BOTOX Cosmetic and Xeomin are prescription botulinum toxin type A injections used to temporarily relax selected facial muscles and soften frown lines, forehead lines and crow’s feet. Coastal Dermatology + Aesthetics administers them at its San Luis Obispo and Santa Maria offices. Appointments take 15 to 30 minutes and results last three to four months.
What it actually does to a frown line
Some lines on your face are creases in the skin. Others are the result of a muscle pulling the same way ten thousand times. A neuromodulator only works on the second kind. It quietly turns down the signal telling that muscle to contract, the pull stops, and the line it was carving softens over the following week.
That distinction is the whole treatment, and it is why the assessment matters. Lines that are there when your face is completely still are usually a filler question or a resurfacing question, not this. Lines that appear when you frown, squint or raise your brows are this. Most people have some of both, which is normal and worth knowing before you pay for the wrong one.
The word people are afraid of is frozen. Frozen is a dosing decision, not a property of the drug. Treated conservatively and placed properly, your forehead still moves, your brows still lift and your face still reads as yours. That is the standard here, and it is easier to hold to when the person injecting does this every day.
What it is good at
- Softening the vertical frown lines between your brows that make you look angry
- Smoothing horizontal forehead lines without dropping your brows
- Easing crow’s feet at the corners of the eyes
- Small refinements: bunny lines on the nose, chin dimpling, a gummy smile, vertical neck bands
- Stopping heavy underarm sweating, which is a medical treatment rather than a cosmetic one
- Slowing new lines from setting in, if you start before they are permanent
Typical appointment. Most of that is assessment. The injections themselves take a couple of minutes, and there is no recovery: people come at lunchtime and go back to work.
How treatment works
We watch your face move
You will be asked to frown, raise your brows, squint and smile. Where and how much you get is decided from how your muscles actually pull, not from a diagram. Faces are not symmetrical and treating them as if they were is how people end up with one brow higher than the other.
The injections
A few minutes with a very fine needle. Most people describe it as a quick pinch. There is no numbing needed for the vast majority, no recovery, and you can go straight back to your day.
It settles over a week
You will start to notice it in two to seven days and see the full result at about two weeks. We would rather start conservatively and add a little at a review than overshoot, because you can always add and you cannot take away.
Facial areas BOTOX Cosmetic is FDA approved to treat: frown lines between the brows, crow’s feet, forehead lines and vertical neck bands. Xeomin is approved for the three upper-face areas. [1][2]
Areas we treat
Between the brows
Softens the deep vertical frown lines that read as angry or worried.
Forehead
Smooths horizontal lines while keeping your brows where they belong.
Around the eyes
Eases crow’s feet without flattening your smile.
Nose
Settles the bunny lines that crinkle when you scrunch.
Around the mouth and chin
Takes the pucker out of a dimpled chin and softens a gummy smile.
Neck
Relaxes the vertical bands that stand out when you tense.
Underarms
Stops heavy sweating. This uses the therapeutic formulation, not BOTOX Cosmetic, and is usually a medical visit rather than a cosmetic one. See hyperhidrosis.
Real results
Before & after
These are our own patients, photographed at our offices and published with their consent. Individual results vary. There are more in the practice’s private gallery, and we will show you cases close to yours at your consultation.
Individual results vary. Photos shown are unretouched patients of Coastal Dermatology + Aesthetics, published with consent.
How long a cosmetic result typically lasts. It varies with muscle strength, dose, area and your own history, so your interval should come from how you actually respond rather than from a calendar. [1]
The staff is terrific, front to back. Thank you, Dr. Kilcline, for the great work today.
The Coastal difference
Injected by the people who trained on skin
Neuromodulators are prescription drugs, and where you have them done changes the result far more than which brand goes in the syringe. Here they are given inside a dermatology practice, by providers who look at faces all day and who are not working to a fixed template of units per area.
We treat conservatively on purpose. It is easier to add a small amount at a two-week review than to wait three months for too much to wear off, and the people who look untouched are almost always the ones whose injector held back. If you come in asking for something we think will make you look done, you will hear that.
We also carry both. BOTOX Cosmetic and Xeomin are not interchangeable and the reasons to choose between them are real, which is the next section.
BOTOX® or Xeomin®, and why we carry both
Both are botulinum toxin type A. Both work by turning down the signal to a muscle. What differs is what comes along with the toxin, and what each one is approved to treat.
Xeomin is the naked one. It is the same active toxin with the surrounding accessory proteins stripped out, so it contains no complexing proteins. [2] Those proteins are one of the things an immune system can learn to recognize, which is why a product without them is less likely to lose its effect on you over years of treatment. If you have been having injections for a long time and feel they do not last the way they used to, this is a conversation worth having.
BOTOX Cosmetic is approved for more areas. Xeomin is FDA approved for the three upper-face areas: frown lines, forehead lines and crow’s feet. BOTOX Cosmetic is approved for those three plus vertical neck bands. [1][2]
Their units are not interchangeable either, so a dose of one cannot simply be converted into a dose of the other. Which you get depends on your area, how you have responded before, and clinical judgment. Neither is universally better, and anywhere that only stocks one will always recommend the one it stocks.
Is it right for you?
It is probably a good fit if:
- The lines that bother you appear when your face moves
- You look tired or cross in photographs and you do not feel that way
- You want something with no recovery that you can have at lunchtime
- You want to start before the lines become permanent
- You sweat heavily through your clothes regardless of temperature
We will steer you somewhere else if:
- The lines are there when your face is completely still, which is usually filler or resurfacing
- You are pregnant or breastfeeding
- You have a neuromuscular condition that makes this unsafe
- You have an infection at the injection site
- What you are describing to us sounds like it will end up looking overdone
What to expect afterward
Almost nothing. You may have small red bumps at the injection points for twenty minutes and the odd bruise. Some people get a mild headache the first time. You go straight back to your day.
For the rest of the day, do
- Stay upright for about four hours
- Use your face normally: frowning and raising your brows is fine and may even help
- Go back to work, the school run, whatever you had planned
For the rest of the day, don’t
- Rub, massage or press the treated areas
- Lie flat, work out hard, or sit in a sauna
- Panic at day three if one side looks ahead of the other. It evens out.
Call us about anything severe, worsening or simply not what we described, including significant pain, signs of infection, drooping, or trouble swallowing, speaking or breathing. Botulinum toxin products carry an FDA boxed warning about effects spreading beyond the injection site. It is rare with cosmetic treatment, and it is the reason this is done by a medical provider rather than at a party.
Concerns treated
Pick a concern to see how we approach it.
What treatment costs
Neuromodulators are priced by the number of units used, and how many units you need depends on the area and on how strong the muscle is. That is why nobody can quote you a real number before looking at your face, and why a per-area flat price usually means a fixed dose whether it suits you or not.
You will be told the number of units and the cost before anything is injected. No surprises at the desk.
Treatment time
15 to 30 minutes
Downtime
None
Results appear
2 to 7 days
Results last
3 to 4 months
BOTOX and Xeomin frequently asked questions
How long before you start to see it. Full effect is at about two weeks, which is when we would review you rather than at the appointment itself.
Offered at
Both offices offer neuromodulator treatment. San Luis Obispo offers BOTOX Cosmetic and Xeomin. Santa Maria offers Xeomin.
Ready when you are. Request your consultation
Fill out the form below, book online in Santa Maria (opens online scheduler), or give us a call. Cosmetic and aesthetic appointments need no referral. For medical dermatology, we are accepting new patients by referral from your primary care physician; send the referral across and then use the same form.
Cosmetic consultations are $125, paid at booking and credited toward the cost of treatment.
Sources and medical review
1. BOTOX® Cosmetic (onabotulinumtoxinA) Prescribing Information, Allergan Aesthetics, October 2024. Approved for temporary improvement in the appearance of moderate to severe glabellar lines, lateral canthal lines, forehead lines and platysma bands in adults. Duration of effect for glabellar lines is approximately 3 to 4 months. https://www.botoxcosmetichcp.com/indications/ufl-indications · Regulatory / Prescribing Information
2. XEOMIN® (incobotulinumtoxinA) Prescribing Information, Merz Pharmaceuticals, July 2024. Indicated in adults for temporary improvement in the appearance of upper facial lines: moderate to severe glabellar lines, horizontal forehead lines and lateral canthal lines. Retreatment no more frequently than every three months. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/125360s074lbl.pdf · Regulatory / Prescribing Information
Content on this page is for educational purposes and is not a substitute for professional medical advice. Botulinum toxin products carry an FDA boxed warning regarding distant spread of toxin effect. BOTOX® Cosmetic is a registered trademark of Allergan. Xeomin® is a registered trademark of Merz Pharmaceuticals. Individual results may vary. Cosmetic consultations are $125, paid at booking and credited toward the cost of treatment.