…and other related queries answered by Dr. V
Q: If Botox is the brand name, what actually is it, and what other brands are there?
Dr.V: Botox is the brand name for the botulinum toxin type-A, which is an injectable neurotoxin that has been widely used in the anti-aging industry for the treatment of fine lines and wrinkles on the face. Other marketed brands include Dysport, Xeomin, and Jeuveau.
Q: Are there differences between the brands? Is Dysport better than Botox, for example?
Dr. V: There are slight differences in the formulations of each brand, but all of them are very similar in action. It’s sort of like comparing band-aids. Band-Aid brand has become the household name for boo boo strips, when in reality, Curad Bandages are nearly identical with some minor variations. Xeomin is recognized for being a pure toxin, meaning it has no added proteins in it like Botox, Dysport, and Jeuveau. The assumption is, as a pure protein, Xeomin can treat someone who may have developed a resistance to the other brands.
Q: Wait a minute! People can become resistant to Botox?
Dr. V: That’s a great question, with, unfortunately, no clear answer. It is a very controversial topic across the industry. Clinical trials have been unable to prove the presence of neutralizing antibodies in those who feel they’ve become resistant. In practice, however, we have noticed a very small percentage of those patients who have been receiving frequent injections over many years (we’re talking decades), have built up a resistance that shortens the effects of the treatment.
Q: Do you have a preferred brand you work with?
Dr. V: I do, generally speaking. My preference over the years has become Dysport because my experience has shown that Dysport kicks in much more quickly than Botox or the others, 2 to 3 days versus up to 2 weeks. Dysport has also been shown to last longer, with patients showing high satisfaction rates up to 6 months after treatment, according to some recent, large-scale clinical trials. Of course, I have worked with all of the brands, and have learned the minute differences between them, and will certainly use whichever brand best meets the needs of each individual patient.
Q: Are there cost differences between the brands?
Dr. V: The costs between the products are relatively comparable. The cost is generally related to the volume of injections at the practice and the level of training and experience of the injector. For example, I do A LOT of injections in a week, which enables us to buy in bulk at a lower cost, which is then transferred to the client. Also, if your face were a canvas, would you prefer Van Gogh holding the brush or the guy at the mall doing pet caricatures? Van Gogh will cost more, but some things are just worth it!
Q: Is Botox, or injecting any neurotoxin, safe?
Dr. V: Absolutely! Botox, Dysport, and all of the other botulinum toxin type A formulations are extremely safe. There have been tens of millions of these injections done over the years across the globe, and only 36 instances of serious side effects have been reported world-wide, all of which occurred as a result of improper use.
Q: Does Botox hurt?
Dr. V: I’d say no, or just barely. You are getting a teeny tiny needle injected into your face, which sounds harsh, but the needle is so small and it is super quick, that you barely register any pain. Any experienced injector will have plenty of tricks too. I like to use tapping or the pinch & pull technique; maybe a small ice pack. Let’s just say it hurts far less than a bikini wax!
Q: Does Botox prevent wrinkles?
Dr. V: Yes! Especially if you start at an early age. Generally speaking, 30’s is the best time to start because we can catch those animation or expression lines before they have a chance to etch themselves. We can retrain the muscles towards a softer expression, which will help prevent those etched-in lines from forming, like the “11” lines between the brow. An experienced injector will also focus on the depressor muscles, which are the muscles that tend to bring the face down. By relaxing those with Dysport or Botox, it trains the elevator muscles to take over and create that natural, beautiful lift.
Q: Does Botox help under-eye wrinkles?
Dr. V: It’s great for eliminating crow’s feet, or those lines around and under the eyes. Again, you want to start treating those lines before they get really etched in. If they are very deep, it may take an additional treatment, like filler, laser, or chemical peel to smooth them out.
Q: What about smile lines?
Dr. V: Unfortunately, smile lines going from the corner of the nose to the mouth, cannot be treated with Botox, or any botulinum toxin. These lines are caused by volume loss, collagen reduction, and changes in the underlying bone structure, and not by excessive animation. However, marionette lines, which are the lines that go from the corner of the mouth to your chin are often caused by frowning or making a sad face respond well to a small injection of Dysport or Botox. Sometimes you can even get a little lift in the mouth corners which makes your at rest expression look happier, and more approachable. The lines won’t disappear with the injection, but it will absolutely lift the smile.
Q: What’s the deal with Botox and the lips lines? I’ve heard mixed schools of thought.
Dr. V: Neurotoxin injections can be very effective to treat the fine lines above the lips, which are caused by pursing the lips, or the kissy face. This does, however, require a special technique and should only be done by an advanced injector, because, if it is not done properly, it could cause an asymmetrical smile or difficulty enunciating certain words or even drinking properly. That said, if done by a highly experienced injector, the results are amazing! It creates a gorgeous, fuller, more youthful upper lip. It is also the best treatment for a gummy smile. If the lines are very deep, I would recommend additional treatment with filler or lasers.
Meet Dr. Vanden Bosch!
Dr. V - Neda Vanden Bosch is an highly-trained physician and sought after injector of dermal fillers and neurotoxins. With over 10 years of experience in aesthetic medicine, she is a faculty member of the prestigious Galderma Injection Training Network (GAIN) and trains physicians how to perform cosmetic procedures. Dr. V was recently named to Galderma's Top 100 Injectors. She has had extensive training and experience with collagen stimulators, laser and radiofrequency treatment, as well as skin care. Dr. V is licensed in 10 states. She is board certified by the American Board of Radiology. Dr. V has treated thousands of patients with injectables and has numerous of hours of experience perfecting specialized injection placement to correct facial volume loss and facial asymmetries. Preciseness with a woman's deft touch means the best and longest lasting results from volume replacement treatments. Most recently, Dr. V was named a "Top Doctor" by online, aesthetic and cosmetic treatment community Realself.com. This recognition is awarded to less than 10% of doctors site wide.