A woman in her middle 60’s who is bothered by an aged appearance, but is on a blood thinner, Eliquis. As part of her facial improvement, she decided to try Daxxify, the first long-acting neurotoxin on the market. It excels in both strength and duration compared to the short-acting neurotoxins on the market.
She is shown before and again, 3 weeks after the placement of 100 units of Daxxify, which is equivalent to 50 units of Botox. The results are dramatic in the frown line area ( corrugator and procerus muscles) as well as in the Lateral Canthal Lines or “crow feet” area. She thankfully did not have significant problems with bruising despite being on the Eliquis. The full frown view shows that she is unable to frown, The smile view shows the improvement in the lateral canthal lines or “crow’s feet” area. Full brow elevation shows a decrease in forehead lines even though we did not place any Daxxify in the frontalis- she does not have a “Dr. Spock” or “McDonald arches” unnatural shaping of the brows after her treatment.
A woman in her middle 60’s who is bothered by an aged appearance, but is on a blood thinner, Eliquis. After discussions, she elected to try nonsurgical facial improvement by replacing some of the age-related volume loss with Resilient Hyaluronic fillers, or RHA. These are one line of Non-Animal Stabilized Hyaluronic Acid fillers distributed in the US by Revance. Other NASHA lines include the Restylane line by Galderma and the Juvederm line by Allergan. The NASHA fillers have the benefit of being reversible with the ability to dissolve them with an enzyme, hyaluronidase. The RHA line has the added benefit of being especially flexible and resilient, which is a benefit in parts of the face that move.
In her case, I placed one syringe of Redensity (which would be RHA 1) in the “tear trough” area, where it is frequently used off-label in Europe. I then placed 2 syringes of RHA 4 (firmer but flexible) in the cheeks, and 1 syringe of RHA 2 (firmer than 1, softer than 4 but still flexible ) in the upper nasolabial creases.
She did not have much problem with bruising despite being on Eliquis and returned for Daxxify, a long-acting neurotoxin for frown lines and crow feet lines, where I have found that it excels in both strength of effect and duration over the short-acting neurotoxins on the market.
The overall effect of these two treatments is dramatic and does not require surgery.
A woman in her later 60s who wanted an improvement in an aged appearance but did not want a facelift or brow lift.
She is shown before and again, 3 weeks after 100 units of Daxxify, placed to the corrugator and procerus muscles, lateral orbicular, and mentalis. She has had a remarkable improvement in the “crow’s feet” area with activity and at rest. The “smile lines” seen in the before view are dramatically better both with activity and even at rest. This is a much stronger effect than I was previously able to obtain with Botox. She does not have a strong “frown” before but it is better after and at rest we can see some slight elevation across her brows. She describes this as feeling “lighter” than her prior treatments with Botox. The chin is less “pruney” after treatment of the mentalis muscles. I have also placed rha-4 along her jawline. This is similar to treating deflation along the cheeks, and this has improved the jowls, and given her a better jawline.
A woman in her early 80s who is shown before and again, 2 weeks after 100 units of Daxxify to the forehead and 1 Redensity to the upper lip At rest she actually has a few mm of eyebrow elevation. The skin has a better appearance, something that patients are noticing after Daxxify that we don’t have an explanation for yet.
The redensity to the upper lip shows a nice improvement of the dynamic lines (sometimes called “smokers lines”) with a “whistle” view, but no fullness of the lips at rest. At 2 weeks she still has a small bruise.
A woman in her early 80’s who is shown before and again, 2 weeks after 100 units of Daxxify. At rest, she actually has a few mm of eyebrow elevation. The skin has a better appearance, something that patients are noticing after Daxxify that we don’t have an explanation for yet.
The smiling view shows dramatic improvement in the crow feet area, which I would not have been able to achieve as well with Botox. The frowning view shows the elimination of the frown. The forehead elevation view shows the normal appearance of the eyebrows with no “Dr. Spock’ or “McDonald’s arches.” Not only is Daxxify shown in studies to last significantly longer (an average of 2 months longer than Botox), but 93% of patients who have previously had Botox, prefer the results of Daxxify treatment at 2 weeks.
A woman in her early 50’s who gets Botox with us every 3 months is shown before and again, 4 weeks after 100 units of Daxxify. She has previously had Botox ( and had it 3 months before) but prefers the early results with Daxxify Studies are showing that 93% of patients who have previously had Botox prefer their Daxxify result at 2 weeks.
She has also been told that her skin looks better which is a result that many patients have mentioned but we are not yet sure how Daxxify is causing this.
On resting view before and after, we can see that she has a few millimeters of eyebrow elevation after the Daxxify. With Daxxify we target the muscles that cause frowning more directly ( corrugator muscles) and avoid weakening the lower frontalis muscles ( which are the only elevator of the brows and can give unnatural shape to the brows if overtreated, ie Dr. Spock brows or “Mcdonald’s arches” at rest or with activity. It is also important to treat the procerus muscle which can pull down the brow when active.
When she actively raises her brows she has a normal look. Some patients are worried that Daxxify hasn’t worked because they can still elevate their brows normally and have lines with activity in the forehead. And we could treat the forehead with Daxxify but didn’t with her to prevent a funny shape to the brows. After reviewing the results she prefers the natural look of the Daxxify and does not want a frozen forehead with unnatural brow position and loss of the brow elevation that we have achieved
The smiling view is also dramatic. She has a much stronger result in the crow’s feet area (lateral orbicularis muscles) than I have been able to achieve with Botos, and the studies suggest that this effect with Daxxify should be good for 5 months as opposed to Botox where the maximum duration we can typically achieve is 3 months.
With 4 months of experience with Daxxify, most of my patients prefer it over Botox. It is dramatically better in the corrugator area ( “ the 11’s”) and in the lateral orbicularis (“crow’s feet”). The results are much stronger at 2 weeks, and studies demonstrate that the results for them should be 2 months longer. Especially for my patients who get treated every 3 months with Botox, as the added duration of Daxxify that expect is even more important. For my patients who are mainly focused on the forehead lines and have been happy with the Botox treatment that we have mapped out in the forehead then I have been staying with the Botox for them for now, especially if they do not have strong corrugator and lateral orbicularis activity.
A woman in her later 50s is bothered by dynamic lines of the upper lip (“smokers lines”) and wants an improvement but does not want the fullness of the upper lip. She is shown before and a few months after one syringe of Redensity to the upper lip. No significant difference at rest but a dramatic difference with the pursing of the lips.
A woman in her later 50s wanted to improve the “smokers lines” of the white portion of the upper lip as well as correct some age-related collapse of the vermillion. But she still wanted a soft, natural look. She is shown before and again, 1 month after one redensity to the white portion of the upper lip and 1 Kysse to the vermillion.
29 yo with very active lines and wishes to control this as well as prevent the development of deep lines at rest who has received Botox in the past. She is shown before and again, one month after 120 units of Daxxify.
A woman in her mid-40s showed before and again, 2 weeks after 100 units of Daxxify were placed on the glabella ( frown lines) the lateral orbicularis ( “crow’s feet”), and the upper forehead. She has normal positioning of her eyebrow at rest but the forehead lines are diminished at rest and with activity. She can still raise her forehead and did not want to look “frozen”. Her frown lines are gone. The crow’s feet area is improved with smiling.