Discover Neuromodulators: Botox, Nuceiva, Dysport, and Xeomin

In this episode of “Anti-Aging Insights,” Dr. Teri Fisher dives into the world of neuromodulators, covering popular treatments such as Botox, Nuceiva, Dysport, and Xeomin. Dr. Fisher provides a comprehensive overview, explaining the function and application of neuromodulators in cosmetic procedures. He discusses how these treatments work by interrupting communication between nerves and muscles, reducing movement and the appearance of wrinkles.

Listeners are guided through the differences in dosing, particularly between “Baby Botox” and regular treatments, which is primarily about the amount administered. Baby Botox involves smaller doses and is often used for subtle line reduction or for first-time users who wish to ease into the cosmetic treatment experience.

The episode also addresses common areas treated with neuromodulators, including the glabella, forehead, crow’s feet, and other regions where facial muscles contribute to dynamic wrinkles. While effective for dynamic lines, Dr. Fisher notes that static wrinkles may require alternative treatments like fillers for optimal results.

Dr. Fisher highlights the temporary nature of neuromodulators, noting they typically last around three months, with the effects becoming noticeable within a few days of treatment. Despite being temporary, the treatment provides an opportunity for physicians and patients to build a relationship, offering customized care to achieve desired cosmetic outcomes.

Dr. Fisher encourages potential clients to schedule consultations at his clinic, Anti-Aging Medical and Laser in Kitsilano, Vancouver. He emphasizes the importance of understanding each patient’s unique needs and delivering safe, effective treatments. For those interested in learning more or arranging an appointment, Dr. Fisher invites listeners to explore his website and social media platforms.

Key Insights

• Neuromodulators, such as Botox, Nuceiva, Dysport, and Xeomin, work by interrupting nerve signals to muscles, reducing movement and wrinkles.
• The difference between “baby Botox” and regular Botox lies in the dosing, where baby Botox uses smaller doses, suitable for softer effects or first-time users.
• Common areas for Botox application include the glabella (between the eyebrows), forehead, and crow’s feet, with additional uses for gummy smiles, lip flips, and other facial concerns.
• The effects of Botox injections typically begin to show after 2-3 days, reach full effect by 10-14 days, and last around three months, depending on individual metabolism.
• Botox treatment is temporary and needs repetition every three months, offering flexibility if one chooses not to continue, yet requiring ongoing maintenance for those satisfied with the results.

Episode Transcript

Dr. Teri Fisher: Hey there. Welcome to this week’s episode of the podcast. Today, we’re talking all about neuromodulators: Botox, Nuceiva, Dysport, Xeomin. This is essentially your neuromodulator overview, neuromodulators 101, if you will, and this is again a recording of an Instagram live that I did from Anti-Aging Medical and Laser just recently in the past week. And again there was a lot of valuable information in this episode that I did. I thought I would share it here as a podcast as well. So sit back, enjoy. If you have been wondering about neuromodulators, we cover it all here, dosing, where you inject it, how it works, the whole bit. So I’m going to stop talking and I’m going to transfer over to the Instagram live. Enjoy.

Hey there, Dr. Teri Fisher here at Anti Aging Medical and Laser in Kitsilano. Today we are talking about neuromodulators, and I’m going to give you the quick overview of neuromodulators.

Consider this your neuromodulator 100 course, in about 5 to 10 minutes. What are neuromodulators? You may know neuromodulators as the very common brand name, Botox. There are actually a number of other different types of neuromodulators. So in addition to Botox, we’ve also got Nuceiva, we’ve got Xeomin, we’ve got Dysport. You can kind of think of them as all different versions of the same chemical, which is essentially what they are. It’s like having Coke or Pepsi, same kind of deal. They’ll have slightly different proteins that are attached to them, but they all work in the same way. So what does it do? What does a neuromodulator do?

Well a neuromodulator works by interrupting the signal between the nerve and the muscle. What that means is that when you send, when your brain sends that message to your muscles to contract, whether it’s your hand, whether it’s your face, whenever you are sending a message from your brain to your muscles to contract, that is what is happening, of course. That nerve talks to the muscle, the muscle contracts, and you see the movement.

When we inject neuromodulator, it interrupts that communication. So even if you’re trying to send that message to certain muscles in your face, or wherever they are, wherever you’ve had the neuromodulator, you will find that the muscle is relaxed. It doesn’t respond as well to that nerve impulse, and as a result, you get less movement and you get less wrinkles. And that’s the key when it comes to the neuromodulator. When we are injecting neuromodulator, Botox, Nuceiva, Dysport, Xeomin, in different areas of the face, we are having those muscles relax, and then the overlying skin is not moving as much, and you get less wrinkles.

Now, one of the things that we often get asked here is what is the difference between baby Botox and regular Botox? And the big difference really is the dosing, to be honest. We’re using the same type of Botox, whether we’re doing baby Botox or regular Botox, but the difference is we are using smaller doses.

Now, when someone comes in for an assessment for Botox, neuromodulator. We always want to have a discussion. What do you want to do? Do you want your face to be quite frozen? Do you not want to have any movement so that you have no lines visible at all? If that’s the case, great. We can certainly accommodate that. And that means that you would have a little bit higher dose in order to accomplish that.

If you say, you know what, I just want to soften things a little bit, but I still want to have some movement. Then we’re talking more about the baby Botox dosing where the number of units are much less. Another very common reason to get baby Botox is when somebody’s coming for the first time to get Botox and they just want to have a little bit to see what it’s like to try it. Maybe it’s just in the 11s area, maybe it’s just for the crow’s feet, but they just want to have the slight softening. That also can be classified as baby Botox.

So there are lots of different places that we can use Botox to soften lines or to get rid of wrinkles. It’s very effective at getting rid of dynamic lines, dynamic wrinkles. And what I mean by that is when you move your face and you get those lines that show up as a result of the movement, that is dynamic, it’s moving. And so, as I explained at the beginning, when you use neuromodulator, you soften the muscle, you get less movement, you get less wrinkles.

Unfortunately, Botox is not as good for static wrinkles. Those are those lines that are there all the time, whether or not you are moving. And so in that case, we can use Botox over a series of cycles of Botox. And over time, you may see some softening of those static lines, but oftentimes we might have a discussion about filler in that case, to fill those.

All right, we had a question about where is Botox good. Botox is great in a number of areas of the face. The most common area to get Botox would be right here. It’s known as the glabella, and that’s to deal with these 11 lines from when you’re frowning and you start to develop vertical lines. Very, very common place to get Botox, probably the most common place. Another very common place to get Botox is in the forehead, and when you lift your brow up and you get those lines, we can do injections along there. And actually, while we’re talking about the forehead, I can just show you some examples here, and then I’ll come back and get to the rest of the places where we can use Botox.

This lovely patient, you can see that there’s some lines here. And when you put the Botox in, you put the neuromodulator in, it does take about 10 days to 2 weeks for it to fully have its effect, but then you can see that when this patient is trying to raise the eyebrows up, those lines are no longer there because the muscle isn’t moving as much.

Here’s another similar example of this. So here is a gentleman, and you can see that he’s raising his brow up and you get the wrinkles, you get the creases in the forehead. And once we have injected the Botox and you look at that expression, you get much less.

So again, you can use Botox in this area, the glabella. You can use it in the forehead. You can also do Botox for crow’s feet. So when people smile, you may develop some lines along the side of the eyes, known as crow’s feet. Botox is very effective there as well. Botox can be used for a gummy smile. If you smile and you notice that your teeth are showing a lot, we can put Botox in certain muscles next to the nose, and that can allow that to relax a bit.

We can use Botox for a lip flip. You put Botox in the lip, and it allows the lip to come up a little bit. You can also use Botox for a frown. You can use Botox in the chin. You can use Botox in your traps, if you want to relax traps. You can use Botox in the jaw for jaw pain and for migraines. And you can even use Botox to slim your face by injecting into the muscle. So there are tons of different areas where you can use neuromodulator, and that’s just a sampling.

I wanna show you as well the needle that we use, because some people are wondering if they’ve never had Botox, like what is the process like? And this is the needle that we use typically. It is tiny. It is literally like the size of a little mosquito. So it is a very, very small needle. It’s in fact very similar to the type of needle that somebody with diabetes might use to inject insulin. And the volumes that we use are also very, very small. This needle, if it’s fully loaded, would have 30 units. And to give you an example, we might do an injection with four units. Here is what one unit would look like of Botox. So if I just place the mirror here, and I’m just going to inject out one unit of water, you’ll get to see the size of the volume. That’s one unit there. Okay. So it is a very, very small amount of volume. And so when you have a neuromodular injection, it’s literally like a mosquito. We put that in, we inject this tiny little amount of volume. And that is the process.

Dr. Teri Fisher: As I mentioned, it takes a few days for it to kick in, usually about two or three days for you to start to see the effects. And then it’s really at its full effect after about 10 to 14 days. And it lasts, depending on your metabolism, about three months or so.

So that is the overview of neuromodulators, Botox, Nuceiva, Dysport, Xeomin. And the results of this are extremely effective. It works very, very well. In fact, it’s quite dramatic what you see after a few days of having the Botox or the neuromodulator in your system.

So it’ll last approximately three months. Everybody’s going to be a little bit variable. There’s always a little bit of individual variation based on your metabolism, how quickly your body can process medications. But I would say the general rule is about three months, depending on where you place it in the body as well. There may be some variability there, but the rule of thumb is generally about three months time.

And then and then if you choose to, you can repeat it. It is a completely temporary treatment though, which is something that some people don’t realize, is that there’s nothing permanent about Botox, which can be a good thing depending how you look at it, because if you don’t, for whatever reason, you don’t enjoy it, it wears off after three months and you never have to worry about it. It’s gone.

The downside of that is if you do like it, which people often do enjoy it, is that, well, unfortunately it doesn’t last longer than that. So it is something that you need to repeat every three months. And it’s actually really nice to develop the relationship with patients and be able to see them every three months and see how they’re doing, what’s going on in their lives.

So we are happy to have a discussion with you. Here at Anti Aging Medical and Laser, we have a number of injectors. There’s myself with two other colleagues here that also provide the injections. We’re here every day of the week. And by all means, if you’re interested in learning more about Botox, neuromodulator injections, feel free to make an appointment with us. We really want to make things customized to you because there is an art to this in terms of figuring out the right dosing, where to put the injections, knowing the anatomy and all the things that go along with providing safe, competent care. And that’s really important to us here.

So thanks again for tuning in. Hope that was helpful to you. Hope you learned a lot and we look forward to seeing you here at Anti Aging Medical and Laser. Until next time, it’s Dr. Fisher.

There you go. Hope you enjoyed that information about neuromodulators. As I said, feel free to reach out and discuss this. Come in for a treatment. You can check out the Instagram live on my Instagram at Dr. Teri Fisher, T E R I F I S H E R or at the Anti-Aging Medical and Laser Instagram profile. Of course you can check out my website as well at Dr. Teri Fisher dot com. And thanks for tuning in, and I look forward to chatting with you again next week. Hope you’re doing well. Take care.