Wrinkle Reduction - Marlene J. Mash, MD

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Wrinkle Reduction

Cosmetic Dermatology
Looking into the mirror and seeing too many fine lines around your eyes? Do you see frown lines between the eyebrows? Wrinkle Relaxers are an excellent treatment option for you to create a smoother, more youthful appearing face and used to specifically reduce unwanted facial wrinkles caused by expression. Often  referred to by their product names, BOTOX®, Xeomin®, and Dysport®, wrinkle relaxers are most often performed on the brow (glabella), forehead, around the eyes (crow’s feet), on the ridge of the nose (bunny lines), on the border of the lips (perioral wrinkles along the vermillion border), and neck. There is no downtime and minimal discomfort and risk. Dr. Mash and her professional injectors will help you decide which one is the best for you.

Injection of very small amounts of these products into the appropriate muscles will block the transmitter chemicals which are necessary for the nerve impulses that control muscle contraction. This will cause the muscle to stay in its relaxed and uncontracted position. Intricate knowledge of the facial muscles, their insertions and attachments and their function in regards to facial movement is vital for successful treatment.

Because there are different causes of wrinkles, we need different solutions. In addition to wrinkle relaxers, most patients require dermal fillers to complete the desired results. A complimentary consultation is recommended in order for us to recommend the best treatment plan for you. And, using our 'visualizer,' it is also possible to get a good idea of potential results!

Products for you to purchase from our Professional Product Collection. (We recommend our complimentary product consultation before purchasing.)
BOTOX® Cosmetic is the first and only FDA-approved prescription product that temporarily improves the appearance of both moderate to severe frown lines between the brows and moderate to severe crow’s feet in adults. BOTOX® Cosmetic (onabotulinumtoxinA) is a prescription medicine that is injected into muscles and used to temporarily improve the look of both moderate to severe crow's feet lines and frown lines between the eyebrows in adults. (To see more, click on the image to see the changes before your eyes on the Allergan/Botox website.)

BOTOX® Cosmetic works beneath the skin's surface and targets the underlying muscle activity that causes frown lines and crow's feet to form over time.
We will inject BOTOX® Cosmetic into the muscles that cause frown lines and crow's feet lines, temporarily reducing the activity of those muscles. The result is a reduction in the appearance of those lines.
Dysport is a wrinkle relaxer very similar to Botox. The desired effects are the same and Dysport is used in the same way to relax frown and worry lines and smooth wrinkles. The difference is in the dosing units. Dysport unit number requirements are higher, though this does not mean the product is less effective. It is simply the way the product is diluted and delivered. (To see more from the makers of Dysport click on the image below.)

Possible differences:
  • Time to effectiveness. Dysport is said to be faster-acting for some patients
  • Diffusion “spread” may be better and thus may be more widely effective for forehead wrinkles
  • Longevity – some possible increase in longevity but not determined to be substantial

Dosing units are not comparative to Botox. An average conversion is between 2 to 2.5 units of Dysport to 1 unit of Botox. Your treatment with Dysport will use an equivalent amount of the neuroprotein. As with Botox, individual requirements will vary with men generally requiring more units for full effect than the units required by women.

For those who have developed antibodies to Botox which makes it no longer effective or less effective, Dysport is a welcome addition to the wrinkle-fighting arsenal.
Xeomin is the latest product developed to reduce or prevent frown-causing muscle contractions. Recently approved in the U.S. by the FDA, Xeomin, pronounced zee-oh-min, acts similar to its predecessors Botox and Dysport. The new “tox” product is designed to stop the contractions of the glabellar muscle between the eyes.

(To see more from the makers of Xeomin click on the image below.)

Xeomin is somewhat different from Botox and Dysport. The difference in Xeomin (incobotulinumtoxinA) is that it does not carry the proteins that are typical of the other products. The manufacturing process removes the proteins so that Xeomin is referred to as the “naked” botulinum product. The potential advantage lies in the lessened likelihood of antibodies being formed to the proteins which – for a very limited number of patients – can render the product ineffective. (This typically is only seen in patients who have used botulinum toxin for an extended period of time.)
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