Wrinkle Warriors: What's In A Name?

Tired of people asking you "Are you tired" or "Are you mad"? Everyone could use a bit of a "pick me up" now and then, right? When it comes to fighting gravity, that little lift is easy with a lot of options.

Most people researching quick, one-hour make overs for their faces are familiar with "Botox." Botox became a cosmetic medicine by accident when a doctor, treating a patient for eye spasms, noticed that the eye being treated had no wrinkles! Wha-la, the birth of Botox.

It is approved by the FDA for cosmetic procedures as well as migraines and hyperdrosis(extreme sweating). We now have three toxins to choose from: Botox, Dysport and Xeomin.

Here is a perfect example of similar products that deliver similar results with different labels at different price points. Kleenex, Scotts and Puffs tissue. Most people ask for a Kleenex even if what they mean is a tissue. And people ask for Botox not realizing that there are Dysport and Xeomin available.

So what is the difference between them if they are all neurotoxins?

The most important difference is what the literature, approved by the FDA states. Botox lasts up to three-four months, Dysport lasts up to four months and Xeomin lasts up to three months. The literature also states that it can take 7-10 days to see the full effect but that you should see some effect within three days.

The next difference is in the units that a service dose is measured. Most practitioners use an insulin syringe to deliver the product. Each line on the syringe indicates one unit depending on how the product was reconstituted. Botox and Xeomin, when reconstituted with 1cc of normal saline, is equal. Meaning that each line is one unit. With Dysport, 3 units are equal to 1 unit of Botox. This is reflected in the price.

At Vita Nova Medical Spa, the price of Botox is $12.00/per unit(when not on sale). Dysport is $4.00/per unit(when not on sale). So $4.00 x 3= $12.00. Same as Botox. Because Xeomin, the new kid on the block, from the makers of Radiesse, is new to the line-smoothing market, it is at a promotional price at participating offices.

Another huge difference is how doctors charge for the product. For example some charge by the area. Meaning for example the forehead, between the eyes and the crows feet around the eyes. I had a patient who spent $750.00 for that area and when she came to me, I assessed her and she only needed 35 units. Botox was on sale for $10.00 so her total was $350.00. A far cry from what she had paid by the "area."

We have two kinds of lines on our faces. Dynamic lines are those you only see when you animate. Static lines are lines that are beginning to be etched into the skin. Once these become deep they begin to look like scars in some cases. And if you want them erased, you are looking at a CO2 resurfacing laser. This is more costly.

I consider treating facial lines and wrinkles as preventative maintenance. I get my teeth cleaned to prevent cavities and root canals and I get Dysport to prevent deep etched lines. I don't want to look 25 years old, I just want to look the best that I can for my age.

I am often asked which toxin I prefer. I advise patients to do a comparison test by first trying one, noting the longevity you get, and then doing the same with another toxin. This way you can choose the one that lasts you the longest.

Just remember toxins cannot be used if you are pregnant or if you are taking certain antibiotics. Patients with myasthenia gravis, ALS or history of facial nerve palsy.

Coming soon in my next blog: Dermal Fillers, everything you wanted to know but were afraid to ask.