What’s the difference between all of the “Botox” brands?

types of botox

Different Types of Botox

At this point most people have heard of Botox, but did you know that this is just one of many different types of botox brands we call neuromodulators or neurotoxins?

Neuromodulators are the umbrella term for any product that utilizes botulinum toxin to temporarily relax a target muscle in order to prevent and sometimes treat fine lines and wrinkles. Botox has come to be the household name for neuromodulators, but other common brands include Dysport, Jeuveau, and Xeomin. What’s the difference between all of the brands or types of botox and which one is right for you?


The biggest difference between brands is the form of botulinum toxin that is used- Botox is made of onabotulinumtoxinA, Dysport is abobotulinumtoxinA, Jeuveau is another form of botulinum toxin type A, and Xeomin is incobotulinumtoxinA. At the end of the day, all of these forms are effective in relaxing muscular contraction, so all will help to reduce the appearance of fine lines and wrinkles. However, there are some slight nuances that arise due to the different formulations.

Onset and Duration

According to the International Association for Physicians in Aesthetic Medicine (IAPAM), the average onset of Dysport is 3 hours, Botox is 72 hours, and Xeomin is 96 hours. In practice, most people notice the results of Dysport and Jeuveau within 3-7 days post injection, while Botox and Xeomin are typically noticeable after 1-2 weeks. For all products, dose = duration, meaning that the higher the dosage used, the longer the results can be expected to last (within reason). The average duration for most people is between 2-5 months.


While rare, some people may develop a tolerance or resistance to neurotoxins due to the creation of antibodies. A person’s immune system may identify the ingredients used in these injections as being a foreign invader, so it responds by producing antibodies that neutralize their effect. While resistance can occur with any of these four types of injections, it’s most common with Botox and Dysport. Botox and Dysport contain additives that can “irritate” the immune system and, thus, trigger the creation of antibodies.

Xeomin, on the other hand, consists solely of botulinum toxin, so it’s less likely to cause resistance than its counterparts, however there still have been reported cases of tolerance to xeomin. This has led researchers to believe that it might be the actual botulinum toxin causing antibody formation instead of, or possibly in addition to the additives, however the jury is still out on that. All in all, only about 1 in 100 people who receive a neurotox injection will develop a resistance to it.

Dosage and Pricing

Dosage will vary from person to person, however you can typically expect that you will need 2-3 times the number of units of Dysport as you would with Botox, Xeomin, and Jeuveau. Botox is usually the most expensive per unit as you are paying for the brand, and Jeuveau is usually the most cost effective. Evolus, the company that produces Jeuveau, was able to achieve a lower price by focusing its FDA approval specifically on cosmetic applications for its product, whereas Botox is approved for both medical and cosmetic purposes.

At the end of the day, all four products are FDA approved and all work well to help reduce and prevent fine lines and wrinkles. Come in for a consult today to help decide which brand could be the right fit for you! types of botox types of botox types of botox types of botox

What is the difference between neurotoxins and fillers?

One of the most common questions we get is “What is the difference between neurotoxins and fillers? And which one is right for me?”.

Neurotoxins (NTs), or neuromodulators, are injectables made up of different forms of botulinum toxin, which when injected relax the targeted muscle. Brands include botox, dysport, jeuveau, etc. Relaxing dynamic muscles helps prevent static lines from forming over time in areas such as the glabella (11s), forehead, and crow’s feet (lines around the eyes). NTs can also help to smooth out lines that have already formed in these areas, but only to an extent. Once a line is there at rest, it is much harder to get it to completely go away, so NTs are actually best for wrinkle prevention!

Fillers are injectables made up of hyaluronic acid (HA) (with a few brand exceptions such as Radiesse), which when injected can provide structure, volume, and contouring. Brands include Restylane, Juvederm, Belotero, etc. Fillers are mostly used to treat something that has already happened, such as volume loss to cheeks that can cause the face to sag and create jowls or to fill a line caused by a dynamic muscle that has not been treated preventatively with neurotox!

So which treatment is right for you? That all depends! Everyone, no matter how old or how young, can benefit from wrinkle prevention with neurotox. A skilled injector at Accent Aesthetics can help decide if fillers are a good option for you as well.

What to expect at a neurotox appointment

Wondering what to expect at your next neurotox appointment?

First, we will discuss which product you want to use factoring in price, look/feel, onset time, etc. Next, we will take before pictures to help track your progress. Then, we will go over the consent and have you sign it. Finally, I’ll take a look at your movement to help determine how many units are needed per spot. Then we ice, and inject!

The biggest thing to remember is that just because a number of units worked for you one time does not mean that same number will work again. Multiple studies have been done showing that dose = duration, meaning the higher dose we use, the longer the product will last. Results can last anywhere from 3-5 months.

Knowing the average number of units used per treatment site can help give you an idea of pricing beforehand, but just know that everyone is different and these numbers are not hard and fast rules. Here’s a few averages for the most common areas: “11s” need anywhere from 10-30 units, the forehead needs 10-30 units, and crow’s feet need 4-15 units per side. Remember that Dysport is dosed a little differently than Botox and Jeuveau, but it roughly comes out to 2-3x the number of Botox units.

Have any other questions about neurotoxins or other injectables? Schedule a consult so we can find the perfect dose for you!

Essential Wedding Skincare: Tips to get that gorgeous bridal glow!


So many people dream of that special day. And 100% of the time, that dream includes gorgeous, glowing skin.

Just like a wedding,  beautiful skin takes planning and patience. We love working with Dermatologists because together we can address serious issues such as cystic acne, rosacea, melasma and scarring. And if you’re already starting with non-problematic skin we can keep it that way and get it looking even better!

Here are our recommendations for achieving the skin you want on your BIG day!

#1: Come in for a professional consultation. 

This is the first place any bride or groom should start on their journey to gorgeous skin. Ideally this would happen 6-12 months  before the wedding date. Skin issues can be stubborn and take time to remedy. The sooner we start, the more relaxed the process will be. We can address all of your skin concerns, set up a scheduled timeline of treatments and start you on a premium skincare regime at home.

If your considering injectables for dark circles, wrinkles or to add volume to the face, start sooner than later. A good injector will need time to see what and how much of a product works.

#2: Stay consistent with your skincare regime.

A consistent morning and evening skincare regime is what will give you long term results. Many home-care products work better over time, so you must be diligent and consistent! While these products are often medical-grade and very active, they are going on the skin and take time to penetrate and achieve desired results. This is also why it’s important to start this journey early on so we can see what works and what doesn’t in your home-care regime.

#3: Set up a skincare treatment plan and stick to it.

Together we will create a time line of treatments best suited to your needs. Every person is different and has different issues to address. If your concern is acne, you may need to have an exfoliating and extracting treatment done every 2-6 weeks to get it under control.

If Laser Hair Removal is at the top of your priority list, it’s important to start 6 months to 1 year before the big day, depending on the area being treated.

Other skin concerns require monthly or every other month treatments.

A month or 2 before your wedding, we will really “fine tune” your skincare plan, making sure you look your absolute best!  Laser Genesis gives the skin a beautiful rosy glow right before the special event. HydraFacial can plump and hydrate the skin a few days before and AquaGold gives a luxurious “Red Carpet” luminous, finishing touch to skin about a week before the big day.

#4: Don’t neglect your neck, decollete’ and back.

Chances are you’ll be wearing something that will highlight one or all of these areas. The skin in these areas can be different from the skin on your face and require different treatment. Talk to your Aesthetician about your vision and your planned attire. We offer many treatments for these often neglected areas. Together we can make you glow from head to toe!

#5: Get your mind and body right!

It’s important to FEEL your best, so let’s talk about stress reduction, healthy diet and water intake. All of these things are important to not only get your skin looking it’s healthiest but to ensure you’re keeping it that way.

Planning a wedding is in the TOP 5 most stressful situations a person can go through, next to moving and death! WOW!

To avoid a complete breakdown, sleep, nutrition and a healthy diet will be a lifesaver and assure your skin is in tip top shape.

Working in western medicine, there truly are no conclusive studies linking nutrition and skin conditions, BUT I think we all know in our hearts and minds that what we put in our bodies shows up on our skin. So through this journey we will discuss what may be effecting certain skin issues and start the process of elimination.

#6: Go with the best makeup artist: If your looking for an amazing Colorado Makeup artist, I’m linking one here: antlersandrose.com

Brook at Antlers and Rose’ is an amazing makeup artist based out of Vail, Colorado. She is also an amazing stylist, lifestyle blogger, wife, mother and human! Check out her website and all of the services she has to offer. She is simply the best!





Beyond Botox….

I think by now we all know there is no miracle in a bottle, and botox has been the closest thing we have seen to astonishing results with minimal side effects.


However, optimum skin health goes beyond botox.  It is similar to the health of our bodies- to be optimally healthy you have to work on several factors- diet, cardio and strength training.  Having youthful healthy skin is much the same. IF you only do botox, you are only addressing one aspect of what takes place as we age. The aging face is multifactorial and thus your anti-aging treatments should be so as well. Bone loss, descent of fat pads, skin texture changes, dermal thinning and photodamage all contribute.  When you work with a dermatologist and their staff, you are offered non-invasive treatment options to address these different aspects of aging.


Technology advancements in the field of cosmeceuticals has brought us amazing topical skin care products.  I recently attended a conference where a scientist was reviewing various ingredients/ peptides and said to conduct the research, develop best formulations and then bring those highly active ingredients to market costs money!  If you are getting a Vitmain C serum on Amazon for under a certain price point- do not expect much change to your skin.  Even when we find highly effective products it is good to change your regimen every so often.  We do not like to use growth-hormone products long term and not every person can tolerate tretinoin.  So partner with someone who can help you achieve your best! Last but not least- healthy inside will reflect healthy outside- clean eating, restful sleep, adequate water intake, physical exercise…..and wear an SPF 30 on your face daily!


I always tell patients our goal is find the treatments that will give the most bang for the buck and find the balance between a treatment that is highly effective while still being safe.  You want to partner with a skincare expert who attends educational events, stays up on current trends, has access to multiple modalities to use and works alongside a Board-Certified Dermatologist or Plastic Surgeon to minimize unwanted side effects.  Look for someone who will be candid, give realistic expectations and instead of trying to sell you something- will give you both short term as well as long –term goals for your skin.


Written by Kerri Zukosky, PA-C