Xeomin injections are one more option for in-office procedures treating facial wrinkles and could be the best solution for you – come discuss it with our experts at Ophthalmic Plastic and Cosmetic Surgery, Inc. As with other botulinum A neurotoxins - effects on your wrinkles can be so subtle that no one will know you have had the procedure. If you have facial wrinkling caused by increased muscle tone, you may be an excellent candidate for Xeomin cosmetic in St. Louis.
Our practice is delighted to remain in the forefront of the investigation and treatment of medical and cosmetic conditions using Botox, Botox Cosmetic, Dysport, Xeomin and Xeomin Cosmetic. Botulinum A neurotoxins have been used in humans for over 25 years, mainly in the treatment of various neurological conditions associated with spasticity and also cosmetically for facial wrinkle reduction. Minor uses have been in the treatment of hyperhidrosis (sweating) and migraine headache.
Botulinum A Neurotoxins
Dr. Holds was fortunate to be in on the groundfloor in the use of botulinum A toxin, then trademarked as “Oculinum”, which became Botox. Dr. Holds began to use botulinum toxin for the treatment of facial spasm disorders beginning in 1987, three years before FDA approval for medical indications. Dr. Holds also performed what remain some of the best neuroanatomic studies on the effects of botulinum A toxin on human nerves and muscles. This plus 24 years of intensive use of botulinum toxins in the treatment of facial spasm disorders and for cosmetic indications have made Dr. Holds a well know authority on the effects and use of botulinum toxins. Excerpts from Dr. Holds curriculum vitae are below.
Ms. Carr has worked with Dr. Holds as his cosmetic clinical nurse for over 10 years, and is a highly skilled nurse injector with an active medical spa practice (Aesthetic Medispa of West County) within Dr. Holds’ practice (Ophthalmic Plastic and Cosmetic Surgery, Inc.). Ms. Carr is delighted to be able to add the newer and more pure Xeomin Cosmetic (incobotulinumtoxinA) as well as Botox Cosmetic (OnobotulinumtoxinA) and Dysport (AbobotulinumtoxinA). Botulinum B (Myobloc) is seldom used for medical indications and there is no real cosmetic use for this drug anymore. Myobloc has a
shorter duration of effect and other problems that make it very much a “small niche” drug.
What are the Differences between these drugs?
Patients receiving Botox Cosmetic, Dysport or Xeomin Cosmetic must be aware that there are subtle differences between all of the drugs. All of these medications must be properly stored, freshly mixed, and appropriately administered. The most common problems in cosmetic treatment are an under- or overeffect related to the drug dose (undereffects are easily treatedmwith a tiny touch-up 2-3 weeks after treatment), rarely a ptosis (droopy eyelid) or even double vision. Dry eyes and exposure of the ocular surface rarely occur in cosmetic applications.
Dosing between Botox Cosmetic and Xeomin Cosmetic are very similar. Dr. Holds has over 24 years of Botox experience and over a year of extensive experience using Xeomin for the treatment of facial spasm conditions. Most of Dr. Holds’ medical Xeomin patients who have experienced dozens of prior Botox treatments for facial spasm cannot define any difference between Botox and Xeomin in overall effect. Xeomin has the advantage of being a “naked” toxin molecule (see .png image) stripped of proteins that surround the toxin molecule. The benefits may be largely theoretical, although it appears logical to use a drug which delivers the minimum amount of protein. Small is good here, as injected proteins could potentially stimulate the immune system. Dysport is derived from a different strain of the bacterium than Botox and Xeomin. As such, the drug behaves quite a bit differently than Botox and Xeomin, which must be understood by patients.
Feel free to discuss with Dr. Holds, Ms. Carr and the office staff the advantages of treatment with a specific drug. We look forward to working with you.
Curriculum Vitae references for John Holds, MD relating to use of botulinum toxins:
Zimbler MS, Holds JB, Kokoska MS, Glaser DA, Prendiville S, Hollenbeak CS, Thomas JR. Effect of botulinum toxin pretreatment on laser resurfacing results: a prospective, randomized, blinded trial.
Arch Facial Plast Surg. 2001 Jul-Sep;3(3):165-9.
Holds, JB, Alderson K, Fogg SG, Anderson RL. Motor nerve sprouting in human orbicularis muscle following botulinum A injection. Invest Ophthalmol Vis Sci 1990;31:964-967.
Holds JB, Fogg SG, Anderson RL. Repeated Botulinum A Toxin Injection: Failures in Clinical Practice and a Biomechanical System for the Study of Toxin-Induced Paralysis. Ophth Plastic Reconstr Surg 1990;6(4):252-259.
Harris CP, Alderson K, Nebeker J, Holds JB, Anderson RL. Histologic features of human orbicularis oculi treated with botulinum A toxin. Arch Ophthalmol 1991;109:393-395.
Holds JB, White GL, Thiese SM, Anderson RL. Facial Dystonia, Essential Blepharospasm and Hemifacial Spasm. Am Fam Phys 1991;43(6):2113-2120.
Alderson K, Holds JB, Anderson RL. Botulinum-induced alterations of nerve-muscle interactions in the human orbicularis oculi following treatment for blepharospasm. Neurology 1991;41:1800-1805.
Anderson RL, Patel BCK, Holds JB, Jordan DR. Blepharospasm: Past, present and future. Ophthal Plast Reconstr Surg. 1998;14:305-317.
Holds JB. Injection of Botulinum A Toxin for Hemifacial Spasm. Plast Reconstr Surg., 1993;92:1409.
Physician CME presentations (national-excerpted):
“Botox and Fillers” 2010 Oculofacial Plastic Surgery Conference University of Illinois Eye and Ear Infirmary, May 21, 2010.
Course co-director: Cosmetic Blepharoplasty and Introduction to Face Lift. Practical Anatomy Workshop, St. Louis, MO, June 26-28, 2009.
Course co-director: Advances in Cosmetic Blepharoplasty, Brow and Midface Lifting. Practical Anatomy Workshop, St. Louis, MO, January 23-4, 2009.
Medical Spa Panel. Winter Symposium on the Latest Advances in Facial Plastic Surgery. Telluride, CO January 18, 2009.
Cosmetic Botox and fillers for eyelid rejuvenation.” Illinois Neuro-ophthalmology and Oculoplastics Symposium U. of Illinois, Chicago, IL, May 17, 2008.
Botulinum toxin, fillers and more. Skills Transfer Lab LAB 303A 2006 Annual Meeting of the American Academy of Ophthalmology, November 12, 2006, Las Vegas, NV
Non-ablative skin rejuvenation – fillers/chemical denervation. Advances in Cosmetic Blepharoplasty, Brow and Midface Lift, Practical Anatomy Workshop, (with George Hruza, MD) January 28, 2005, St. Louis, MO
Free paper symposium discussant of “Comparison of High-dose Botulinum Toxin Type B to Botulinum Toxin Type A in the Amelioration of Lateral Canthal Wrinkles.” 2003 Annual American Academy of Ophthalmology Fall Meeting, November 17, 2003, Anaheim, CA.
Cosmetic treatment of glabellar folds. In Spotlight on Botox symposium, American Academy of Ophthalmology Fall Meeting, October 22, 2002, Orlando, FL.
Research award from Allergan Pharmaceuticals for study of “The effects of repeated Botulinum A toxin injection”, September, 1988-March, 1989. Award $5000.00.
Research award from the Benign Essential Blepharospasm Research Foundation, Inc. for the study of “The chronic effects of botulinum toxin on the neuromuscular junction: An investigation of the role of neuroanatomic changes in the development of resistance and a possible method of blocking this response”, March, 1989-December, 1989. Award $5150.00.