Xeomin® (incobotulinumtoxinA) is the 3rd botulinum toxin A to become FDA-approved for the treatment of wrinkles between the eyebrows (angry 11s). It joins
in the U.S. market and can be used in a similar manner by a skilled, board-certified physician. Dr. Palm was one of the first physicians in San Diego to be provided with Xeomin® following its FDA approval.
Xeomin® is closer to Botox® than Dysport® in terms of the "units" used to treat an area—both products are manufactured as 100 unit vials. Dysport® typically takes more "Dysport® units" to have the same effect as Botox® Cosmetic or Xeomin®. There are two very unique features of Xeomin®. As opposed to the other two products, Xeomin® does not require refrigeration. Additionally, Xeomin® is a "naked" botulinum toxin A, meaning there is no additional protein content. This may lower the risk of patients developing antibodies to the product.
What about antibody production and Xeomin® use?
Xeomin® is pure botulinum toxin A, there is no protein content. As a result, the risk of developing a neutralizing antibody should be less. Antibody production causes any botulinum toxin A product to be less effective. This means that wrinkles caused by muscle movement may not improve following injection if a patient has developed antibodies.
How does Xeomin® work?
Xeomin® (incobotulinumtoxinA) causes relaxation of facial muscles. The product works by blocking the communication between nerve endings and their surrounding muscles. Xeomin® is injected into specific regions to treat overactive muscles that cause wrinkles with facial animation. The effect of Xeomin® is temporary and repeat treatments are necessary periodically to maintain the softening of facial furrows and creases.
Will I look expressionless and how long does Xeomin® work?
The goal of treatment with Xeomin® is to soften facial expression. Treated patients can still smile and frown and should not look "frozen." The improvement of wrinkles usually occurs within 2-7 days following treatment. Xeomin® lasts 3-4 months.
Is Xeomin® safe?
Xeomin® was FDA-approved in 2010 for blepharospasm and cervical dystonia and in 2011 for the treatment of glabellar wrinkles (angry 11s). The product is similar in safety to Botox® Cosmetic and Dysport®, both of which have been used in millions of patients worldwide.
Where can Xeomin® be used?
Xeomin® is FDA-approved for moderate to severe wrinkles between the brows (angry 11's) and for blepharospasm (eyelid spasm) and cervical dystonia (abnormal head position). Although Xeomin® is commonly used for the treatment in the upper third of the face, there are many additional areas of the face and neck that may benefit from their use:
- Forehead wrinkles: Small amounts are injected into the forehead muscle called the frontalis to soften horizontal forehead lines.
- Crow's feet: Wrinkles around the eyes that are accentuated by smiling and squinting can be improved.
- Lateral eyebrows: Injection near the side of the eyebrows can keep eyebrows elevated and give a pleasing position to the eyebrow and a more "open" appearance to the upper eyelid.
- Bunny lines: Wrinkles along the sides of the nose that appear when you crinkle your nose can be softened with treatment.
- Gummy smile: A smile that is too "toothy" in which a person's upper gum disappears and only the upper teeth show can be improved by very small amounts of Xeomin®.
- Vertical lip lines: Small lines around the mouth caused by speaking or smoking can be softened with treatment.
- Dowturned mouth: Small amounts of Xeomin® can help to correct downturned corners of the mouth, creating a smile at rest rather than a scowl.
- Pebbled chin: A wrinkly or pebbled chin with changes sometimes referred to as peau d'orange (orange skin) can be improved by injecting small amounts of Xeomin®.
- Neck wrinkles and undefined jawline: The muscle of the neck is called the platysma. With time this muscle separates causing vertical bands called "platysmal bands." Xeomin® can be injected in a specific pattern along the neck and jawline to smooth the bands and help lift the jawline.
- Jaw reduction: The masseter muscle along the side of the jawline can be large in some people, causing the jaw to look big and the face to look square. Small amounts of Xeomin® can be injected into the sides of the cheeks to soften the appearance of the jawline.
- Bell's Palsy: This condition is a facial paralysis resulting from a variety of causes. The non-affected side of the face can be treated with modest amounts of Xeomin® to create better facial symmetry.
- Blepharospasm and hemifacial spasm: Uncontrolled contraction and twitching of the eyelids or face can be improved with treatment using Xeomin®.
- Excessive sweating of the underarm, hands, & feet: Xeomin® can reduce sweating in the armpit, or moistness of the hands or feet. Results typically last longer, sometimes as long as 6-12 months.
What are the side effects of Xeomin®?
Side effects are uncommon with correct placement of Xeomin® by a well-trained, board-certified, core-specialty physician. The majority of side effects are temporary and injection-related. These include localized swelling, pain, or bruising at the site of injection. Uncommon but more serious side effects include headache, tiredness, double vision, blurred vision, or drooping eyelids. Complete safety information can be obtained by asking your doctor for the Xeomin® patient information pamphlet or package insert.
Is treatment with Xeomin® painful?
Treatment with Xeomin® is virtually painless. Very small (insulin) needles are used to administer the products. Numbing cream and ice packs can be used during treatment if desired. Xeomin® is considered a "no downtime" procedure.
How much does Xeomin® cost?
According to the American Society of Plastic Surgeons, the average cost of Xeomin® is $400-$600. Dr. Palm charges by the unit, rather than the area treated. Therefore, a treated patient is only charged for the amount of Xeomin® used.
Can Xeomin® be combined with other procedures?
Yes, Xeomin® is often combined with other procedures to enhance facial rejuvenation. Fillers and volumizing agents such as Juvéderm®
) can be performed during the same treatment session. Xeomin® is often administered to specific areas of the face prior to laser resurfacing to preserve and enhance the wrinkle reducing effects of this procedure.
How Long do results from XEOMIN® last?
Similar to Botox Cosmetic or Dysport, the results of Xeomin last on average three months. The duration of action of Xeomin may vary based on the individual. Additionally, the area of Xeomin placement may determine the duration. Treatment in the upper third of the face such as the forehead or angry 11s typically lasts three months. Areas of continuous or frequent movement such as around the mouth may have decreased duration, closer to 2-3 months. Treatment of neck bands may last longer, around 4 months. Treatment of axillary hyperhidrosis may be longer lasting, on the order of 6 months or longer.
When does XEOMIN® BEgin to work?
The onset of action of Xeomin is typically 3 to 7 days. Some muscle groups may respond to Xeomin treatment before others. The results of Xeomin are typically maximal around 2 to 4 weeks. Muscle relaxation wanes over a three month period on average.