Cosmetic Plastic Surgery Articles

Facial rejuvenation procedures continue to be the fastest-growing segment of cosmetic plastic surgery, and botulinum toxin type A injections are one of the biggest reasons why. Last year, close to 7.7 million of them were done in the United States, which set a new annual high, according to the American Society of Plastic Surgeons.

(Dermal fillers were second on the list of most-performed cosmetic procedures last year, at 2.7 million.)

You’re probably more familiar with the different brand names of botulinum toxin type A: Dysport, Xeomin, Jeuveau, and, of course, Botox. While there are subtle differences between them, they all work the same way, essentially. 

In order for any muscle to contract, the nerves release a chemical messenger called acetylcholine at the point where nerve endings meet muscle cells. Acetylcholine attaches to receptors on the muscle cells and causes the cells to contract, or shorten.

Botulinum toxin type A injections prevent the release of acetylcholine, which stops the muscle cells from contracting. Basically, they temporarily put the muscles to rest, which helps the muscle become less stiff. In the process, they also temporarily minimize or eliminate altogether creases and fine lines that stem from the constant contraction of those muscles, like forehead wrinkles, crow’s feet, and the dreaded “11” between the eyebrows.

Which one is right for you?

Without getting too technical, a board-certified plastic surgeon distinguishes between the brands based on subtle but significant differences, like how much it will spread after it’s injected. 

First, they’ll want to hear all about your expectations for the procedure. They’ll then be able to select the botulinum toxin type A that’s best suited for that particular area of the face and the desired outcome.

Much of the outcome, however, will come down to the injector. For example, the pressure that’s used to inject the botulinum toxin type A can have a big impact on the results. Also key is the injector’s knowledge of the muscles in the targeted area. It may seem fairly straightforward—rest the muscle, the lines disappear—but the human body is a series of intricate, interconnected networks.

In other words, for every action, expect a reaction.

Case in point: In order to lift the forehead, botulinum toxin type A should be injected into the depressor muscles around the brow, because they’re the ones working to pull the brow (and forehead) down. But simply injecting those muscles isn’t enough. The injections need to be precise because if they land in the wrong parts of the depressor muscles, the botulinum toxin could seep into the frontalis muscle, which lifts the forehead. 

The result in that scenario is an even heavier-looking brow than what the patient started with. And it’s surprisingly common.

Expertise matters most

I have extensive experience with doing botulinum toxin type A injections. Even more, I train plastic surgeons, dermatologists, and nurses across the country on behalf of all of the aforementioned brands in how to use them appropriately and accurately.

I’m convinced of their value in creating a younger, more vibrant appearance. But I also know that those results depend more on who’s doing the injecting than which brand is being injected.

If you would like to discuss your options, my team at Davis Cosmetic Plastic Surgery is available to answer questions and schedule your virtual consultation.