Aesthetic services have grown exponentially in the last few years  because many are searching for non-surgical alternatives to maintaining a  youthful appearance. It is clear a customized treatment plan improves  both individual experience and outcome. This is especially true when it  comes to the neurotoxins Xeomin and Jeuveau.    

Becoming an informed person before scheduling a procedure is  important. It outlines your goals, informs you on the product and  prepares your expectations. This optimizes your results because no two  people are alike. Here are a few things you should know before you book  your appointment.    

A:  Xeomin and Jeuveau are neurotoxins that  can temporarily improve the appearance of moderate to severe wrinkles in  adults. Xeomin® is an incobotulinumtoxinA and  the newest neurotoxin to hit the market is Jeuveau. The main difference between  Xeomin and Jeuveau is that Xeomin contains just one ingredient: botulinum  toxin A. The manufacturing process is slightly different with both,  which leads to some potential, subtle differences in clinical practice.

Xeomin is thought of as a “naked injectable,” meaning that it does  not contain any additives. A benefit of this pure-form injectable is  that the body is less likely to become resistant to it.  Xeomin is the only one of  the two  injectables that does not need to  be refrigerated before use, due to its lack of additives.

Xeomin might have the slowest “onset” of action of the 2 ( Jeuveau onset in 72 hours, and Xeomin onset in 4 days.)

Xeomin may be “mildly more convenient” than  Jeuveau, as the  “product’s lack of complex proteins will help prevent antibody  formation, or resistance to neuromuscular treatment with botulinum type A  toxin, in patients being treated for neuromuscular conditions.”

Neurotoxins diffuse differently, in part because Jeuveau has protective  proteins clustered around the active part of the molecule, while Xeomin  has no protective proteins. In areas like the forehead, diffusion is  good so you can cause greater effect over a larger area. Around the eyes  and mouth you want less of a diffusion and the effects of the  medication to stay in one area.

Jeuveau™ on the other hand, is also a neurotoxin like Botox Cosmetic  and it can be injected in between the eyebrows or at the corners of the  eyes to stop the natural muscle contractions that form the wrinkles. It  can also prevent new lines from forming and smooth out the old ones  which could potentially deepen with time. Jeuveau™ is almost the same as  Botox® treatment since both are extracted from the same type of  bacteria. In other words, the same molecule as the one used in Botox® is  in Jeuveau™. There have been no reports of bad side effects or adverse  complications from the use of Jeuveau™.

Similar in weight to  Botox, Jeuveau™ is an FDA approved purified botulinum toxin formula type  A. Although all the drugs used for aesthetic treatments contain the same  formula, the safety and effectiveness profile for Jeuveau™ is similar  to the one of Botox®. Therefore, the injectable can be substituted for  one another.

Botulinum toxin A, Xeomin,  is a prescription injectable that blocks “the release of chemicals that  cause these muscle contractions so frown lines are softened.” It was  also approved by the FDA for “temporary improvement in the appearance of moderate to severe  glabellar lines with corrugator and/or procerus muscle activity.”

Candidates for Xeomin experience frown lines between their eyes, are  in good overall health, and have realistic expectations for the outcome.  Do not use Xeomin if you're allergic to any of its ingredients, have a  skin condition, or have experienced an allergic reaction to other  botulinum toxin products. 

Patients see visible results within four days of the injections, but  it can take up to a week for the full results to appear. Xeomin lasts  three to four months. 

The newest botulinum toxin A, Jeuveau,  is "a prescription medicine that is injected into muscles and used in  adults for a short period of time (temporary) to improve the look of  moderate to severe frown lines between the eyebrows (glabellar lines)." 

Candidacy requirements for Jeuveau are similar to those for the  aforementioned neurotoxin products. Patients experience wrinkles between  the eyebrows and have realistic expectations for results. You should  not use Jeuveau if you are allergic to any of its ingredients, have  experienced an allergic reaction to other botulinum toxin A products,  have a skin infection, or are under the age of 18.  

Studies have shown patients see visible results two days following the procedure. Results typically last for three to four months. 

 Choosing between Jeuveau®, and Xeomin® depends on  factors including the area you wish to treat, results you have had in  the past with neuromodulators, your unique anatomy,  and the  personal preference of both yourself and your provider. Choosing the  correct product for you can be done after a thorough consultation, so  that your goals and situation can be assessed. 

Dermal  fillers are FDA-approved injectable substances used to plump or fill  soft tissue. They are FDA-approved and absorbed by the body over time.

Dermal  fillers are known for their versatility. When patients just want to  look a little better, dermal fillers are probably the solution. Fillers  can:

• Smooth out lines around the nose and mouth
• Restore and build volume in sunken or hollow cheeks
• Lift and volumize sagging temples or jawline
• Plump and reshape the lips
• Smooth out a chin crease
• Improve symmetry across the face
• Fill in some types of scarring

RHA is the new line of fillers designed to provide an  exceptionally natural appearance, whether your face is at rest or in  motion. Developed in Geneva, Switzerland, RHA dermal fillers are the first and only FDA-approved HA fillers dedicated to treating  dynamic facial wrinkles and folds. Dynamic lines are those that form  when you make certain facial expressions, such as forehead lines,  creases between the eyebrows, and crow’s feet in the outer corners of  the eye. These concerns were previously only addressed effectively with  neuromodulators like Botox, Xeomin, Jeuveau and Dysport. 

What makes RHA fillers unique? The  RHA formula more closely mimics natural hyaluronic acid than traditional  fillers. Specifically, RHA fillers consist of longer chains with less  crosslinking, making them more malleable and more resilient and allowing  them to mold and bend with your expressions. This formulation makes  them less “stiff” than fillers with shorter HA chains, creating the most  natural-looking results that make them the perfect choice for dynamic  wrinkles. 

The RHA® Collection is the first hyaluronic acid filler formulated to  treat dynamic lines while also allowing the injectable gel to easily  move with your facial muscles. Previous solutions to alleviating  expression lines and wrinkles completely immobilize these muscles. This  causes patients to appear expressionless, and unable to emote through  facial cues. These results might appear unnatural and discouraging to  some patients. 

The RHA® Collection is designed to adapt to the dynamic movements of  your facial muscles without limiting their mobility. This produces a  more natural-looking outcome while also reducing the appearance of  dynamic facial wrinkles.

The RHA Collection is a  series of resilient “designer” fillers. RHA is the only FDA-approved  hyaluronic acid filler for dynamic wrinkles and folds.

Treatment: RHA can treat wrinkles caused by movements like squinting, frowning, laughing and talking. It can also increase facial volume.

• RHA 2: Fills mild wrinkles, such as lines in the lips or around the face. It can also plump the lips.
• RHA 3: This filler targets deeper wrinkles around the nasolabial area, corners of the lips, and jowls.
• RHA 4: This filler is perfect for deep wrinkles in the cheeks or jowls. It can also contour the cheeks and jawline.

Lifespan: RHA lasts between 9 and 18 months. Result  lifespan will depend on the age and lifestyle of the individual, as well  as the area of treatment. 

Filler strengths: It  can be difficult to treat dynamic areas of the face with filler without  making them look stiff. RHA is designed to be more like real hyaluronic  acid, so dynamic areas around the eyes and mouth can be given a natural  and lineless look.