Patel Plastic Surgery Salt Lake City and St. George
  • Home
  • Locations
    • Plastic Surgery Salt Lake City
    • Plastic Surgery St. George
  • Conditions
    • Aging Of The Face
    • Aging of Lower Eyelids
    • Aging of the Forehead and Brows
    • Aging of Upper Eyelids
    • Aging of the Cheeks
    • Aging of the Neck
    • Aging of the Lips
    • Aging of the Mouth
    • Aging of the Chin
    • Aging of Eyelashes
    • Aging of the Hands
    • Aging Of Skin Colour
    • Aging Of Hair
    • Aging of the Jowls
    • Aging of Men
    • Aging of the Skin
    • Aging of Veins and Vessels
    • Scars
  • Cosmetic
    • Facelift
    • Browlifts
    • Lower Blepharoplasty
    • Upper Blepharoplasty
    • Midface Lift/Hammock Lift
    • Necklift
    • Cosmetic Surgery for Men
    • Lip Lines
    • Lips
    • Mouth
    • Neck Liposuction
    • Fat Transfer
    • Skin Resurfacing
    • Cheeks
    • J-PLASMA SKIN RESURFACING
    • J-PLAZTY FACE
    • Removal of Moles, Lesions, Tags, Cysts and Blemishes
    • Facial Implants
    • Otoplasty, Ear Pinning, or Bat-Ear Repair
    • Complications?
  • Reconstruction
    • Acquired Ptosis and Dermatochalasis
    • Congenital Ptosis
    • Ptosis in Myasthenia Gravis
    • Blepharophimosis Syndrome
    • Entropion
    • Ectropion
    • Thyroid Eye Disease
    • Nasolacrimal Duct Obstruction
    • Skin Tumors
    • Orbital Tumors
    • Blepharospasm
    • Pterygium
    • Anophthalmos and Microphthalmos
    • Enucleation and Evisceration
    • Exenteration
    • Symblepharon
    • Congenital Anomalies - Lid Disorders
    • Acne Rosacea
    • Trauma
    • Infections
  • Non Invasive
    • Photorejuvenation
    • Aerolase Laser
    • Botox
    • Radiesse
    • Restylane
    • Juvederm
    • Fractional Carbon Dioxide CO2 Laser
    • Fractional Resurfacing Lasers: Erbium lasers
    • Laser Hair Removal
    • Kybella
    • Chemical Peels
    • XEOMIN ®
    • Voluma
    • LATISSE EYELASH TREATMENT
    • Leg Veins and Spider Vein Treatment
    • Sculptra
    • Neck and Chest Cosmetic Concerns
    • Dysport
    • Accent Radiofrequency
    • Microdermabrasion and Light Chemical Peels
    • Melasma
    • Laser Tattoo Removal
    • Color and Texture Issues – Brown Spots on Face, Redness
    • Scars and Acne
    • Permanent Cosmetic Makeup
  • Resources
    • Patient Forms & Downloads
    • Out Of State and Overseas Patients
    • Reviews
    • VIDEOS Patel Plastic Surgery
  • About
  • Blog
  • Contact

Dysport, Myobloc, Xeomin  

Botulinum toxin products come in different forms. They are essentially purified proteins derived from the bacterium Clostridium botulinum.
  1. Botox
  2. Dysport
  3. Myobloc
  4. Xeomin

Botox (onabotulinumtoxinA, Allergan) first earned Food and Drug Administration (FDA) approval in 1989. Dysport (abobotulinumtoxinA, Medicis) was approved in 2009. Xeomin (incobotulinumtoxinA, Merz) was FDA-approved in July 2010 for treatment of adults with cervical dystonia or blepharospasm. Myobloc (RimabotulinumtoxinB) also called botulinum toxin type B.

Botox (onabotulinumtoxinA, Allergan) comes in 100 units per vial (but can also be obtained in 50 unit and 200 unit vials).

Myobloc (RimabotulinumtoxinB) also called botulinum toxin type B comes in 5000 units/ml. Myobloc was approved for the treatment of patients with cervical dystonia.

Xeomin (incobotulinumtoxinA, Merz) comes in 100 units per vial.

Dysport (abobotulinumtoxinA, Medicis) comes in 300 units or 500 units per vial. ​
"Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love..."  D. Rock  63 Yrs Old with Fat Droopy Eyes - Salt Lake City, UT

What are the contraindications to receiving neuro-toxin injections?

If you have a history of any of the following problems, there may be an absolute or relative contraindication to receiving neuro-toxin injections: 
  1. have a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease],
  2. myasthenia gravis or Lambert-Eaton syndrome)
  3. have had any side effect from any other botulinum toxin in the past
  4. have a breathing problem such as asthma or emphysema
  5. have a history of swallowing problems or inhaling food or fluid into your lungs (aspiration)
  6. ​have bleeding problems
  7. have drooping eyelids
  8. have plans to have surgery
  9. have had surgery on your face
  10. are pregnant or plan to become pregnant. It is not known if XEOMIN® can harm your unborn baby.
  11. are breastfeeding or plan to breastfeed.

Can I have the same dose of Botox or Dysport or Myobloc or Xeomin?

This is the commonest cause of confusion, not just among patients but also practitioners. A common mistake is to just use a formula to convert the number of units of a particular product into another. For example, a commonly circulated number is X3 for the number of units of Dysport needed to be equivalent to the Botox dose. So 30 units of botox is equivalent to 90 units of Dysport. In theory!
​

In practice, the diffusion of each product is different since the dilution is different. Furthermore, because the products are different, they will have

different effects even if injected in a similar way. Experience shows that the distribution of the injections may have to be different, depending upon the product being used. Therefore, most of us will have (should have) the experience and skills to inject several different types of botulinum toxin products. ​
Picture
Anatomy of the face. The facial muscles which are modified by neuro-toxin injections.
Picture
Neuro-toxin injections for neck bands. Careful attention to the anatomy and level of injections is necessary.

How is the administration and effect of Dysport different from Botox 

As far as the surgeon is concerned, the diffusion of Dysport is a little more than the diffusion of Botox. Therefore, the surgeon must modify the technique of injection to reduce side-effects. Of course, this does not guarantee that there will be no side-effects (like ptosis, for example). The distribution of the Dysport injections is also different from Botox injections because of factors

such as dilution, diffusion and maximal and minimal effects.
As far as the effects are concerned, there is some debate whether Dysport takes effect a little sooner than the three days it takes for Botox to show an effect.
Dysport and Botox have protective proteins around the active part of the molecule, thereby affecting the diffusion rate and distance once injected. This makes Dysport and Botox heavier than Xeomin and the complexes therefore migrate more slowly than Xeomin, which has no protective proteins and is therefore lighter. Xeomin migrates faster and further but that also means there may be less precision if the surgeon is not experienced in injecting Xeomin.
If a surgeon injects by the numbers and uses simple converting formulae, it will result insufficient, excess or unwanted muscle relaxation and unhappy patients!
​
Picture
Neuro-toxin injections for frown lines and forehead lines
"I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm."  D. Gull Highly recommended for eye lift surgery - Salt Lake City, UT

Is it important for the surgeon to know the physiology and biochemistry of the different drugs?

Only if the surgeon wants to become an expert in injecting the different materials and have happy patients! Whilst bruising, swelling and occasional side-effects are inevitable, for the most part, a properly informed surgeon can obtain reliable and predictable results. As discussed on the page on Botox, injecting the face is like playing a musical instrument. The music can be brilliant, or the type that makes you wish you were elsewhere. ​
Picture
Neuro-toxin injections for forehead lines needs careful titration and distribution to avoid the brows from dropping.

When should I try a different botulinum toxin product from the one I am receiving?

If you are getting a satisfactory and satisfying result from your current product, resist the temptation to play the field. Only try another product if, for some reason, you feel you are not getting as much of a result as you would like, or, if the effects have diminished. It is very rare for a person to become resistant to a particular botulinum toxin product. Nevertheless, in patients receiving injections for functional reasons, where much larger doses of the toxin is injected, it does pay to try a different product if the patient sees a diminishing result from the current product. In general, it is best to use a product over three courses of injections before passing judgement.
Picture
Dysport injections for forehead and frown lines and to raise the brows.

How many units of Botox or Dysport or Xeomin shoult I have?

As mentioned above, the number of units is a moot point because the units of one product are not equivalent to the same number of units of another product. In general, because injections should take into account the balance of muscle function, together with a technique that improves wrinkles but does not completely stop all movement of the injected muscles, the technique, together with a record of what has worked on your face is more important than an exact number of units. For this reason, it is unwise to flit from one clinic to another for injections as you will probably end up with sub-optimal results since the surgeon will not know your face, your muscles and your response. ​
Picture
Neuro-toxin injections can be used to smooth forehead lines without dropping the brows.

How do I know that I am getting the best possible result with botulinum toxin injections?

Too often, in this hurly burly capitalist world of ours, injections are administered by the lowest person in the clinic. Furthermore, no photographs are taken, nor are results reviewed. This is a great disservice to you, the customer/patient. We always take photographs prior to the first time we inject you and obtain follow-up photographs and a clinical examination of the results in person about a month after our injections. This is at no additional cost and allows us to determine what distribution, strength and ratios these injections work best for you. Once we have a documentation of the results, we can endeavor to obtain the same results (or very similar results) every time. The assessment is based upon photographic differences, the surgeon’s assessment of the results and the patient’s views of the results as well.

Picture
Neuro-toxin injections for marked frown lines and horizonatal nasal lines.

Will I bruise?

Remember that the face is full of vessels. We use cooling of the skin to reduce the risk of bruising. Some areas are more likely to bruise than others: for example, the lower eyelids and the crow’s feet areas are vey vascular and may bruise more easily than the forehead or the frown muscle injections. After the injections, use of ice can reduce bruising.

I hate needles: will it be painful?

None of our patients has ever jumped up and run away! We apply an anesthetic cream when patients want it. Our regular patients have an anesthetic cream prescribed which they apply before they leave home: this reduces the sensitivity of the skin sufficiently to make the injections almost pleasant! We also apply ice and we have a Zimmer cooling device which is very helpful in reducing bruising as well as discomfort. ​
Picture
Marked improvement in corrugator and procerus muscle action improves the “elevenses” in the middle of the forehead.

How long will the effects of the injections last?

Although there are scientific studies that show that regeneration of the nerve endings allows the muscles to work again as early as two-and-a-half months after injections, we find that the benefits of the injections often last three to five months. Of course, the effects of the injections don’t just stop suddenly but wear off gradually. ​

How often will I need injections?

Most patients find that getting injections every three to four months is ideal.

However, if your lines, wrinkles and bulges are not too prominent, you can easily go longer. We always assess your results after a month when we first inject you to ensure that you get the best possible result and also to guide you as to how long the effects may last. ​
Picture
Neuro-toxin injections for forehead lines.

How do I avoid the “Plastic Face”?

“Over-botoxed” faces are all too common. They started in Hollywood and have spread to suburbia. The same applies to overly done fillers (chipmunk faces, haemorrhoidal lips, and over-filled cheeks). Beauty is in subtlety and finesse, not in numbers and volumes. Let an experienced surgeon guide you. Robert Browning was right in admonishing in his poem “Andrea del Sarto” in 1855 that “less is more”. Or as the architect Ludwig Mies van der Rohe 
​
so aplty said, “God is in the details.”

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Locations: 
​Dr. BCK Patel MD, FRCS
​65 Mario Capecchi Drive
Salt Lake City, Utah, US
(801) 585-6641/6646

Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
​Saint George, UT 84790
(435) 215-0014

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Conditions

Aging Of The Face
Aging of Lower Eyelids
Aging of the Forehead and Brows
Aging of Eyelashes
Aging of the Cheeks
Aging of the Neck
Aging of the Lips
Aging of the Mouth
Aging of the Chin
Aging of Eyelashes
Aging of the Hands
Aging Of Skin Colour
Aging Of Hair
​Aging of the Jowls
Aging of Men
Aging of the Skin
Aging of Veins and Vessels
Scars

Cosmetic

Facelift
Browlifts
Lower Blepharoplasty/Hammock Lift
Upper Blepharoplasty
Midface Lift/Hammock Lift
Necklift
Lips
Mouth
Neck Liposuction
Fat Transfer
Skin Resurfacing
Cheeks
J-PLASMA SKIN RESURFACING
J-PLAZTY FACE
Removal of Moles, Lesions, Tags, Cysts and Blemishes
Facial Implants
Otoplasty, Ear Pinning, or Bat-Ear Repair
​Complications?

Reconstruction

​Entropion
Acquired Ptosis
Ectropion
Congenital Ptosis
Blepharospasm
Anophthalmos and Microphthalmos
Thyroid Eye Disease
Enucleation and Evisceration
Nasolacrimal Duct Obstruction
Symblepharon
Congenital Anomalies - Lid Disorders
Acne Rosacea
Trauma
Infections
Skin Tumors
Orbital Tumors

Non- Invasive

 Photorejuvenation
Aerolase Laser
Botox
Laser Hair Removal
Kybella
Juvederm
Chemical Peels
Fractional Carbon Dioxide CO2 Laser
XEOMIN ®
Voluma
Latisse Eyelash Treatment
Leg Veins and Spider Vein Treatment
Sculptra
Neck and Chest Cosmetic Concerns
Restylane
Dysport
Accent Radiofrequency
Microdermabrasion and Light Chemical Peels
Melasma
Fractional Resurfacing Lasers: Erbium lasers
Color and Texture Issues – Brown Spots on Face, Redness
Laser Tattoo Removal
Radiesse
Acne
​Permanent Cosmetic Makeup

VIDEOS

links
​
www.hammocklift.com

WWW.PATELFACELIFT.COM

www.englishsurgeon.com

www.drbhupendrapatel.com
​
bckpatel.info

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Patel Plastic Surgery  .  Copyright 2022 . All Rights Reserved
  • Home
  • Locations
    • Plastic Surgery Salt Lake City
    • Plastic Surgery St. George
  • Conditions
    • Aging Of The Face
    • Aging of Lower Eyelids
    • Aging of the Forehead and Brows
    • Aging of Upper Eyelids
    • Aging of the Cheeks
    • Aging of the Neck
    • Aging of the Lips
    • Aging of the Mouth
    • Aging of the Chin
    • Aging of Eyelashes
    • Aging of the Hands
    • Aging Of Skin Colour
    • Aging Of Hair
    • Aging of the Jowls
    • Aging of Men
    • Aging of the Skin
    • Aging of Veins and Vessels
    • Scars
  • Cosmetic
    • Facelift
    • Browlifts
    • Lower Blepharoplasty
    • Upper Blepharoplasty
    • Midface Lift/Hammock Lift
    • Necklift
    • Cosmetic Surgery for Men
    • Lip Lines
    • Lips
    • Mouth
    • Neck Liposuction
    • Fat Transfer
    • Skin Resurfacing
    • Cheeks
    • J-PLASMA SKIN RESURFACING
    • J-PLAZTY FACE
    • Removal of Moles, Lesions, Tags, Cysts and Blemishes
    • Facial Implants
    • Otoplasty, Ear Pinning, or Bat-Ear Repair
    • Complications?
  • Reconstruction
    • Acquired Ptosis and Dermatochalasis
    • Congenital Ptosis
    • Ptosis in Myasthenia Gravis
    • Blepharophimosis Syndrome
    • Entropion
    • Ectropion
    • Thyroid Eye Disease
    • Nasolacrimal Duct Obstruction
    • Skin Tumors
    • Orbital Tumors
    • Blepharospasm
    • Pterygium
    • Anophthalmos and Microphthalmos
    • Enucleation and Evisceration
    • Exenteration
    • Symblepharon
    • Congenital Anomalies - Lid Disorders
    • Acne Rosacea
    • Trauma
    • Infections
  • Non Invasive
    • Photorejuvenation
    • Aerolase Laser
    • Botox
    • Radiesse
    • Restylane
    • Juvederm
    • Fractional Carbon Dioxide CO2 Laser
    • Fractional Resurfacing Lasers: Erbium lasers
    • Laser Hair Removal
    • Kybella
    • Chemical Peels
    • XEOMIN ®
    • Voluma
    • LATISSE EYELASH TREATMENT
    • Leg Veins and Spider Vein Treatment
    • Sculptra
    • Neck and Chest Cosmetic Concerns
    • Dysport
    • Accent Radiofrequency
    • Microdermabrasion and Light Chemical Peels
    • Melasma
    • Laser Tattoo Removal
    • Color and Texture Issues – Brown Spots on Face, Redness
    • Scars and Acne
    • Permanent Cosmetic Makeup
  • Resources
    • Patient Forms & Downloads
    • Out Of State and Overseas Patients
    • Reviews
    • VIDEOS Patel Plastic Surgery
  • About
  • Blog
  • Contact