What are Neuromodulator injections?

Neuromodulator is a toxin produced by the bacteria Clostridium botulinum. In large amounts, this toxin can cause a form of muscle paralysis known as botulism, which is usually associated with food poisoning. Even though one of the most serious complications of botulism is paralysis, scientists have discovered a way to use it to human advantage. Small, diluted (weakened) amounts can be directly injected into specific muscles, causing controlled relaxation of the muscles.

The FDA approved such usage in the late 1980s when it was discovered that Neuromodulator could stop ailments such as blepharospasm (uncontrolled blinking) and strabismus (lazy eye). Cosmetic physicians have been using it for years to successfully treat wrinkles and facial creases. Neuromodulator injections are approved for treatment of frown lines on the forehead, crow’s feet (lines around the eye), and axillary hyperhidrosis (increased sweating of the armpits).

Currently, there are four primary options available for the neurotoxins ( neuromodulators), and the newly released Juneau. While the formulations vary, they all use the same active ingredient and similar secondary ingredients, leading to products that perform in very comparable ways.

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When injected into muscles in the upper face, the Botulinum Toxin Type A disrupts communication between the muscle fibers and nerves, which reduces movement and allows the overlying skin to smooth out. This aspect of all Botulinum Toxin Type A products is the same across the board, while the unique preparation process and secondary ingredients can alter the dosing and price while still providing similar results and longevity. Typically, patients can expect their results to last around four – six months before effects wear off.

It can be used on the forehead lines, frown lines, crow’s feet, bunny lines (lines in the nose), chin (for dimpling), skin bands on the neck, and around the mouth (for smoker’s lines and down-turned corners of the mouth). Wrinkles caused by sun damage and gravity often will not respond to Neuromodulator. It is important to re-emphasize that Neuromodulator is NOT a facial filler (that is, it does not fill existing wrinkles) – it merely relaxes the muscles that are creating those wrinkles.

Neuromodulator is injected with a fine needle into specific muscles, with only minor discomfort. The procedure takes only a few minutes and no anesthesia is required. It generally takes 3 to 7 days, but sometimes even as long as 2 weeks, to take full effect. It is best to avoid alcohol at least one week before treatment. Aspirin and anti-inflammatory medications should be stopped 2 weeks before treatment (if given permission by a physician) in order to reduce the risk of bruising.

The most common side effects of Neuromodulator injections are temporary bruising and slight pain with injection. Headaches, which go away in 24 to 48 hours, can occur, but this is rare.

A very small percentage of patients may develop eyebrow or eyelid drooping, drooping of the corner of the mouth, or inability to use a straw, depending on where the Neuromodulator is injected. For this reason, one should not rub the treated area for 12 hours after injection, or lie down for three to four hours after injection. No serious side effects have been noted when using Neuromodulator at the dermatologic (prescribed) doses.

Patients with following conditions should not use Neuromodulator 

  • pregnant
  • breastfeeding
  • allergic to albumin or constituent (part) of the preservative
  • suffering from neurological diseases
  • As Neuromodulator does not work for all wrinkles, a consultation with a doctor is recommended

The effects of Neuromodulator will last for up to 6 months. As muscle action gradually returns, the lines and wrinkles begin to reappear and will need to be re-treated to maintain the effect. After repeated injections, the lines and wrinkles will often appear less severe because the muscles are being trained to relax.

Woman face before and after neuromodulator injection

Before/After injections

7 Days After Treatment

Woman face before and after neuromodulator injection

Before/After injections

7 Days After Treatment

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