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  • by Dr. Donald Brown

    A new cosmetic injectable just hit the shelves—and it’s creating quite a stir in the plastic surgery community. Manufactured by Merz Aesthetics, Xeomin was just approved for use in the United States in July of last year, and already a number of cosmetic surgeons are offering it alongside comparable injectables, such as Botox and Dysport, at their clinics.

     The buzz about Xeomin is deafening; but what is it, exactly, and what makes it different from its competitors?

     What is Xeomin?

     Xeomin, like Botox, is a botulinum toxin that can be applied in injectable form to temporarily eliminate wrinkle lines, particularly the frown lines between the eyebrows. It works by blocking the signals your nerves send to your muscles, which prevents the muscle contractions that cause wrinkles from occurring.

     Though it only recently became available here in the U.S. for cosmetic purposes, Xeomin (under a different name, “Bocouture”) has been in use by plastic surgeons in many European countries, such as France, Italy, Spain, Germany, and the UK, for a few years now.

     Are Xeomin and Botox the same?

     For all intents and purposes, Xeomin is very similar to Botox. The only structural difference between the two (we’re going to get technical for a minute, here, bear with me!) is that Xeomin doesn’t have any complexing proteins wrapped around its active toxin molecule, while Botox does.

     What does this mean? Well, theoretically it means that Xeomin could work for the small handful of people who have experienced adverse reactions to Botox. The proteins that encase Botox can prompt your body to create antibodies, which in turn can make you resistant to treatments (it’s rare, but it does happen occasionally); Xeomin’s lower protein load could reduce the likelihood of that happening.

     However, the fact that Xeomin has fewer protecting proteins could have a downside as well: there have been some concerns about whether Xeomin’s “naked” structure might make it less stable—and therefore more likely to spread outside the areas where it’s been injected—than Botox.

     Which cosmetic injectable is best?

     Probably the biggest reason that Xeomin is getting so much hype right now is that it’s slightly less expensive than Botox. Prices, however, are subjective: some doctors currently offer Xeomin at a lower cost than Botox, but others charge about the same for both. If you truly want to get a better deal on Xeomin, you may have to search around a little.

     As far as performance goes: at this point in the game, there doesn’t seem to be a big enough difference between Botox and Xeomin to say that one is conclusively better or worse than the other. Since Xeomin has unit-to-unit equivalence with Botox, comparing the treatment effects is a relatively straightforward process—and so far, the two toxins seem to be neck and neck.

     What it really comes down to, then, is personal preference. If your priority is to save every dollar you can on your procedure, you probably will be able to find Xeomin at a slightly lower price. However, from a safety standpoint, Botox looks better, at least for now—plenty of studies have been conducted about its long-term effects, whereas very few have been conducted about Xeomin’s.

     At the end of the day, Xeomin is still new to all of us here in the U.S., so it’s a little early to be handing down a definitive verdict about it. Perhaps once more studies are done on Xeomin, it will prove to measure up to Botox; for now, though, from my point of view, the jury is still out.

    About Dr. Donald Brown

    Dr. Donald Brown is of the most experienced and trusted plastic surgeons in the San Francisco Bay Area. He places the comfort, safety and satisfaction of his patients of above all else. He also strives to offer the most comprehensive range of cosmetic procedures possible, including minimal incision and non-surgical options design to restore youth and beauty to the skin, breasts, face and body.

    Dr. Donald Brown is a double board certified plastic surgeon in the San Francisco Bay Area.