What is a Neuromodulator?

Neuromodulators such as Botox, Dysport, Jeuveau and Daxxify are used to treat facial wrinkles in areas like the forehead, between the eyes, and around the eyes known as ‘crows feet’. These substances weaken the muscles responsible for facial expressions. This results in the relaxation of the muscles’ pull and flattening of the overlying skin, which in turn reduces wrinkles in a natural way. This method differs from dermal fillers that fill 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?

The expert performing the treatment injects small amounts of the substance into the targeted muscles using a very tiny needle. They may require 5-15 (or more) needle pricks, depending on the areas being treated. However, discomfort is minimal.

Side Effects

The injection may puncture a small blood vessel and cause bruising, which can last for 5-10 days and may require makeup to cover. To decrease the risk of bruising, you should discontinue aspirin, ibuprofen or other blood thinning substances three weeks prior to the treatment.

If the botulinum toxin reaches a facial muscle that is not intended for treatment, it may cause partial weakness in that muscle for several days to weeks. To prevent this, you should avoid massaging the injected area for 12 hours following the injection. If an untreated area experiences muscle weakness, the only solution is to wait for the effect of the toxin to wear off.

There are no recognized permanent side effects of neuromodulators. Though rare, complications may include paralysis of a nearby muscle resulting in its temporary loss of function, such as a drooping eyelid. Botulinum toxin has been safely used 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 determination of specific risks and the appropriateness of this procedure for a particular individual can only be made during the consultation. All procedures carry some level of risk, with occasional occurrence of minor complications that do not impact the final result. Major complications are rare.

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