Neurotoxin Injections

Botulinum toxin is a naturally occurring protein produced by the bacterium Clostridium botulinum. In purified form, botulinum toxin type A is a very safe, effective treatment used not only in cosmetics, but also for a number of medical conditions, including migraine, bruxism (involuntary grinding, clenching, or gnashing of teeth) and hyperhidrosis (excessive sweating).

Botulinum toxin type A works by blocking nerve signals to the muscles. When the muscles are unable to contract, the overlying skin smooths out, reducing the appearance of fine lines and wrinkles.

Neurotoxin injections use botulinum toxin type A to temporarily relax the small facial muscles responsible for dynamic wrinkles — the lines that form from repeated expressions like frowning, squinting, or raising your brows. By softening muscle contraction, the skin above smooths out, restoring a more relaxed, refreshed appearance without surgery.

Neurotoxin brands include Botox®, Daxxify®, Dysport®, Jeuveau®, and Xeomin®.

Dr. Piya offers FDA-approved neurotoxin brands so treatment can be tailored to your goals, muscle strength, and previous experience with neurotoxin.

Botox®: OnabotulinumtoxinA, the most recognized neurotoxin brand, approved for glabellar lines, forehead lines, crow's feet, neck bands and frown lines. Results usually appear in a few days and last 3–4 months.

Daxxify®: DaxibotulinumtoxinA-lanm, similar to Botox® but longer lasting — about 6–9 months, compared to the 3–4 months typical of other botulinum toxin products.

Dysport®: AbobotulinumtoxinA, similar to Botox® but with a slightly different protein structure, which may spread more easily, making it effective for larger treatment areas like the forehead.

Jeuveau®: PrabotulinumtoxinA-xvfs, similar to Botox®, primarily used for glabellar lines. Results last about 3–4 months.

Xeomin®: IncobotulinumtoxinA, a "purified" formulation without accessory proteins, used to correct frown lines and wrinkles. It is also known as a "naked" neurotoxin because it doesn't have additives, which may reduce the risk of developing resistance to the treatment over time. Results last about 3–4 months.

Botulinum toxin blocks the transmission of chemical messages from the nerve to the muscles so that the muscle stays in a resting state for a period of about 12 weeks on average.

Neurotoxin is injected into targeted muscles, temporarily interrupting the nerve signals that cause them to contract. This creates a smoother appearance of dynamic wrinkles, caused by facial expressions.

By reducing muscle movement, neurotoxin also helps prevent future wrinkles from forming or deepening.

Results may last 3–6 months, except Daxxify, which may last about 6–9 months. Frequent treatment at intervals of less than 3 months is not recommended. Repeating treatment when movement recovers will deliver optimum results over time. Frequency of treatments may be reduced according to the quality of your skin and your response to treatment.

Neurotoxins are an effective treatment for cosmetic concerns and for medical conditions including migraine, bruxism and excessive sweating.

Forehead Lines (Worry Lines): Horizontal lines and wrinkles that form on your forehead when raising your eyebrows.

Glabellar Lines (Frown Lines or "11" Lines): Vertical lines and wrinkles that form between the eyebrows when squinting.

Crow's Feet Lines: Branching fine lines and wrinkles that form at the outer corners of the eyes when smiling, laughing, and squinting.

Eyebrow Lift: A non-surgical procedure that relaxes the specific muscles pulling your brows down, allowing your upper forehead muscles to gently elevate the eyebrows.

Bunny Lines: Small, diagonal wrinkles that form on the sides of the upper bridge of the nose when smiling, laughing, or scrunching the face.

Lip Lines (Smoker's Lines): Vertical lines or creases that form on or directly above the upper lip when puckering the lips or whistling.

Jawline Slimming: The jawline is the lower contour of the face, formed by the lower edge of the jawbone (mandible) where the lower face meets the neck. A well-defined jawline creates a crisp, clear separation between the chin, lower face, and submental area (under the chin). Neurotoxins can slim the jaw by relaxing the masseter muscles.

• Early signs of aging: if you start seeing wrinkles when making facial expressions.
• Maintenance and prevention: even in your late 20s or early 30s, neurotoxin treatments can prevent wrinkles from forming and getting worse over time.

It is important you tell your physician about any medicines or dietary supplements you are taking; some medicines can adversely affect the way the toxin works or increase your risk of bruising.

If you are taking supplements such as aspirin, NSAIDs (ibuprofen), vitamin A, C or E, ginkgo biloba, or St. John's wort, these can increase your risk of bruising and it may be advisable to stop taking them a few days before your treatment. It is also advisable that you do not drink alcohol the night before your treatment, for the same reason.

Make-up will need to be removed before the injections and you will be advised not to reapply it for 12 hours in order to reduce the risk of infection or irritation at the injection sites.

It is not advisable to have treatment if you are not feeling well.

Please make sure that you follow aftercare advice and schedule a follow-up.

A very fine needle is used and it is well tolerated with no anaesthetic. Please request an anaesthetic cream if you are nervous about needles. Most people feel only minimal discomfort, often described as a slight pinching sensation.

Pre-Treatment: Your physician will cleanse the treatment area, and a topical numbing cream may be applied if you're sensitive to needles.

Injection: A fine needle is used to inject the neurotoxin into targeted muscles. Each injection only takes a few seconds, and the entire treatment usually lasts 10–30 minutes depending on the area of treatment.

You can return to daily activities immediately after treatment. You will be advised to avoid touching or massaging the treated area for 4–6 hours to prevent the neurotoxin from spreading to unintended muscles. Avoid extremes of heat or cold, vigorous exercise, lying down or leaning over, and consuming alcohol for 24 hours to reduce the risk of bruising and swelling.

After treatment, you can expect to start seeing an improvement within 2 or 3 days. For some people this takes longer. The full result may be judged at 2–3 weeks. Please make a follow-up appointment at 2–3 weeks, where the success of the treatment may be assessed and adjustments made to your personal treatment plan, if necessary.

Should you experience any unexpected side effects or any that concern you, please contact the clinic.

Onset: Results typically appear within 2–5 days, with full effects visible around 2 weeks after treatment.

Duration: Results last about 3–4 months, except Daxxify, which may last 6–9 months.

Maintenance: With regular treatments, many people find that they need fewer units over time to achieve the same results, as the muscles are conditioned to relax.

Neurotoxin is not recommended if you have any of the following:

• Egg allergy
• Breastfeeding
• Pregnancy
• Taking muscle relaxer medications
• Active infection or inflammation at the intended injection site
• Taking acne treatment medication such as Accutane (isotretinoin)
• Recent surgery or other cosmetic treatments near the area to be treated
• Taking aminoglycoside antibiotics such as amikacin or tobramycin
• Known allergy to botulinum toxin or any of the ingredients in the neurotoxin products
• Neuromuscular disorders such as amyotrophic lateral sclerosis, myasthenia gravis, or Lambert-Eaton syndrome

Common Side-Effects: Mild swelling, bruising or redness at the injection sites.

Less Common Side-Effects: Temporary headache, slight drooping of the eyelid or eyebrow, or asymmetry if one side of the face reacts differently.

Rare Side-Effects: Muscle weakness or difficulty swallowing, though this is uncommon in aesthetic treatments when administered by an experienced professional.

Most side effects are mild and temporary, resolving within a few days to a week.