dysport® also contains smaller molecules, so you may need less product if you choose Dysport®. This difference in composition also means that Dysport® spreads out after injection slightly more than BOTOX® does. Dysport® may therefore be better at treating diffuse, smaller wrinkles, while BOTOX® offers more precise results.
Xeomin® differs from BOTOX®, Dysport®, and Jeuveau in the fact that it contains only purified botulinum toxin, with no added ingredients. Some experts believe that using only botulinum toxin can prevent resistance to the effects of neuromodulators. (Some people notice that BOTOX® and Dysport® become less effective over time because their bodies develop a tolerance to both compounds.) Xeomin® produces results that are virtually indistinguishable from those of BOTOX®.
Jeuveau is the latest neuromodulator to be granted FDA approval for cosmetic use. Aside from using a slightly different form of botulinum toxin, Jeuveau sets itself apart from similar compounds by its price tag. Jeuveau is less expensive than either BOTOX®, Dysport®, or Xeomin®, even though it creates very similar results. There’s only one caveat to be aware of when choosing Jeuveau over more established neuromodulators: To keep the cost of Jeuveau low, Evolus decided not to have their product approved for medical uses. This means that if you want to use a neuromodulator to treat migraine headaches, for example, you won’t be able to receive any insurance coverage if you choose Jeuveau.
Comparing the Cost of BOTOX® and Jeuveau
BOTOX® usually costs between $10 and $20 per unit, depending on where you’re getting your injections and how qualified your injector is. Jeuveau is expected to cost 20-30% less or about $8 to $16 per unit. This might not sound like a big difference, but it adds up: Most people need about 20 units of BOTOX® per treatment, so switching to Jeuveau could save you $40 to $80 each time you receive injections.
Should I be Concerned When I See Discounted Specials?
Now that multiple neuromodulator options are available, the prices of these compounds are falling. Seeing BOTOX®, Dysport®, Xeomin®, or Jeuveau offered at a discount isn’t in itself a cause for alarm, but you should still review special offers carefully. When you see one of these compounds being offered at a discount, make sure the injector is properly qualified and operating in an accredited medical facility. Avoid attending “BOTOX® parties” and other informal events where BOTOX® injections are offered. You may encounter black-market knockoff products at these events. The impure substances injected at these parties can be incredibly toxic.
What Happens if I Change to a Different Neurotoxin?
Most people don’t notice any change in their results after switching from BOTOX® to another neurotoxin, like Dysport® or Jeuveau. However, in rare cases, patients report that one compound works much better for them than the other available options. This difference can be attributed to natural variations in human physiology.
If you switch to another neuromodulator and don’t like your results as much, you can resume using BOTOX® again after a few months have passed. Experimenting with neuromodulators is safe, as long as you allow one compound to wear off before trying another.
Who Can Inject BOTOX®?
Unfortunately, BOTOX® and other neuromodulators are not federally regulated. This means that (in some states) virtually anyone can inject BOTOX® or Jeuveau without facing legal repercussions.
To make sure you have a safe and comfortable injection experience, you should take the time to verify your injector’s credentials. Your injector should be Board Certified in a specialty that is trained in cosmetic procedures such as a Facial Plastic Surgeon, Plastic Surgeon, Dermatologist or Oculoplastic Surgeon. There are many highly qualified and talented nurses, nurse practitioners, physician assistants and nurse anesthetists who inject neurotoxins, and the best way to know that these individuals are well trained is that they work with one of the Board certified specialists cited above.
Why Should I Choose an Injector Who Specializes in Facial Cosmetics?
Choosing an injector who specializes in facial cosmetic procedures, such as a facial plastic surgeon, generally leads to more flattering results. Board-certified facial plastic surgeons have an in-depth knowledge of the muscles that control the face because they receive, on average, about ten years of education and training. As such, they know how to target the muscles that create wrinkles without altering the patient’s ability to make facial expressions.
Where Can I Learn More About BOTOX® and Jeuveau?
If you’re interested in trying BOTOX®, Dysport®, or Jeuveau, our team of experts can help you choose the right product to meet your needs. To learn more about these compounds, contact Faces PLLC in Ridgeland, Mississippi at (601) 607-3033. Dr. J. Randall Jordan and Dr. J. George Smith will be happy to answer any questions you have about neuromodulators. You can also reach out to us via our online form. We look forward to your call or visit!