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Afraid of Tox?

Updated: Jul 2

Unveiling the Magic of Botox: Enhancing Beauty and Beyond

In the pursuit of maintaining a youthful appearance and enhancing natural beauty, individuals have explored various cosmetic treatments. One name that often surfaces in this realm is Botox, also known as a Botulinum toxin type A called OnabotulinumtoxinA. With its growing popularity, "Botox" has become a buzzword in the practice of aesthetics despite there being 5 formulations of Botulinum toxin A and 1 type B that are FDA approved for cosmetics in the US. Researching "Botox near me"? This blog aims to delve into the world of neuromodulators, shedding light on its uses, benefits, and considerations for those interested in exploring this cosmetic treatment.

1. Understanding Neurotoxin

Botulinum toxin is an injectable neuromodulator derived from neurotoxins produced by Clostridium botulinum, the bacterium responsible for botulism. Through the inhibition of neurotransmission between peripheral nerve endings and muscle fibers, botulinum toxin weakens or paralyzes skeletal muscle. OnabotulinumtoxinA was used for medical indications, specifically around the eye to prevent blepharospasm (eye twitching) when the ophthalmologist and his wife found the effects to also include a reduction of wrinkles. Today, Botox injections have now become one of the most requested procedures in facial rejuvenation.

2. Beyond Aesthetics:

The clinical utility of botulinum toxin initially became evident in the treatment of strabismus. Subsequently, botulinum toxin has been utilized for a variety of other medical conditions characterized by muscular hyperactivity, including blepharospasm, hemifacial spasm, and cervical dystonia. In fact, neurotoxin are highly effective for many medical conditions including migraines, excessive sweating (hyperhidrosis), muscle spasms, and and pain management (Carruthers, J., 2023).

3. The Cosmetic Benefits:

According to Carruthers, J., (2023), since 1992 the benefit of botulinum toxin type A for the treatment of glabellar frown lines extended to treat many other areas of the face such as:

  • Drooping nasal tip

  • Glabellar rhytides

  • Horizontal lines on the forehead

  • Lateral canthal lines (crow's feet)

  • Depressed brow

  • Hypertrophic orbicularis oculi muscle (small palpebral aperture)

  • Rhytides from upper nasalis muscle contraction (bunny lines)

  • Nostril flare

  • Nasolabial folds (selected patients)

  • Vertical perioral rhytides

  • Mouth frown

  • Gummy smile

  • Melomental folds (marionette lines)

  • Mental crease (horizontal crease on the chin)

  • Peau d'orange chin

  • Masseteric hypertrophy (square jaw)

  • Horizontal neck lines

  • Platysmal bands on the neck

4. Safety and Considerations:

When used appropriately, botulinum toxin injection is an overwhelmingly safe method for improving cosmetic defects that are caused by or exacerbated by muscle contraction, such as prominent glabella rhytids (also know as static wrinkles in between the eyes). The effects of botulinum toxin are transient, meaning the muscular function will typically return to baseline within a few months. When placed in the muscles that cause contraction of certain facial muscles neurotoxin injections improve wrinkles and help give a more youthfulness looking appearance (Carruthers, J., 2023).

Botox near me
Good Bye 11's!

According to Carruthers, J., (2023) absolute contraindications to botulinum toxin injection include infection at the site of injection or known hypersensitivity to any component of the product. Relative contraindications to treatment include neuromuscular disorders that could amplify the effect of the toxin, such as myasthenia gravis, Eaton-Lambert syndrome, myopathies, or amyotrophic lateral sclerosis. Caution should also be exercised in patients taking drugs that can interfere with neuromuscular transmission. Although there may be some benefits for muscle spasms related to Multiple Sclerosis (MS), injections can also increase muscle weakness and in most cases should be avoided unless otherwise deemed appropriate by a medical specialist for those with MS.

Additionally, neurotoxin injections should be avoided in pregnant women given that data are considered insufficient to confirm the level of risk of adverse developmental outcomes. Furthermore, the risks of mom transmitting botulinum toxin to breastfed infants are unknown and should be avoided in this population.

Formulation variances can direct product use, for example: a unique contraindication for the use of AbobotulinumtoxinA (Dysport) is an allergy to cow's milk protein. This limitation does not carry over to onabotulinumtoxinA (Botox), incobotulinumtoxinA (Xeomin or Bocouture), prabotulinumtoxinA-xvfs (Jeuveau), rimabotulinumtoxinB (Myobloc or NeuroBloc) or daxibotulinumtoxinA (Daxxify). Another important difference, especially for those VEGANs out that all of the FDA approved neurotoxins with the exception of Daxxify contain human serum albumin (HSA) whereas Daxxify is vegan and contains a synthetic protein chain instead of HSA.

5. Longevity and Maintenance:

In general, the clinical effects of botulinum toxin begin to appear in one to three days, peak in one to four weeks, and gradually decline after three to four months (Carruthers, J., 2023). Neurotoxins vary slightly their molecular attributes so it is important to go to a provider that knows how each product works to achieve the best results. In general, duration and efficacy depends the product's dilution, dose used, spread of the product and depth of injection. Some patients, particularly those who have received repeated injections in the same area, may experience benefits for six months or longer. This may be at least partially due to the development of muscle atrophy and the injection of a higher dose in a more concentrated dilute. Others, who are considered fast metabolizers of the product or those that may have built up some resistance may only have partial or short term response.

6. Debunking Myths:

The ultimate fear by most is the possibility of an unwanted outcome such as a crooked smile or a droopy eyelid. Although rare, the possibility of the product migrating into an unwanted site post injection can occur which is why it is important to avoid vigorous activities, facial massage and or exacerbated movements around the areas of injection. Even rubbing your face during your skin care routine could be detrimental if done within 90 minutes post injection. Overall, experienced injectors know where to place the product and at which dilution to avoid the spread of toxin into unwanted sites and most importantly how and when to correct a problem if it dose occur.

Botox Ptosis
Botox complications

Some feel one product is superior than another. This is simply not the case. However, each toxin formulation does have a variance in spread and the differs in the way to manufacturer recommends dilution. This is where your injector needs to be familiar with the variances and understands how to dilute each product to achieve the desired outcome according to the area being treated. Generally, the greater the dilution the greater the spread of the toxin which will either allow for better results with less injection points or undesired outcomes if migration occurs into a space not intended.

Normal complications associated with injections are bruising, tenderness or pain at the injection site and minor bleeding. There have been some complaints about a heaviness in the forehead or even a mild headache after injections. Botox and Dysport seem to be associated with this complaint in our practice whereas Xeomin and Jeuvea seem to be better tolerated.

7. The Future of neurotoxin:

A exciting newer product on the market called Argireline is a synthesized formulation of neurotoxin intended for topical use only. Argireline, a synthetic peptide, is patterned from the N-terminal end of the protein SNAP-25, and has been proven to both reduce the degree of existing facial wrinkles and demonstrates effectively against their development. In a recent study, Argireline had a significant anti-wrinkle effect in Chinese subjects and that it was safe and well tolerated (Wang, Y., et al., 2013). When used immediately after a microneedling treatment this product may be a very effective alternative to the injection of toxin for those nervous or scarred of injections.

8. The Procedure: What to Expect:

In the state of NJ, only licensed personal such as an registered nurse (RN), advanced practice nurse (APN), physicians assistant (PA), or medical doctor (MD) are able to inject neurotoxin under their scope of practice. However, according to law you must first be evaluated by an advanced provider licensed to evaluate, diagnose and treat medical conditions. During your first appointment your medical history and allergies will be reviewed prior to having any injections. Additionally, you will want to go to an experienced injector who knows not only where and how to deliver the product to achieve the best outcomes but also who knows how to avoid and correct any complications or adverse events that could arise.

You can rest at ease at the Med Spa at Clinical Edge, Dr. Davina Soernssen is a doctorate prepared nurse practitioner with over 30 years of clinical and nursing education experience at the university level. During your initial consultation you will be counseled on all the aesthetic treatments available and guided toward those that will be meet your needs and expectations including the appropriateness of neurotoxin injections. Click here, call or text 609-336-3313 to make an appointment towards a more youthful version of you!


Botox has transformed the field of aesthetics, offering individuals a non-surgical option to enhance their appearance and address certain medical conditions. With proper understanding and guidance, Botox treatments can help individuals achieve their desired aesthetic goals while maintaining a natural look. Whether for cosmetic purposes or medical reasons, Botox continues to evolve, unlocking new possibilities for the future.

Disclaimer: This blog is intended for informational purposes only and should not replace professional medical advice. Consult Dr. Davina Soernssen at the Med Spa at Clinical Edge for personalized guidance regarding Botox treatments.


Carruthers, J (2023). Overview of botulinum toxin for cosmetic indications. In J.S .Dover (Ed), UpToDate. Retreived June 25, 2023, from:

Wang, Y., Wang, M., Xiao, X. S., Huo, J., & Zhang, W. D. (2013). The anti-wrinkle efficacy of Argireline. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology, 15(4), 237–241.

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