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XEOMIN® for Treatment of Moderate to SevereFacial Frown Lines

According to the American Society of Plastic Surgeons, 5.67 million injections of botulinum toxin type A were performed in the United States in 2011, up 5% over 2010, making it the most popular non-surgical cosmetic procedure performed in the US. Until recently,a majority of these procedures were performed using the popular BOTOX® neurotoxin manufactured by Allergan. Allergan’s BOTOX® neurotoxin was approved by the US FDA in 2002 for cosmetic use to treat frown lines and creases between the eyebrows, and has since become a household word.

Other pharmaceutical firms in recent years have entered this very lucrative market and are competing with BOTOX® for market share. One of these neuromodulators is XEOMIN® manufactured by Merz Pharmaceuticals.The United StatesFederal Drug Administration (FDA) approved XEOMIN in July 2011 for use as a cosmetic treatment to diminish glabellar (the area between the eyebrows) wrinkles and for the management of moderate to severe frown lines of the forehead and upper facial areas.

XEOMIN® (incobotulinumtoxinA) is a botulinum toxin type A neuromodulator which is very similar to the market leader BOTOX®, and to DYSPORT®, another neuromodulator approved by the FDA in 2009, and is steadily gaining in popularity in the US.

XEOMIN®, likeDYSPORT®( but unlike BOTOX®) isfree from accessory proteins, meaning it is a “naked” botulinium toxin with the theoretic advantage of having a lower risk of antibody formation so there may be less chance of a patient’s immune system rejecting a “foreign” protein and developing a resistance to the neurotoxin.

As is the case with BOTOX® and DYSPORT®, the active ingredient in XEOMIN®(incobotulinum toxin Type A) blocks the release of acetylcholine, a chemical “messenger” that carries signals from nerve terminals and causes the contraction of muscle fibers.  Since not all the nerve terminals are affected by botulinum toxin the muscles can still contract, but much less emphatically. Wrinkles, caused by contracted muscle fibers, relax and the skin’s surface appears smoother, often dramatically.

Development of XEOMIN® as an Alternative to BOTOX®

XEOMIN®was first introduced to the U.S. market by Merz Pharmaceuticals, LLC in 2010. Globally, Merz is a leader in the development of pharmaceuticals for the treatment of neurological and psychological disorders as well as for aesthetic medicine.XEOMIN® was originally developed by Merzto treat adults with cervical dystonia (abnormal head position and neck pain) as well as blepharospasm ( abnormal spasm of the eyelids), both conditions which also responded to treatment with Allergan’s onabotulinumtoxinA (Botox).Sharing a similar history, BOTOX® had originally been developed and marketed by Allergan for the treatment of strabismus or amblyopia (deviated or crossed eyes) until the side effects of eradicating facial wrinkles was observed and its current use for facial rejuvenation was developed.

Prior to being approved by the US FDA XEOMIN® had been approved for use in Germany, the United Kingdom, France, Italy, Spain and eight other countries under the name BOCOUTURE®.

The overwhelming popularity in both the US and worldwide using neuromodulator injections to diminish wrinkles  means there will no doubt be more options as more pharmaceutical companies enter the market. Healthy competition among pharmaceutical firms traditionally leads to technical advances in manufacture and testing and may even lead to lower prices to the consumer for neurotoxins. Merz’s XEOMIN® and DYSPORT®, made by Medicis, are both slightly less expensive than Allergan’s BOTOX®.

Except for minor differences in administration, dosage and diffusion, all three neurotoxins so far have been shown to have a similar high marks for patient safety and an duration of effectiveness of 3 to 5 months.

Who Should Choose the Right Neurotoxin for You?

The key to deciding which neurotoxin (XEOMIN®, BOTOX®, or DYSPORT®) is “best” for you depend upon the expertise and experience of your designated physician.  Dilution procedures often differ and injection sites within the frown lines may vary also. The patient’s age, type of skin and nature of the wrinkles are also factors to be considered.  Also, as a patient you may request a longer lasting full blockage or, alternatively, a milder effect which may be of shorter duration.

While the products are all FDA approved and very similar, choosing which to use may be simply a matter of asking your dermatologist or  board certified plastic surgeon which product he feels most comfortable with and with which he has obtained the most consistently pleasing results.

Some dermatology forums report that XEOMIN® and DYSPORT® diffuse more quickly after injection (24-48 hours sooner than  BOTOX® in some reported cases), perhaps due to the molecular size and lack of accessory proteins.  This diffusion factoris a positive in some facial areas but could also have a potential down side an area where it might diffuse into surrounding tissue causing unwanted side effects such as eyebrow or eyelid drooping . The expertise of the injector is the most important factor.

Choosing the Right Physician

These variations in both products and methods arevery good reasons why you should choose a Board Certified Plastic Surgeon if you are considering undergoing a cosmetic procedure using a neurotoxin.XEOMIN®, as well as BOTOX® or DYSPORT®, should only be administered only by a skilled injector in a certified medical facility to ensure sterile procedures and standards.  XEOMIN® should never be injected in beauty salons, hotels, or at private home parties.

There is no substitute for obtaining expert advice from an experienced surgeon such as Dr. Scott Mosser, who has specialized training and knowledge and is current with the latest techniques and developments in aesthetic and restorative cosmetic procedures.

An acknowledged expert on cosmetic injectable enhancements, Dr. Mosser has built a very successful San Francisco practice with his highly personal approach to creating the most natural results for each individual patient. Whichever neuromodulator he uses for your treatment you can be sure it was chosen to achieve the results you desire. 

Schedule a consultation with Dr. Mosser to discuss what treatment is best for you to diminish facial wrinkles.