Botox®/Xeomin® are a safe, effective treatment performed by Dr. Nield to reduce dynamic fine lines and wrinkles. This technique has been used in Canada for over 30 years. Dr. Nield is an expert Botox®/Xeomin® injector and many patients seek out Dr. Nield because she is so well known in her field. Dr. Nield is also known in her area as giving very natural, soft looking results, which is very important at a time when many individuals look quite over done.

The treatment is performed with you lying on an examination bed in a treatment room. Dr. Nield will examine your face carefully to determine the best sites to inject a very small amount of the Botox®/Xeomin® into the specific muscles that are causing unwanted lines. These include smile lines near your outer eyes, worry lines on your forehead or between your eyebrows. The treatment takes less than 15 minutes, and the results will become noticeable within a few days. It may take up to 2 weeks to experience the final, smoother results of the treated muscles.

The Botox®/Xeomin® is a naturally occurring, purified protein that can be easily injected into select facial and neck muscles to soften wrinkles and reduce frown lines. Botox®/Xeomin® interfere with the transmission of nerve impulses to the affected facial or neck muscles, preventing the muscles from contracting, leaving the muscles to remain smooth and hence, the overlying skin will be wrinkle free.

Although the injectable Botox®/Xeomin® are very potent in high concentrations, in cosmetic treatments, they are used in very small, very safe quantities. The most common injectable Botox®/Xeomin® has been approved since 1990. One safety feature of these injectable nerve blockers is that their results are not permanent. Your body will form new neurotransmitter receptor sites that will allow reactivation of the muscle; the injected area will completely recover over time.

The treatments are always performed by Dr. Gail Nield who is recognized as an expert in cosmetic dermatology. Dr. Nield was the first Dermatologist in Vaughan to offer Botox®/Xeomin® and remains at the forefront of non-surgical rejuvenation techniques.

For most patients, it lasts between 3 and 4 months. We suggest re-injection every 3-4 months to keep the muscles inactive and allow furrows to smooth out completely. Once an area is smooth, you’ll only need to return once you notice a return in muscle movement, which may not occur for up to 4 to 6 months.

We use very small needles, and the medicine itself stings less than a local anesthetic. Dr. Nield has a very light touch and a gentle approach when she is doing any cosmetic office procedures.

The most common areas are the forehead lines, the lines between the brow known as frown lines, crow’s feet lines around the eyes, and lines around the mouth and chin.

Injectable nerve blockers work well to smooth aging skin in the neck area, reducing necklace lines and softening neck bands and jaw lines. They can also be used to lift low or sagging eyebrows. Botox®/Xeomin® can eliminate gum show (excessive gum visible above the upper teeth when smiling), and a few miniscule injections can reduce perioral lines (lines that radiate out from the mouth) and even make lips look somewhat fuller. Frowning, downturned lips can be corrected. These injections can stop chin dimpling and reduce fine wrinkling on the chest. Neck bands and necklace lines can also be treated, rejuvenating your neck region.

The effects of Botox®/Xeomin® treatments are not immediate. You will notice some muscle weakness several days after an injection, with results peaking at about 14 days. You will eventually notice a softening of your expression lines, so that you look more refreshed, less tired, less angry, less worried, and more relaxed.

Botox®/Xeomin® are usually very well tolerated. It is by far one of the simplest and easiest procedures performed by Dr. Nield. Occasionally, you may notice some numbness in the injected area. If used around the eyes, it can cause a short spell of dry eyes (a rare side effect), and if it’s used around the mouth, it may cause a temporary dry mouth sensation. Some people occasionally experience bruising and short-term headaches.

Complications are rare; temporary drooping of one or both eyelids occur in well below 1% of all injections. If it does happen, effects are usually minimal and resolve completely with time.

The effect that the Botox®/Xeomin® will have on you (and the length of time it will last) depends on several factors:

• Your gender. Women’s facial muscles are easier to relax, which means that the smoothing effect is more complete and longer lasting, but men are also very good candidates for this treatment.
• Your age. Anyone over 18 will respond to Botox®/Xeomin®. More individuals are starting treatments at an earlier age (late 20s to 30s) to prevent lines from forming in the first place.
• The thickness of your skin. Thinner skin responds better and has a more stable result than thicker, coarser skin.
• The expressiveness of your face. The more naturally animated your expressions, the better the results.
• The area being treated. The facial areas that generally respond best to Botox®/Xeomin® treatments are foreheads, central frown lines and exaggerated crow’s feet around the eyes.
• The amount and concentration of the Botox®/Xeomin® being used. Each facial zone requires an optimum amount of liquid nerve blocker injections to achieve the best results.

For safety reasons, it is our policy not to treat women who are pregnant or nursing. If you become pregnant shortly before or after treatment, please rest assured that several medical patients have delivered healthy children after receiving Botox®/Xeomin®.

If you have a history of neuromuscular disease (such as amyotrophic lateral sclerosis or myasthenia gravis) or other types of disease involving neurotransmission, you should avoid this treatment.

If you are taking aminoglycoside antibiotics (Streptomycin, Tobramycin and Garamycin injections), penacillamine, quinine and calcium channel blockers (Calan, Cardizem, Dilacor, Norvasc, Procardia, Verelan), you may experience increased effects of Botox®/Xeomin® in the treated muscles.

If you are taking anti-inflammatory drugs such as Aspirin or Advil, stop taking them at least 4-7 days prior to treatment, since they may cause excessive bruising or bleeding.

The Botox®/Xeomin® can be injected into the anterior neck bands to make them less prominent. This technique softens the appearance of the neck and gives it a slight lift by tightening the surrounding skin. These injections can also reduce “necklace lines.”

We often use this treatment in combination with other procedures, giving you better, more dramatic results:

• YAG Laser treatments for fine lines If you have significant wrinkles on your forehead and around your eyes, Botox®/Xeomin® will enhance the results of YAG laser treatments.
• Deep folds and wrinkles. If you have persistent lines and furrows even after a treatment, they can be smoothed with injectable soft tissue fillers. Small amounts of Botox®/Xeomin® and dermal fillers can also be combined to correct droopy mouth corners.
• Ultherapy can be combined with Botox®/Xeomin®.
• We often combine Botox®/Xeomin® with our Intense Pulsed Light (IPL) treatment to reverse sun damage.
• Chemical peels. This non-invasive technique freshens your skin and enhances the benefits of Botox®/Xeomin®.
• Microdermabrasion and anti-aging products recommended by Dr. Nield can further enhance your treatments.