Botox® & Dysport®

There is now an approved competitor to Botox® called Dysport®. If you have any questions about this please ask.

Many wrinkles are actually creases that have been worn into the skin by making the same expression thousands of times. These are called "expression lines" or “dynamic wrinkles”. Typical dynamic wrinkles include “frown lines” between the eyebrows, “crow’s feet” around the eyes, and forehead lines. The presence of these wrinkles can add years to our appearance, often making us look angry, tired or worried when we are not.

Now, thanks to a new use for an approved drug, Botox®, or Dysport®, these lines can be dramatically softened. The procedure known as Neuromodulation uses Botox®/Dysport® injections to improve the appearance of worry lines, frown lines, laugh lines, crow's feet and other dynamic wrinkles.

Botox®/Dysport® can help you to control your facial expressions so that you don't look angry or worried when you aren't. Botox®/Dysport® treatments can help to prevent the unintended display of negative feelings, and in this way help some people to express themselves more accurately.

If dynamic wrinkles are starting to make you look older or more “negative”, Botox®/Dysport® can help restore the rested, confident appearance you desire.

Botox®/Dysport® has been used safely and effectively for many many years in adults and even in small children to treat many medical conditions where overactive muscles require relaxation such as cerebral palsy. Each year hundreds of thousands of patients receive Botox®/Dysport® treatments for a variety of medical conditions, and Botox®/Dysport® has also become a leading treatment for reversing some of the visible signs of aging by relaxing the muscles which cause many of our wrinkles. Botox®/Dysport® is also a leading treatment for excessive sweating, and for migraine and tension headaches as well as neck and back pain.

Botox®/Dysport® is a highly purified, naturally occurring protein which has the ability to very precisely relax the muscles to which it is applied. This relaxation lasts for a number of months, and then the treated muscles gradually return to their original condition.

Botox®/Dysport® does not affect the nerves responsible for sensation, so there is no numbness in the treated area.

The benefits of Botox®/Dysport® on wrinkles come from the ability of Botox®/Dysport® to selectively and precisely relax the muscles which are causing wrinkles to occur. The skin over the treated muscles gradually becomes smoother and less wrinkled as the muscles relax.

The treated muscles usually start to relax within a day or two, and reach their maximum degree of relaxation within a couple of weeks. About 3 or 4 months after the first treatment, the effects of the Botox®/Dysport® gradually start to wear off. If you liked the effect of your Botox®/Dysport® treatment you will want to return for another treatment before the Botox®/Dysport® effect has completely worn off.

If you have a second treatment before the treated muscles have returned to their old bad habits, your second treatment will usually last longer (perhaps 4-5 months, instead of 3-4 months). Likewise, if you have your third Botox®/Dysport® treatment when you notice that the second treatment is starting to wear off, the third treatment may last 5-6 months instead of 4-5 months. It is common, after a couple of years, for people to go 6-12 months between treatments.

Untreated facial muscles continue to contract in their usual way, so that normal facial expression is unaffected. Because it relaxes the muscles that cause dynamic wrinkles, Botox®/Dysport® treatments can also prevent new lines from forming in the areas on your face, forehead and neck which are treated.

A common use for Botox®/Dysport® is to reduce (often by 70-80%) the deep furrows and lines that many people have between their eyebrows. These lines can make people look quite angry or concerned, even when they are happy. Crow’s feet around the eyes can also add years to your appearance, and make you look like you are squinting much of the time. Crow’s feet usually improve nicely when the muscles which cause the crow’s feet are treated with a bit of Botox®/Dysport®.

Not all facial wrinkles are related only to the activity of underlying muscles. These deep creases and skin folds (also known as “static wrinkles”) are the ones that can still be seen when the skin is lightly stretched with your fingers. “Static wrinkles” are made worse by sun exposure, by the natural maturing process, and in particular by smoking. Many “static wrinkles” result from a combination of muscle activity and aging, and can be greatly improved when Botox®/Dysport® (to relax the underlying muscles) is used in combination with filling substances like Restylane®.

In some cases, Botox®/Dysport® can be used to delay or eliminate the need for a surgical procedure like a facelift, browlift or necklift; and Botox®/Dysport® can be used to prolong and enhance the effects of those procedures if you have already had them done.

However, this procedure cannot improve wrinkles due to aging and sun-damaged skin since they are unrelated to facial muscle contractions. Botox®/Dysport® injections will not improve sagging skin or replace the need for a facelift or brow lift. In these cases, as previously mentioned, you may wish to consider an alternative like Restylane®. Please see our sections on these topics for more information.

Neuromodulation with Botox®/Dysport® is a simple and safe procedure. Using a tiny microneedle, a very small amount of Botox®/Dysport® is injected, very precisely, into several locations on the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the injections is minimal. Most patients compare the sensation to a mosquito bite. No sedation or local anaesthetic is required, and you can resume normal activities immediately. You can even drive yourself home or back to the office. Some patients experience a slight temporary bruising at the injection site, usually less than 1 – 2 cm. With ice and covering with make-up this generally is not noticeable and usually lasts less than 2-3 days. Botox®/Dysport® treatments take only a few minutes and are performed personally by Dr. Waldron. A small amount of discomfort may be felt when the needle is inserted and a few drops of Botox®/Dysport® are applied to exactly the muscles which need relaxation. This sensation lasts approximately 5 seconds.

There have been no long-term side effects, allergic reactions or health hazards related to Botox®/Dysport® use thus far. Some patients have been getting Botox®/Dysport® treatments for 20 years or more, with no problems.

Bruising is the most common temporary side effect. In some cases, Botox®/Dysport® can migrate and cause a temporary weakness of nearby muscles. In rare cases, there can be a drooping of an eyelid or asymmetry of facial expression. The risk of any side effect depends on the muscles injected. Because the effects of Botox®/Dysport® are reversible, any side effects are temporary, lasting only a few weeks.

People who are pregnant, breast feeding, have rare neurological disorders like Eaton-Lambert syndrome or myasthenia gravis, or who are allergic to albumin should generally not be treated with Botox®/Dysport®.

You will be provided with extensive details as to the possible side effects before your treatments. Be sure to carefully read the appropriate consent form we will provide and ask any questions you may have, before any treatment.