Neuromodulators
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
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
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.



Aesthetic Nurse Injector
Injectables, skin health, and treatment planning at the medspa.
@aesthetics_by_arabeth
Plastic Surgery Nurse Liaison | Aesthetic Nurse Injector
Injectables at the medspa.
@beauty_by_baileyyyyBotox 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.comTreatment 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.
Discussing your expectations with our injectors helps set the right plan for maintenance treatments, so you keep getting the results you want.
Ask Sandel Duggal
Answers from our website
Ask about our procedures, our surgeons, or where to find something on the site. I cannot give medical advice or tell you whether a treatment is right for you — those are conversations for the office.
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