Yes. In the 1970s scientists stared using botulinum toxin (Botox) in the treatment of strabismus (crossed eyes) and noticed that i reduced lines in the glabella region (frown lines). Botox was first approve for use for cosmetic purposes for frown lines by the FDA in 2002 and has been safely used for medical and cosmetic purposes for over 20 years. Xeomin was first approved by the FDA for the treatment of glabella lines in 2011.

Always make sure you are getting authentic Botox by seeking a reputable provider who purchases Botox from Allergan. If you are unsure, ask to see the vial of Botox, it will have the Botox cosmetic logo and a holographic image that says Botox.

Botox and Xeomin are injected into the muscle and work by temporarily blocking the nerves to the muscle reducing the contractions and giving the overlying skin a chance to rest, smoothing out lines and wrinkles. It won’t work on lines caused by gravity or sun damage although we do have other options for treating these lines too.

People often liken the treatment to a tiny sting and some feel nothing at all. The needles are very small, and most will describe it as mild discomfort. It does trigger some people to sneeze. No anaesthesia is necessary as it would be more painful to inject the anaesthetic and there are additional risks with using anaesthetic including topical. Everybody has different pain tolerances, and some people find during periods of stress, it may be slightly more painful. We use a special saline preparation that helps reduce the sting and makes it more comfortable for the patient.

Botox and Xeomin are not recommended during pregnancy and breastfeeding or if you are actively trying to conceive, in those with neuromuscular disorders such as myasthenia gravis, Lambert-Eaton syndrome and amyotrophic lateral sclerosis, if you are taking certain muscle relaxants and antibiotics such as aminoglycosides, bleeding disorders, and those with infection or inflammation at the proposed site of injection.

If you have allergies to any of the ingredients in the product you should not have this treatment and if you suffer from multiple allergies or have had any side effects to anti-wrinkle treatments previously, please discuss with your provider first. If you are feeling unwell are recovering from surgery or have an upcoming surgery in the next couple of weeks, it is advisable to delay treatment. Your current medical history will be
checked with you at your cosmetic consultation and prior to any injections. Please make sure you disclose any new medications and changes to your medical history as they arise as these treatments are medical treatments and your safety is our priority.

The treatment typically takes 7 to 14 days to take full effect, but you may notice changes as soon as 3 days.

The effects last around three to four months for most people, but there can be variations in this, and it is often determined by the dose and individual responses. Some treatment areas tend to respond better than other areas.

An example of this is the difference between the frown and forehead. As the frown muscles are depressors, when injected with the neurotoxin, the muscles will stop pulling and contracting downwards and the treatment will work to make this area appear lifted and well rested. The forehead muscle however is an elevator and lifts, so when injected it relaxes the muscle and can in some people cause a drop in the brow, which we want to avoid. This is why every patient is assessed based on their individual
and unique facial structure. Some people are not good candidates for forehead treatment or require a smaller dose and injections to other muscles to help counteract these potential effects, and therefore may not get the same longevity as they do in other areas due to the reduced dose. This is all discussed in detail at your consultation.

There is no downtime. You can return to work or most normal activities directly after treatment, so long as you do not do anything to cause pressure to this area over the next four hours, and stay upright following treatment. This includes no strenuous exercise, saunas, hot yoga, alcohol, massage to the area or any other activities that could potentially cause pressure. You may have some temporary redness and swelling, but this usually goes down with half an hour, and although bruising is unlikely if you develop bruising, this can easily be concealed with makeup. You need to refrain from any facials, or face treatments, including facial massage for one week after injections.

Certain herbal and natural medications can increase your risk of bruising such as Omegas, Fish Oil, Tumeric, Vitamin E, and Green Tea. Most people will discontinue these about one week prior to treatment and one week post treatment to help further avoid bruising. Please do not discontinue any medications that have been prescribed to you from your Dr.

Probably not. We tailor the treatment to suit your face preserving some expression and creating a softer appearance but still natural. We favour the “natural” look over the “frozen” look, and most of our clients do too! If your friends are having it done and know what to look for they may suspect, but would never know unless you told them. People are often misled by social media and celebrities that look overdone. This is likely a combination of several different treatments, too much product, filters, and bad technique. The ones you see who look good for their age, are probably having these treatments, they are just doing it well.

The results are temporary and in most cases will last around three to four months, so continued treatments are needed to maintain the effects.

You may have a tiny red bump or be slightly red at the injection point, which will usually disappear in about 10 minutes. Some people may get a small bruise. We do not advise that you use makeup over the treatment area for the remainder of the day to prevent the risk of infection.

You should not lie down flat for the four hours following your treatment or put any pressure on the area (e.g. a bike helmet or lean on your hand). No alcohol on the day of treatment. You should refrain from exercise and any activities that cause excessive heat to the area for the next 24 hours including intense gym workouts, hot yoga, spas and saunas. No invasive or semi-invasive treatments to the area for the next two weeks (microblading, IPL, facial massages etc). Not following these instructions could cause the neurotoxin to diffuse into adjacent muscles increasing the risk of undesired side effects and/or increase the risk of bruising.

While you may not experience any side effects there is always the possibility of side effects with any medications. The doses used in cosmetic medicine are very small, and side effects are usually localised to the injection site and temporary. The most common side effects are pain and stinging at the injection site, redness, and bruising. Occasionally you may get a headache, adjacent muscle weakness, droopy brows, or eyelids, swelling, skin itchiness and tightness. Adverse or allergic reactions are very rare and when performed by an experienced practitioner these injections are typically considered safe.

The injections do not take long, typically a few minutes (although your appointment will take longer as we will always consult with you to determine if there are any contraindications and prep your skin, work out dosage and allow time for questions). Some people choose to have only one area treated while others may have multiple areas, so we allow 30 to 45 minutes for a returning patient appointment and 1 hour to 1.15 hours for a new patient appointment which includes the cosmetic consultation. People will often have this treatment on their lunch break and return to work with nobody knowing they have had anything done.

All our new patients are offered a free follow up appointment at two weeks. This allows us to check how you have responded to the treatment and inject additional units if required. We only do this if necessary and a small amount as if the injections are spaced too frequently together this could increase the likelihood of developing resistance.

We like to rebook patients for their next treatment between three and four months, as we want to retreat before the muscle has had a chance to fully regenerate again. As the treatment wears off, the muscle contraction and overlying lines will start to return. It is like a bell-shaped curve and will peak at around the two week mark and then hold before very gradually reducing and movement slowly returning. Retreating before the muscle has a chance to fully regenerate increases longevity in further treatments as the muscle is not as strong. If too long is left between treatments and the muscle has regained full strength, then you may not get the longevity otherwise acquired.

It is a common misconception that if you stop anti-wrinkle injections then your lines will come back looking worse than pre-treatment. This is simply not true. If you decide to discontinue treatments your muscles will return to normal activity and your lines or wrinkles will start to appear again. While you were having treatments you were preventing these lines from worsening and softening them. As the treatment wears off they will gradually start to appear again.

Xeomin contains a naked form of botulinum toxin as it does not have any complexing proteins like other brands do. Botulinum toxin is a protein complex that contains neurotoxin and complexing proteins, but Xeomin is produced to deliver the neurotoxin without any of these protein additives. This means you are less likely to develop antibodies to it and it lowers the risk of an allergic reaction. This also means that it does not need to be stored at refrigerated temperatures until it is reconstituted, as Botox and Dysport do, so is able to be shipped using more environmentally friendly options.

As these are prescription medicines only a doctor or a registered nurse working under the doctor’s supervision can perform them. At CosMedic Clinic Jaime works under standing orders from Dr Henryk Poczwa from Vein and Skin Institute and member of New Zealand Society of Cosmetic Medicine (NZSCM). Jaime meets regularly with Dr Poczwa in person and has been working under his supervision since 2017. It is important to ask about your injectors experience and qualifications when choosing your injector. Jaime obtained her Bachelor of Nursing Degree in 2002 and has worked as a RN for over 20 years with 13 years working as a cosmetic nurse. She attends regular conferences and training sessions and always keeps up to date with education to ensure best practice. She is a member of Clinical Aesthetic Network New Zealand (CANN) and Complications in Medical Aesthetics Collaborative (CMAC) and her oversight Dr is a member of the New Zealand Society of Cosmetic Medicine (NZSCM).

Botunlinum toxin type A is a neurotoxin produced by a bacterial species called Clostridium botulinum and is the active ingredient in all these brands. It is a protein complex that contains neurotoxin and complexing proteins. Xeomin is produced to deliver the neurotoxin without any of these protein additives meaning that there is less risk in building antibodies and becoming resistant to the treatment and lowers the risk of an allergic reaction. It also enables it to be stored at room temperature until it is reconstituted and therefore can be shipped using more environmentally friendly options.

As Dysport is more diluted it is thought that it diffuses or spreads over a larger area whereas Botox and Xeomin are more localised to the area they are injected, so are potentially more effective in treating stronger muscles that need more attention, and less likely to diffuse into adjacent muscles causing undesired side effects.

Botox has been approved for cosmetic use for the longest and is perhaps the more well known of the neurotoxins.

The formulas used in each are slightly different based on the proteins used and cause them to have different potencies and behaviours which could contribute to duration and onset, but they are all working by blocking nerve signals to the muscles and are all effective and safe cosmetic injectable options that are very similar. Most of the studies in the literature comparing brands are conflicting.

Dysport also contains lactose and may contain trace amounts of cow milk proteins, so if you have a cow milk allergy you should not have Dysport. All three medications contain human albumin; Xeomin also contains sucrose, while Botox contains sodium chloride.

Botox contains botulinum toxin type A, albumin (human) and sodium chloride.

Xeomin contains botulinum toxin type A, albumin (human), sucrose. Xeomin does not have any complexing proteins like other brands. Botulinum toxin is a protein complex that contains neurotoxin and complexing proteins. Xeomin is produced to deliver the neurotoxin without any of these protein additives.

For patients new to CosMedic Clinic who would like Botox/Xeomin (anti-wrinkle) treatment on the same day as the consultation you can book Botox/Xeomin treatment - new patient (includes consultation).

There is also an option for a cosmetic consultation on its own if you do not want to have treatment on the same day.

If you are an existing patient and have not yet spoken to us about this treatment, you will need to book a cosmetic consultation.

As these are prescription medicines only a doctor or a registered nurse working under the doctor’s supervision can perform them. At CosMedic Clinic Jaime works under standing orders from Dr Henryk Poczwa from Vein and Skin Institute and member of New Zealand Society of Cosmetic Medicine (NZSCM). Jaime meets regularly with Dr Poczwa in person and has been working under his supervision since 2017. It is important to ask about your injectors experience and qualifications when choosing your injector. Jaime obtained her Bachelor of Nursing Degree in 2002 and has worked as a RN for over 20 years with 13 years working as a cosmetic nurse. She attends regular conferences and training sessions and always keeps up to date with education to ensure best practice. She is a member of Clinical Aesthetic Network New Zealand (CANN) and Complications in Medical Aesthetics Collaborative (CMAC) and her oversight Dr is a member of the New Zealand Society of Cosmetic Medicine (NZSCM).

Botox and Xeomin treatment can be a stand-alone treatment or combined with other services to further enhance your treatments and meet your aesthetic goals. A personalised treatment plan can be created at your cosmetic consultation. Treatments typically combined with Botox and Xeomin include:

Medical grade skincare - prescribed for your individual skin care needs to improve skin health and quality improving the overall result of your treatments and aiding recovery time.

Profhilo (bioremodelling) - used to provide deep hydration and improve mild to moderate skin laxity. Profhilo also works well as a preventative treatment as it stimulates fibroblast cells to increase collagen and elastin formation and has been shown to preserve fat stem cells under the skin lost with aging. This is not a volumising product like dermal fillers.

IPL photorejuvenation - to reduce redness, rosacea, pigmentation, sunspots and improve skin tone.

Dermal Filler - to volumise areas that have lost volume over time and fill deeper lines where reduced muscle contraction is not recommended. Dermal filler is also used for definition, volumisation and hydration to the lips.

Tixel Resurfacing – Tixel is an energy-based skin resurfacing treatment used to reduce lines and wrinkles, improve pigmentation, skin texuture, scarring and stretchmarks including scarring from acne and in the treatment of active acne. Unlike other treatments it can be used safely around the delicate eye area, an otherwise difficult area to treat. Tixel bridges the gap between microneedling and fractional ablative laser, but with less downtime than laser.

DermaFrac (microneedling with serum infusion) - combines collagen induction therapy with needling, suction to aid in lymphatic drainage and serum infusion in a quick, low pain, low downtime, and effective treatment. Used to improve skin texture, hydration, brightness and reduce the appearance of pigmentation, dark spots and acne.