I thought I would dedicate this page to Botox or otherwise known as botulinum toxin A (drug name), Dysport or Xeomin.  I have people asking me about this treatment often and there are some myths around botox.  For the myths, you can find more information that I had written a while ago by clicking here.  I don't want to go over these myths but wanted to provide a bit of "behind the scenes" look at antiwrinkle injections.

Botox®, Dysport® or Xeomin®?

Heard or seen these names around? Well essentially these are using the same drug which is botulinum toxin A. They all use pharmaceutical grade, purified proteins that deliver very predictable results, accurately and with very few potential side effects. It's just that the brand "Botox" is the oldest American brand whereas Dysport is French and Xeomin is a German brand.

How does it work?

Botox works by blocking neurotransmitters in the target muscles which reduces the strength of muscle contraction. This is help reduces or smooth out wrinkles caused by muscles folding the skin over and over again (eg. Crow’s feet around the eyes, forehead lines), causing crinkling the overlying skin. 

So to put it simply, botox does not actually work on the skin but works on the cause of what creases your skin which is your muscles. If you relax your muscles long enough, it give the skin a break from folding constantly, so in turn the skin over time can rejuvenate a bit. For some, it doesn't take away the wrinkles completely straightaway where others may need another therapy to then smooth out the lines further.

This is dependent on the depth and severity of your wrinkles! Botox can also be used for therapeutic applications, such as night-time tooth grinding, as it relaxes the overactive muscles of the face contributing to the problem. The other thing to note here is there are only certain areas and wrinkles botox can treat and it does not "fill" lines or plump the skin.

Interested but where do I start?

It's important that injections are placed precisely in certain muscles to avoid side effects so the most important thing to do is find a experienced injector. Injectors who can do botox may be nurses, dentists or doctors who had had specific training. Also, someone who understand the dynamics of the muscles on your face and how to use the botox to give you the best results as most times cosmetic injectables is part science and part art.

I would highly recommend for everyone to look around as not all injectors are of the same caliber no matter what title they may have. When you are shopping around, do not just base your decisions on the price but to talk to the injector and asks questions and see who resonates with you. It is an investment of both your time, money and your face! A skilled and properly trained injector can work with you and help determine what best suits your needs.

How do you prepare for the appointment?

Tell your clinician if you've had any type of Botox injection within the past four months. Also tell the clinician if you take muscle relaxants, sleeping aids or allergy medications. If you take blood thinners, you may need to stop taking them several days before your injection to reduce your risk of bleeding or bruising.

What happens during the appointment?

I can only speak for myself here as this is how I practice, but prior to injections, there will be consent forms to read, filled out and signed. There is plenty of time to ask questions about the consent form or about the treatment. Just because you have booked an appointment and wanting to do this does not mean you can't change your mind at this point. I believe you should not feel any pressure to do so whatsoever.

Photos are taken of your face and may include different angles and poses to highlight the dynamics of your muscles. You would then lie down and the sites of injections are marked out and a photo is taken of that. This these photos are for your notes as I go through random case audits with another health professional.

The injections are done with a very fine, very small needle. Most people find that they have minimal, if any, discomfort or sting and a lot of first timers comment on how "uneventful" the whole procedure is. Often you are left with slightly raised red bumps which look a little bit like an itchy bite. These will disappear within 10 -15mins if not sooner.

After the procedure

Don't touch the area for at least 6 hours and do not rub or massage the treated areas or do any activities that could make you sweat profusely for 24 hours. This helps prevent the toxin from spreading to a different area. You can return to your normal activities right after the procedure.


Botox injections usually begin working between 3 - 7 days after treatment but you may not get the full effect for 2 weeks. In my practice, if you are a first timer or it's the first time I injected you, I get people to come back in 2 weeks. This follow up is to assess the results with you as some may need a top up. Dosages is different for all and some minor adjustments may be needed. Depending on the problem being treated, the effect may last three months or longer. To maintain the effect, you'll need maintenance injections but I believe the maintenance times are highly individualised as it should not be the same prescription for all.

Fei Peters
Registered Nurse for Project Physique

Disclaimer: The opinions expressed at Project Physique Ltd Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, this blog should not be considered medical advice. You should always consult with an appropriately qualified health care professional for diagnosis, and treatment, including information regarding which medications or treatment may be appropriate for you. Fei cannot and does not represent or warrant that any particular medication or treatment is safe, appropriate, or effective for you.

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