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Is there an alternative to Botox/Dysport? Xeomin?

Dr. Dean Kane Q & A Q. I have used them for years but became allergic to all of them about two years ago. When injecting any of these three, I get blotchy and itchy and no results. Would a good dose of Prednisone, taken a few days before and after, help in suppressing this allergy? ​A. Currently, there is no other neuromodulator injectible drug FDA approved in the USA for wrinkle reduction with a muscle relaxer such as Botox, Dysport or Xeomin. BUT, there are other options. ​ The art of selectively weakening muscles to rebalance their contraction or pull is being explored with topical medications and/or freezing the muscle / nerve junction. Endoscopic advancements have diminished muscle thickness by excising the muscle mass of the corrugator years ago and are still performed today. ​ ​Considering that the muscles that Botox, Dysport and / or Xeomin are used on cosmetically are to reducewrinkling of the skin, there are other options at the level of the skin to:
  • ​redrape surgically lax skin
  • ​tighten with peels and laser
  • ​firm with Sculptra, and / or
  • ​shrink with retinoids.
​ ​If it is the furrows and wrinkles of the forehead and crow’s feet you speak of, I have found Restylane Silk filler to work very well in this off-labeled area. ​ ​It is most interesting that you have a “allergic” reaction to all 3 drugs particularly when Xeomin is considered to be pure and with the least amount of preservative in it. You may wish to consult an Allergist to identify this cause. ​ ​Seek consultation with a well versed, Board Certified Plastic Surgeon or ENT Facial Surgeon to examine you and review your other options.  Good luck!
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