How Neurotoxins Work: The Science Behind Botox, Dysport, and Xeomin
- Jordan Andrews, DNP, CRNA
- May 9
- 5 min read
If you read our previous blog comparing Botox, Dysport, and Xeomin, you already know that each wrinkle relaxer has unique characteristics that may make one a better fit depending on your goals, anatomy, and treatment history.
In this blog post, we are taking a deeper dive into how neurotoxins actually work, what causes wrinkles to form in the first place, and what patients should realistically expect from treatment. Whether you are considering preventative Botox for the first time or are already receiving regular neurotoxin treatments, understanding the science behind these cosmetic injectables can help you make more informed decisions about your skin and long-term aging goals.
At Aesthetically Yours® in High Point, we believe patient education is just as important as the treatment itself.
What Are Neurotoxins?
Neurotoxins are injectable medications derived from botulinum toxin type A. In aesthetic medicine, these medications are used in highly purified, controlled doses to temporarily relax specific facial muscles responsible for creating dynamic wrinkles (Witmanowski & Błochowiak, 2020).
Common FDA-approved neurotoxins include:
Botox Cosmetic
Dysport
Xeomin
Jeuveau
Daxxify
Letybo
At Aesthetically Yours, we primarily use Xeomin and Dysport to create natural-looking results tailored to each patient’s anatomy and facial movement patterns.
What Causes Wrinkles to Form?
One of the biggest misconceptions about aging is that wrinkles only occur because the skin gets older.
In reality, the majority of wrinkles develop because of repeated muscle movement over time.
Every time you smile, squint, raise your eyebrows, frown or purse your lips your facial muscles contract and fold the skin above them. Eventually, those repeated folds become etched into the skin and remain visible even when your face is at rest.
These are known as dynamic wrinkles.
Over time, dynamic wrinkles can become static wrinkles, meaning the lines remain present even without facial movement. These static wrinkles are what we are trying to help you avoid with regular tox injections.
Additional factors that accelerate wrinkle formation include:
sun exposure
collagen loss
smoking
genetics
stress
dehydration
skin thinning with age
How Do Neurotoxins Work?
Neurotoxins work by temporarily blocking the release of acetylcholine, a neurotransmitter responsible for signaling muscles to contract (Nestor et al., 2020). It is important to remember that toxins treat the muscle, not the wrinkle itself.
When the targeted muscle relaxes:
repetitive folding decreases
tension on the skin is reduced
wrinkles soften
the skin has an opportunity to smooth and recover
This is why neurotoxins are often referred to as wrinkle relaxers.
Tox treatment does not “fill” wrinkles like dermal filler. Instead, it reduces the muscle activity contributing to wrinkle formation.
What Areas Can Neurotoxins Treat?
Patients throughout High Point, Greensboro, and the Triad area commonly seek neurotoxin treatment for:
Forehead lines
Frown lines between the brows (often called 11’s)
Crow’s feet
Bunny lines on the nose
Chin dimpling
Lip flip treatments
Downturned mouth corners
Platysmal neck bands (Nefertiti Neck Lift)
Jawline slimming
TMJ-related clenching
Excessive sweating
Treatment plans should always be individualized based on anatomy, muscle strength, facial balance, and aesthetic goals.
Does Botox Freeze Your Face?
Not when it is done correctly.
One of the most common fears patients have is looking frozen or expressionless after neurotoxin treatment. In reality, that overly stiff appearance is usually the result of over-treatment, improper dosing, or poor injection technique.
Modern aesthetic medicine focuses on preserving natural facial movement while softening excessive muscle contraction (Satriyasa, 2019).
At Aesthetically Yours, our approach emphasizes:
conservative dosing
customized treatment plans
facial balance
natural-looking results
maintaining expression while reducing harsh lines
The goal is refreshed, not frozen.
What Is Preventative Botox?
Preventative Botox refers to strategically using neurotoxins before deep wrinkles fully develop.
Because repetitive muscle movement contributes to wrinkle formation, reducing that movement earlier may help slow the progression of etched-in lines over time (Witmanowski & Błochowiak, 2020).
Preventative treatment does not mean starting excessively young or eliminating all movement. Instead, it involves individualized assessment of:
facial anatomy
muscle strength
movement patterns
existing lines
long-term aging goals
Many patients in their late 20s and 30s choose preventative neurotoxin treatments as part of an overall skin maintenance plan.
How Long Do Neurotoxins Last?
Most neurotoxin treatments last approximately 3 to 4 months, although this varies significantly between patients.
Several factors influence longevity, including:
metabolism
exercise frequency
muscle strength
treatment area
dosage
stress levels
individual response
Some patients naturally metabolize neurotoxins more quickly than others.
Patients who exercise heavily, have very strong facial muscles, or are newer to treatment may notice shorter duration or a need for increased dosing.
Why Does Botox Wear Off Faster in Some People?
This is one of the most common questions we receive at Aesthetically Yours.
Neurotoxins are not permanent treatments. Over time, the body gradually restores communication between nerves and muscles, allowing muscle movement to return (Padda et al., 2023).
Some reasons patients may experience faster wear-off include:
underdosing
high metabolism
intense exercise
strong muscle activity
long intervals between treatments
individual biologic variation
Consistency often improves results over time because the muscles become trained to contract less forcefully.
What Are the Side Effects of Neurotoxins?
When administered by trained medical professionals, neurotoxins are considered very safe and effective cosmetic treatments. Serious complications are uncommon in aesthetic use (Di Santis et al., 2025).
The most common temporary side effects include:
mild redness
swelling
tenderness
bruising
headache
temporary heaviness sensation
Less common side effects may include:
temporary eyelid drooping
uneven brows
smile asymmetry
unintended muscle weakness
These effects are typically temporary and improve as the medication gradually wears off.
Injector expertise, anatomy knowledge, and appropriate patient assessment play a major role in minimizing risk and achieving natural outcomes (Kroumpouzos et al., 2021).
Why Injector Technique Matters
Neurotoxin treatment is not one-size-fits-all.
Two patients can receive the same number of units in the same area and still have completely different results.
This is why choosing an experienced injector matters.
At Aesthetically Yours, all neurotoxin treatments are customized to support facial harmony, balanced movement, and individualized results rather than a cookie-cutter appearance.
What Should You Expect After Treatment?
Most neurotoxin appointments take approximately 15 to 30 minutes with little to no downtime.
Patients may begin seeing results:
within 4 to 5 days for Dysport
within 7 to 10 days for Xeomin
with full results around 14 days
After treatment, patients are typically advised to:
avoid strenuous exercise for several hours
remain upright for approximately 4 hours
avoid rubbing or massaging the area
avoid excessive heat exposure immediately after treatment
Are Neurotoxins Right for You?
Neurotoxins can be an excellent option for patients looking to:
soften wrinkles
prevent deeper lines
maintain a refreshed appearance
enhance facial balance
age more proactively
The best treatment plans are individualized and begin with a thorough consultation and facial assessment.
If you are considering Dysport, or Xeomin in High Point or the surrounding Triad area, our team at Aesthetically Yours is here to help guide you through the process with honest recommendations and evidence-based care.
We offer free Consultations to help guide your decision and determine your tox dose!
Related Reading
If you have not already, be sure to read our first neurotoxin blog:“Botox vs Dysport vs Xeomin: Which Wrinkle Relaxer Is Right for You?”
801 N. Lindsay Street Suite #101 High Point, NC 27262
References
Di Santis, É. P., et al. (2025). Adverse effects of the aesthetic use of botulinum toxin and dermal fillers on the face: A narrative review. Anais Brasileiros de Dermatologia. https://pmc.ncbi.nlm.nih.gov/articles/PMC11745296/
Kroumpouzos, G., et al. (2021). Complications of botulinum toxin A: An update review. Journal of Cosmetic Dermatology. https://doi.org/10.1111/jocd.14160
Nestor, M. S., Arnold, D., & Fischer, D. L. (2020). The mechanisms of action and use of botulinum neurotoxin type A in aesthetics. Journal of Cosmetic Dermatology, 19(Suppl. 1), 9-17. https://pmc.ncbi.nlm.nih.gov/articles/PMC7693297/
Padda, I. S., Tadi, P., & Cooper, A. C. (2023). Botulinum toxin. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557387/
Satriyasa, B. K. (2019). Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: A literature review. Clinical, Cosmetic and Investigational Dermatology, 12, 223-228. https://doi.org/10.2147/CCID.S202919
Witmanowski, H., & Błochowiak, K. (2020). The whole truth about botulinum toxin: A review. Postępy Dermatologii i Alergologii, 37(6), 853-861. https://pmc.ncbi.nlm.nih.gov/articles/PMC7874868/
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