Neuromodulators
Tox Treatments
Botox®, Dysport®, Xeomin®, and Daxxify® — four neuromodulators that temporarily soften the lines made by facial expression. We carry all four and choose between them with you.
At a glance
Products
Botox®, Dysport®, Xeomin®, Daxxify®
Treatment time
10–20 minutes
Downtime
None
Results last
3–4 months; longer with Daxxify
Injectors
Two surgeons, two nurse injectors
Makeup
Wait 24 hours
What we carry
Four products, one decision
All four are botulinum toxin type A and all four work the same way. They differ in how quickly they take effect, how far they spread from the injection point, and how long they last. Which one suits you is a judgment your injector makes with you, based on the area being treated and how you have responded before.
onabotulinumtoxinA
The longest-established of the four and the one most patients arrive asking for, with the longest clinical track record behind it.
Onset
5–7 days
Typically lasts
3–4 months
abobotulinumtoxinA
Takes effect a little sooner than Botox and spreads slightly more widely from each injection point, which some injectors prefer across a broad forehead.
Onset
2–3 days
Typically lasts
3–4 months
incobotulinumtoxinA
Carries no accessory proteins — sometimes called a bare or naked toxin. Worth discussing if you have found other products becoming less effective over time.
Onset
3–4 days
Typically lasts
3–4 months
daxibotulinumtoxinA-lanm
The newest of the four, stabilized with a peptide rather than human serum albumin. In trials the median duration was longer than the other three, though response varies considerably.
Onset
2–4 days
Typically lasts
Often around 6 months
Onset and duration are typical ranges, not promises — both vary with dose, treatment area, and how quickly you metabolize the product. The manufacturer links above go to each company’s own patient site, including full prescribing information and safety warnings.
Who injects
Four injectors
Injections here are done by our two surgeons and our two aesthetic nurse injectors. You can request a specific injector when you book, and see the same one at every visit.
Arabeth Turner, RN, BSN
Aesthetic Nurse Injector
Injectables, skin health, and treatment planning at the medspa.
@aesthetics_by_arabethBailey Lusby, BSN, RN
Plastic Surgery Nurse Liaison | Aesthetic Nurse Injector
Injectables at the medspa.
@beauty_by_baileyyyyHow Botox and Dysport work
Botox Cosmetic is an FDA-approved substance, originally approved as a medical treatment to control excessive contraction of the muscles around the eyes. Because patients receiving it for that purpose were experiencing smoother skin and less wrinkling, it was discovered that a lower dose might be used for cosmetic purposes.
Dysport, like Botox Cosmetic, is a protein extracted from the bacterium Clostridium Botulinum, used in the treatment of wrinkles and fine lines between the eyebrows, on the forehead, and around the eyes. With just one injection into each of five points between and over the eyebrows, Dysport blocks the signal from the nerve to the muscles, reducing muscle activity and temporarily preventing the contraction that causes frown lines.
Dr. Sandel has been named by Allergan, Inc., the makers of Botox Cosmetic, as the number one injector of Botox in Annapolis.
Loyalty programs
Each manufacturer runs its own rewards program. We participate in all three, so points accrue whichever product you and your injector choose. Enrolment is free and the accounts are yours — ask at check-in and we will scan your treatment in.
Points on Botox® Cosmetic, Juvéderm®, Skinvive™, and Latisse®. Successor to Brilliant Distinctions.
alle.com
Treatment with prescription Dysport can temporarily improve the look of moderate to severe frown lines, and generally takes just 10 to 20 minutes. Neither treatment is permanent. Dr. Sandel and Dr. Duggal may recommend combining injections with other treatments such as chemical peels, laser skin treatments, and injectable fillers depending on your needs and desires.
“Facial rejuvenation does not just mean a facelift. There are many other surgical and non-surgical options which can help you look younger and more refreshed, while always making sure you still look like YOU.”
Dr. Claire Duggal
Botox before and after — female patient.
Botox before and after — male patient.
Tox treatment FAQs.
That is a conversation, not a preference. Your injector will weigh the area being treated, how quickly you want to see a change, how long you want it to last, and how you responded to any product you have had before. Patients who find their results fading sooner than expected are often the ones who benefit from switching. If you have never had a neuromodulator, we usually start with a well-established product and adjust from there.
Botox Cosmetic injections have earned FDA approval to treat forehead furrows, crow’s feet, and glabellar lines. Botox derives from a purified version of the botulinum toxin, which allows it to limit muscle activity. When injected in precise amounts in targeted areas such as your forehead and around your eyes, it can reduce dynamic wrinkles and fine lines that occur due to repetitive facial expressions like squinting and smiling.
Treatments are not permanent. In general you can expect results to last around three to four months until the product wears off, though this varies case by case. For many recipients, the effects of subsequent treatments last longer than the initial one because repeated use trains the targeted muscles not to contract. The temporary effect also lets you decide whether you like the results before committing long term.
By reducing the appearance of dynamic wrinkles and fine lines, Botox provides a more youthful appearance, but it does not alter your existing features. If you want to add definition to your cheeks or revise your lips, you may need to look to other non-surgical treatments like dermal fillers. Discuss your aesthetic goals with your provider to learn what complementary procedures may fit.
Following injections you will need to avoid applying any pressure to the treated area to avoid unintended product migration. For best results, we recommend waiting at least 24 hours to apply makeup, giving the neuromodulator time to settle and your injection sites time to recover completely.
After three to four months Botox usually starts wearing off, though the overall timeline varies from person to person. Some patients require a follow-up treatment within two to three months; for others it could take up to six months. Discussing your expectations with Drs. Sandel and Duggal will help set the right maintenance schedule.
Book your appointment.
Discussing your expectations with our injectors helps set the right plan for maintenance treatments, so you keep getting the results you want.