Talkin’ Toxin – The Botox Backstory

  • Botox was introduced in the late 1980s by eye doctors who began using it to treat optic muscle disorders. In 1987, two Vancouver physicians — Jean and Alastair Carruthers — accidentally discovered the toxin’s cosmetic properties.

    Botox essentially paralyzes the muscles that cause wrinkles by blocking the release of acetylcholine, a naturally occurring chemical that causes muscle contractions that create wrinkles.

    This accidental discovery changed the face of beauty. The FDA approved botulinum toxin type A (Botox Cosmetic) for the treatment of moderate-to-severe frown lines between the eyebrows in 2002, and its popularity has soared ever since.

    There are now three botulinum toxin type A toxins approved for cosmetic use in the U.S. and even more in the pipeline; including topical forms! Let’s break down the finer points of each.


  • Botox Cosmetic

    Approved uses: Moderate-to-severe frown lines between the eyebrows (also known as glabellar lines or "11's") and crow’s feet.

    Results: Visible within one or two weeks and last a minimum of three months.

    Cost: $400 to $600

    Manufactured by: Allergan


  • Xeomin (MERZ)

    Approved uses: Lines along the forehead and in between the brows.

    Results: Visible in one week and last from three to six months.

    Cost: $400 to $600

    Manufactured by: Merz North America

  • Dysport

    Approved uses: Forehead wrinkles and frown lines.

    Results: Visible within two to three days and may last up to six months.

    Cost: $300 to $500

    Manufactured by: Galderma Laboratories

  • Decisions, Decisions


    Your dermatologist or plastic surgeon will help decide which of the available toxins is best suited to your needs. Results are fairly consistent between the three, but your doctor’s experience may help guide the process.

    There are some subtleties. For example, Xeomin contains just one ingredient (botulinum toxin A). It is considered “naked” and “pure” meaning there is less risk that a person can grow resistant to it. In addition, it does not require refrigeration which, if passed down, could lead to a lower price tag..

  • Keep In Mind

    Keep in Mind

    The cost of any of these products varies based on how many areas are treated as well as where the practice is located. Some urban areas can and do charge more as their overhead tends to be higher. Exactly how long results last also varies.

    All botulinum-based drugs must carry a "black box" warning to alert users to the chance that the toxin may spread from the injection site to other parts of the body where it can cause potentially life-threatening swallowing or breathing issues. This is not typically seen when the injections are used for cosmetic purposes.

  • Halaas 58x57

    Yael Halaas, MD, FACS

    60 East 56th Street
    3rd Floor
    New York, NY 10022
    (332) 239-6439

  • P

    Cosmetic Surgery Associates of New York

    465 Columbus Avenue
    Valhalla, NY 10595
    (914) 421-0113

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    Min S. Ahn MD

    The Aesthetic Wellness Center
    2 Connector Road, #2C
    Westborough, MA 01581