What is a Neuromodulator?

Neuromodulators, Botox, Dysport and Jeuveau, are used in treating facial wrinkles such as in the forehead, between the eyes, and in the “crows feet” areas. Botulinum toxin works by weakening the muscles of facial expressions. Once the resting tone of the treated muscles are weakened, the pull of the muscles relax and the overlying skin flattens. By physiologically weakening the muscles, wrinkles are lessened naturally. This approach is different from dermal fillers which work by filling in wrinkles or depressions.

How Long Does it Last?

Injection of this material into the small muscles between the brows, in the forehead, and at the corners of the eyes causes those specific muscles to halt their function (be paralyzed), thereby improving the appearance of the wrinkles. This paralysis is temporary, and lasts about three to four months.

How is it Used?

Using a very tiny needle, small amounts are injected into the muscles to be treated. Depending on the areas being treated, 5-15 needle pricks (or more) may be required. Discomfort is minimal.

Side Effects

The needle may puncture a small blood vessel during the injection and a bruise may develop. Such an area can last 5-10 days and may require makeup to cover. Your bruising risk can be decreased by discontinuing aspirin, ibuprofen or other blood thinning substances three weeks prior to your treatment.

If any of the botulinum toxin reaches a facial muscle not being treated, partial weakness of that muscle may last for several days to weeks. For this reason, you are requested not to massage the injected area for 12 hours following the injection. If an untreated area experiences muscle weakness, the only “treatment” is to wait for the effect of the toxin to wear off.

There are no recognized permanent side effects of neuromodulators. Complications are rare but may include paralysis of a nearby muscle, resulting in its temporary loss of function (e.g., a drooping eyelid). Botulinum has been used safely in the treatment of muscular facial spasms for many years.

Neuromodulators in Combination with Facial Surgery

Neuromodulators injected in conjunction with nearby facial surgery has caused unwanted facial weakness in at least one patient. For this reason, we will inject neuromodulators only as an isolated facial procedure or treatment.


The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

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