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Triple Board-certified Expertise

Neurotoxins | Botox Dysport Xeomin

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& Beautiful skin

(770) 771-6591
Closeup on a before and after comparative images on a woman. Both pictures frames the eyes and forehead. The eyebrows are lifted in both images. In the before image several strong wrinkle lines appearing on his forehead. In the after image those lines and wrinkles disappeared. Closeup on a before and after comparative images on a man. Both pictures frames the eyes and forehead. The eyebrows are lifted in both images. In the before image several strong wrinkle lines appearing on his forehead. In the after image those lines and wrinkles disappeared. Closeup on a before and after comparative images on a woman. Both pictures frames the eyes of woman, her face is 3/4 angle. She is smiling in both images. In the before image several strong wrinkle lines appearing next to her eyes, these are called crows feet. In the after image those lines and wrinkles disappeared. Closeup on a before and after comparative images on a woman. Both pictures frames the eyes of woman, her face is 3/4 angle. She is smiling in both images. In the before image several strong wrinkle lines appearing next to her eyes, these are called crows feet. In the after image those lines and wrinkles disappeared. Closeup on a before and after comparative images on a woman. Both pictures frames the eyes of woman. She is frowning in both images. In the before image several strong wrinkle lines appearing between her eyes and  a few fine lines on her forehead. In the after image those lines and wrinkles disappeared.

Indications, Important Safety Information and Prescribing Information

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All images © 2020 Allergan

Indications, Important Safety Information and Prescribing Information

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

Indications

BOTOX® Cosmetic (onabotulinumtoxinA) is indicated in adult patients for the temporary improvement in the appearance of:

- Moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity

- Moderate to severe lateral canthal lines associated with orbicularis oculi activity

- Moderate to severe forehead lines associated with frontalis activity

IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING

WARNING: DISTANT SPREAD OF TOXIN EFFECT

Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses and approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and spasticity and at lower doses.

CONTRAINDICATIONS

BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.

WARNINGS AND PRECAUTIONS

Lack of Interchangeability Between Botulinum Toxin Products

The potency units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of BOTOX® Cosmetic cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Spread of Toxin Effect

Please refer to Boxed Warning for Distant Spread of Toxin Effect.

No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 40 Units (for forehead lines with glabellar lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines), and 64 Units (for simultaneous treatment of lateral canthal lines, glabellar lines, and forehead lines) have been reported. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech, or respiratory disorders occur.

Serious Adverse Reactions With Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX® injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX® to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of BOTOX®. The safety and effectiveness of BOTOX® for unapproved uses have not been established.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.

Cardiovascular System

There have been reports following administration of BOTOX® of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects With Pre-existing Neuromuscular Disorders

Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should be monitored when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise from onabotulinumtoxinA (see Warnings and Precautions).

Dysphagia and Breathing Difficulties

Treatment with BOTOX® and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing (see Boxed Warning).

Pre-existing Conditions at the Injection Site

Caution should be used when BOTOX® Cosmetic treatment is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s).

Dry Eye in Patients Treated With BOTOX® Cosmetic

There have been reports of dry eye associated with BOTOX® Cosmetic injection in or near the orbicularis oculi muscle. If symptoms of dry eye (eg, eye irritation, photophobia, or visual changes) persist, consider referring patients to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.

ADVERSE REACTIONS

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for glabellar lines were eyelid ptosis (3%), facial pain (1%), facial paresis (1%), and muscular weakness (1%).

The most frequently reported adverse reaction following injection of BOTOX® Cosmetic for lateral canthal lines was eyelid edema (1%).

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for forehead lines with glabellar lines were headache (9%), brow ptosis (2%), and eyelid ptosis (2%).

DRUG INTERACTIONS

Co-administration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (eg, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX® Cosmetic may potentiate systemic anticholinergic effects.

The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by

administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.

Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX® Cosmetic.

USE IN SPECIFIC POPULATIONS

There are no studies or adequate data from postmarketing surveillance on the developmental risk associated with use of BOTOX® Cosmetic in pregnant women. There are no data on the presence of BOTOX® Cosmetic in human or animal milk, the effects on the breastfed child, or the effects on milk production.

Please see BOTOX® Cosmetic full Prescribing Information including Boxed Warning and Medication Guide.

Neurotoxins, redefined.

 

We’re here to reduce frown lines, crow’s feet, wrinkles, other signs of aging, pores, redness, and more. Looking for Botox, Dysport, Xeomin, or other neurotoxin injections in Johns Creek North Atlanta? Then visit us at Johns Creek Dermatology so we can advise you on the best cosmetic non-invasive non-surgical solution for your needs.


• All injectables are performed by our Triple Board-certified Dermatologist.

• We apply strict sterile technique to avoid infection.

• Fresh Botox, Dysport, Xeomin is diluted for the highest efficacy per FDA standard.

• You will only be charged for what you get, not a unit more! No flat rates.


Scroll down to read Dr. Timani's answers to FAQ and to view treatment pictures.


WE OFFER

Botox, Dysport, Xeomin, and the list goes on as newer neuromodulators are developed, most notably longer-acting ones that last at least two times longer than older neurotoxins (i.e. Daxi).


We have long excelled at the classic applications of neurotoxins for frown lines, forehead lines and crow's feet, but our expertise and skilled physicians who are master injectors mean we can also offer advanced techniques that are constantly evolving.


Facial Contouring “Slim Your Face”

Did you know botulinum toxin can be used to recontour and slim the face? This treatment is especially effective for relaxing the larger muscles of the lower cheeks to provide a more feminine, V-shaped face.


Lip Lift “Turn Your Frown Upside Down”

We all know that as we age our faces lose fullness and begin to droop. Unfortunately, the same changes occur in our lips. Surgical options can be costly and invasive. A non-surgical lip lift with neurotoxins can reverse the downward frown appearance and can evert the lips for a pouty more attractive look. 


Nefertiti Neck Lift

The Nefertiti Neck Lift is named after Queen Nefertiti whose bone structure has been admired for centuries. The Nefertiti Neck Lift is a cutting-edge technique that utilizes a series of Botox injections along the neck and jawline. This is a safe and non-surgical technique. The net effect is an upward pull from facial muscles resulting in a more smooth and defined jawline.


Pole Size Reduction

This is an effective and safe treatment to shrink pore size. Micro-doses of neurotoxin (aka “Micro-tox”) can be injected directly into the pores by a master injector technique or via the Aquagold Facial device. The neurotoxin acts on the arrector pili muscles to constrict and shrink pore size, while also reducing oil production.


Flushing and Redness Reduction

“Micro-tox” can also be used to reduce redness and flushing in the skin, which is extremely beneficial for our many patients with rosacea. Administered via an injection or the Aquagold facial device, micro-tox blocks inflammatory markers in the skin and inhibits the autonomic peripheral nerves of the cutaneous vascular system, leading to significant reduction in redness and control of facial flushing.  



FREQUENTLY ASKED QUESTIONS


What is BOTOX cosmetic?

This is an FDA-approved injectable to treat wrinkles between the eyebrows, in the forehead and in the eye area. 

 

How much research has gone into BOTOX cosmetic?

This is a treatment that has been used for many years. To date millions of people have received this injectable. 

 

How does BOTOX cosmetic work?

It is a neurotoxin that blocks the ability of a muscle to contract when ordered by a nerve. Thus, it is most effective with wrinkles that are induced by gestures and less effective for wrinkles that are visible at rest.

 

Is there a substitute for BOTOX cosmetic?

There are no generics, however there are other brand names such as Dysport, Xeomin, and Juveua. They have subtle differences in the efficacy and results. Your dermatologist will advise you on the ideal product.

 

Will my face look overdone or unnatural?

You can look very natural and youthful, make sure you explain your goals very well and make sure you consult with a dermatologist that is willing to listen. I advise against overdone looks.

 

How can I save on Botox cosmetic?

Be wary of unbelievable deals because they are probably too good to be true. Be sure you are being injected by a board-certified dermatologist who follows the standard of care for handling and reconstituting the product

 

Is Botox cosmetic only for women?

Absolutely not! Men are more conscious than ever of the aging process especially in this competitive world. We are more visible than ever and are connecting from the comfort of our home on zoom and making many more business and social networks.

 

Do I need to be over 40 to start using Botox cosmetic?

Many patients younger than 30 are getting these treatments for prevention, especially if they have family history of pesky wrinkles. 

 

How much time does Botox cosmetic treatment take?

The treatment itself is quick, but the consult for first time injectors takes time. Even for repeat patients we have to reset the goals depending on the patient’s needs. The plan always evolves and never stays static. Aging is not static. 

 

Will it hurt?

The injections are usually very well tolerated. But there are strategies to make them extremely acceptable. Don’t be shy to discuss your concerns about needles and discomfort with your dermatologist.

 

Will I see results quickly? How long does BOTOX cosmetic last?

I advise my patients that they will start seeing noticeable changes around 48 hours.  Usually the result is optimal around 2 weeks. The injections last approximately 3-4 months depending on the patient’s metabolism.

How long is the recovery time after treatment?

There is minimal to no downtime, there are some precautions that are important to enhance safety of the treatments and maximize its benefit. 

 

How many injections will I receive?

Patients are very unique and treatment plans vary.  There are no set injections or units. Herein lies the difference between a seasoned dermatologist and other injectors.


What were common side effects seen in clinical studies?

All medical and cosmetic treatments have risks and benefits. Not every patient is a candidate. My approach is never to allow the risks to overweigh the benefits. These risks are accessible to you online but it is ideal to discuss them with your dermatologist, their experience is invaluable. 

Closeup on a before and after comparative images on a woman. Both pictures frames the eyes and forehead. The eyebrows are lifted in both images. In the before image several strong wrinkle lines appearing on his forehead. In the after image those lines and wrinkles disappeared. Closeup on a before and after comparative images on a man. Both pictures frames the eyes and forehead. The eyebrows are lifted in both images. In the before image several strong wrinkle lines appearing on his forehead. In the after image those lines and wrinkles disappeared. Closeup on a before and after comparative images on a woman. Both pictures frames the eyes of woman, her face is 3/4 angle. She is smiling in both images. In the before image several strong wrinkle lines appearing next to her eyes, these are called crows feet. In the after image those lines and wrinkles disappeared. Closeup on a before and after comparative images on a woman. Both pictures frames the eyes of woman, her face is 3/4 angle. She is smiling in both images. In the before image several strong wrinkle lines appearing next to her eyes, these are called crows feet. In the after image those lines and wrinkles disappeared. Closeup on a before and after comparative images on a woman. Both pictures frames the eyes of woman. She is frowning in both images. In the before image several strong wrinkle lines appearing between her eyes and  a few fine lines on her forehead. In the after image those lines and wrinkles disappeared.

Indications, Important Safety Information and Prescribing Information

Toggle

All images © 2020 Allergan

Indications, Important Safety Information and Prescribing Information

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

Indications

BOTOX® Cosmetic (onabotulinumtoxinA) is indicated in adult patients for the temporary improvement in the appearance of:

- Moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity

- Moderate to severe lateral canthal lines associated with orbicularis oculi activity

- Moderate to severe forehead lines associated with frontalis activity

IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING

WARNING: DISTANT SPREAD OF TOXIN EFFECT

Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses and approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and spasticity and at lower doses.

CONTRAINDICATIONS

BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.

WARNINGS AND PRECAUTIONS

Lack of Interchangeability Between Botulinum Toxin Products

The potency units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of BOTOX® Cosmetic cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Spread of Toxin Effect

Please refer to Boxed Warning for Distant Spread of Toxin Effect.

No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 40 Units (for forehead lines with glabellar lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines), and 64 Units (for simultaneous treatment of lateral canthal lines, glabellar lines, and forehead lines) have been reported. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech, or respiratory disorders occur.

Serious Adverse Reactions With Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX® injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX® to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of BOTOX®. The safety and effectiveness of BOTOX® for unapproved uses have not been established.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.

Cardiovascular System

There have been reports following administration of BOTOX® of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects With Pre-existing Neuromuscular Disorders

Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should be monitored when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise from onabotulinumtoxinA (see Warnings and Precautions).

Dysphagia and Breathing Difficulties

Treatment with BOTOX® and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing (see Boxed Warning).

Pre-existing Conditions at the Injection Site

Caution should be used when BOTOX® Cosmetic treatment is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s).

Dry Eye in Patients Treated With BOTOX® Cosmetic

There have been reports of dry eye associated with BOTOX® Cosmetic injection in or near the orbicularis oculi muscle. If symptoms of dry eye (eg, eye irritation, photophobia, or visual changes) persist, consider referring patients to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.

ADVERSE REACTIONS

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for glabellar lines were eyelid ptosis (3%), facial pain (1%), facial paresis (1%), and muscular weakness (1%).

The most frequently reported adverse reaction following injection of BOTOX® Cosmetic for lateral canthal lines was eyelid edema (1%).

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for forehead lines with glabellar lines were headache (9%), brow ptosis (2%), and eyelid ptosis (2%).

DRUG INTERACTIONS

Co-administration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (eg, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX® Cosmetic may potentiate systemic anticholinergic effects.

The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by

administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.

Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX® Cosmetic.

USE IN SPECIFIC POPULATIONS

There are no studies or adequate data from postmarketing surveillance on the developmental risk associated with use of BOTOX® Cosmetic in pregnant women. There are no data on the presence of BOTOX® Cosmetic in human or animal milk, the effects on the breastfed child, or the effects on milk production.

Please see BOTOX® Cosmetic full Prescribing Information including Boxed Warning and Medication Guide.

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