All three injectables work by relaxing and softening the action of muscles. These procedures are primarily performed on the face to improve and smooth facial wrinkles. BOTOX® Cosmetic, and Xeomin® are part of a class of “neuromodulating” medications approved by the Food and Drug Administration (FDA) for cosmetic use.


What is the Difference Between BOTOX and Xeomin?

BOTOX and Xeomin are both neuromodulators that work to reduce the appearance of dynamic lines in the forehead and around the eyes. They both come with no downtime or discomfort and can be performed over one’s lunch break.

Xeomin is formulated without additives, however, making it a popular substitution for those pursuing anti-aging injections with BOTOX. Some patients develop resistance to the protective proteins in BOTOX over time and may choose Xeomin to pick up where BOTOX left off.

While results last 3-5 months for both BOTOX and Xeomin, results can be seen within 72 hours with BOTOX. For Xeomin, patients may need to wait up to 4 days to view their changes.

Finally, Xeomin does not require refrigeration, making it an attractive option for certain medical practices, as the storage and distribution of the product is more simple than it is with BOTOX.

Why People Choose Cosmetic Injectables

The muscles of the face are unique in that they insert onto the skin to give us facial expressions. When these muscles move, the overlying skin accordions, resulting in a facial wrinkle. When the wrinkles occur only with facial animation, they are called “dynamic wrinkles” (wrinkles only with activity). When the muscle relaxes, the skin flattens and the “dynamic wrinkle” goes away. Over time, however, dynamic wrinkles can become static wrinkles (wrinkles present all the time), especially in patients with hyperactive facial muscles. Static wrinkles can become permanent and are much more difficult to treat. Many people believe that early treatment with BOTOX® Cosmetic, or Xeomin® can prevent or delay the formation of permanent (static) facial wrinkles.

Facial muscles vary in size and activity between different people. A common area of hyperactivity is the area between our eyebrows, also known as the glabella (corrugator muscles). When these muscle contract, they depress the medial eyebrows conveying a stern, angry, or frowning look. When these muscles are hyperactive, people appear “angry” even when they are not.

The glabella was the first region where BOTOX® Cosmetic was used. Now BOTOX® Cosmetic, and Xeomin® are commonly used all over the face and body. Neuromodulators have strong safety records with millions of patient injections every year and a decade of clinical cosmetic use.

Areas of treatment:

  • Forehead
  • Glabella (area between eyebrows)
  • Crow’s feet (wrinkles on the outer side of the eyes)
  • Nose (bunny lines on nose)
  • Perioral (vertical lip wrinkles around mouth)
  • Platysma (neck bands)
  • Corners of mouth (turns up the corners of the mouth)
  • Jawline (make a square face more angular)
  • Armpits for excess sweating (excess sweating)

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The Consult

During your initial consultation, one of our San Jose plastic surgeonsDr. Jerome Liu or Dr. Tom Liu—will perform a thorough facial aesthetic analysis to determine if you are a good candidate for BOTOX® Cosmetic, or Xeomin®. The goal of the consultation is for you to obtain all the information you need to make an educated decision in choosing an injectable that will meet your needs and expectations. Following your consultation, you will have a better understanding of how neuromodulators can help you achieve a more relaxed and youthful face.

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What to Expect

All cosmetic injections are performed by Dr. Jerome Liu or Dr. Tom Liu, both fellowship trained plastic surgeons. BOTOX® Cosmetic, and Xeomin® injections are very safe and relatively painless. Most patients report very little discomfort. After the injection, you can drive yourself home and resume your normal activities. The effect is not immediate. Patients begin to see some softening of wrinkles in 1-2 days, but may take up to 7 days to see the full effect.

Occasionally, patients request a touch-up at 2 weeks to further improve certain areas or to give a booster for more dramatic effects.  The results of BOTOX® Cosmetic, and Xeomin® last approximately 3-4 months for most people.

The actual duration varies between individuals and by the area being treated. One study showed about half of neuromodulating injectable patients had mild or no glabella frown lines at 3 months. You can space out your injections to suit your own aesthetic desires.


After the injection, patients can immediately resume normal daily activities. Though our plastic surgeons recommend you avoid strenuous activities the evening after injection, you will have no additional restrictions thereafter. Bruising is rare. Occasionally there is a slight redness where the injections were placed that will recede by the next morning.


BOTOX® Cosmetic, and Xeomin® play an important role in any facial rejuvenation program and can offer significant aesthetic and personal benefits for the right candidate by improving or preventing facial wrinkles. To find out if BOTOX® Cosmetic, or Xeomin® is right for you, please make an appointment with Dr. Jerome Liu or Dr. Tom Liu.

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