Xeomin® (incobotulinumtoxinA) is a German drug for botulinum therapy

• which is better Xeomin or Botox: reviews, videos,
• instructions for use (PDF),
• Xeomin price per unit for 2021.

Xeomin® is a drug for botulinum therapy, which can easily be classified as a new generation of botulinum toxins, because it contains only pure botulinum toxin type A, almost completely free of complexing proteins (why this is important and what these proteins affect - we will tell you below). The drug is available in bottles of 50 and 100 units. Manufacturer – German

The drug entered the German market in 2005, and already in 2011 it received approval from the FDA (Federal Bureau of Pharmaceutical Quality Control in the United States) and is now widely used throughout the world. This drug has 2 key advantages that distinguish it from botulinum toxins from other manufacturers. Firstly, as we have already said, there are no complexing proteins, and secondly, this drug can be stored at room temperature for 48 months without requiring a refrigerator or freezer.

Xeomin (release forms 50 and 100 units) –

Such storage conditions guarantee the cosmetologist that the drug will definitely work. After all, any violation of the temperature regime for storing a bottle of Botox, Dysport, Refinex, Botulax and others (from the moment of production until the moment of dilution of the drug in the clinic) leads to complete or partial denaturation of botulinum toxin molecules and a decrease in its effectiveness. With the exception of Xeomin, botulinum toxin preparations from any other manufacturer should be stored until dilution either in the freezer or in the refrigerator at a temperature of 2-8 degrees Celsius.

Botulinum therapy with the drug Xeomin gives the doctor confidence that the effectiveness of the drug will not be affected in any way by the conditional Vasya Pupkin, who accidentally turns off the power supply to the refrigerator where this drug was stored before it was delivered to the clinic. And the patient can also be calm, because... possible power outages in the clinic also cannot in any way affect the effectiveness of the drug. And for this I really like Xeomin, although we also need to return to the topic of complexing proteins, the presence of which leads to the production by the immune system of special antibodies that neutralize botulinum toxin.

Why is botulinum toxin Xeomin® for you?

I am all for natural results from aesthetic correction. Getting rid of wrinkles, not facial expressions, is my principle when working with cosmetology patients. In addition, for young patients it is an ideal drug for the prevention of facial wrinkles and the elimination of negative facial patterns. As is known, Xeomin® does not contain complexing proteins, therefore it has low immunogenicity and can be safely used in young patients. For patients over 30 years old, I use Xeomin® using the full face technique. Patients always note a high aesthetic result and long-lasting effect. When working on the entire face, I prefer to do it in two stages. And I’m not at all afraid of booster injections, since Xeomin® is approved for use at flexible intervals.

I love Xeomin® and use it a lot in the clinic, because I often see young patients and patients aged 45-50 years, and for them Xeomin® is the best choice. In addition, there are more and more patients who want to correct their forehead with botulinum toxin, but in such a way that, in the absence of wrinkles, the correction is invisible. Xeomin® allows you to remove active facial expressions while maintaining emotionality. In my practice, this can only be achieved using Xeomin®.

I use Xeomin® because it is an innovative new generation botulinum toxin; it has a number of unique properties that help me work more efficiently and safely. Xeomin® has very low diffusion and a low content of protein components in the molecule, which allows it to be safely used in difficult patients who are prone to the formation of edema. The next group is young patients, they have a large number of injections ahead of them, and here the low immunogenicity of Xeomin® helps me to be sure that patients will respond to botulinum toxin type A with the same quality even after 10–20 years of injection practice and regular correction. This has been confirmed by a large number of multicenter international studies.

Indications for Xeomin injections

The drug is specially designed for aesthetic cosmetology, and not for medical purposes, like Botox. If you read reviews about Xeomin, you can see that it is very effective in the following cases:

• correction of “crow’s feet” or small wrinkles in the corners of the eyes;
• elimination of longitudinal and transverse wrinkles on the forehead;
• allows you to get rid of eyebrow wrinkles;
• radial wrinkles around the mouth;
• nasolabial folds are not very pronounced;
• wrinkles in the décolleté area.

The Xeomin injection procedure is practically painless; if you are still very afraid of pain, you can ask the doctor to apply an anesthetic cream or gel. In terms of time, all manipulations do not take more than 30-40 minutes. The effect of botulinum toxin can be noticed already on days 2-3, the full effect appears on days 10-17, and lasts 3-4 months. After which the injections can be repeated.

Which areas of the face do you most often correct using Xeomin®?

As I noted above, this is a full face. The drug is especially indispensable when working with the muscles of the middle and lower third of the face and the subcutaneous muscle of the neck. A high safety profile, the presence of scientific research, our own rich clinical experience (thousands of satisfied patients) - all this gives reason to believe that Xeomin® is the optimal drug for the above areas of the face and neck.

I work Xeomin® exclusively on the face, most often the forehead, between the eyebrows, eyes, but I also use the full face technique, the drug gently and correctly regulates muscle activity. As a rule, there are no problems. I do not use Xeomin® in the armpits or other areas.

With Xeomin®, as a rule, I do not correct just some areas of the face, but, taking into account the uniform biomechanics of the facial muscles of the upper, middle and lower thirds and the subcutaneous muscle of the neck (platysma), I perform a full face correction. The technique differs in that it allows the safe use of high doses. The use of Xeomin® in dosages of 100–200 units for immediate correction gives a more beautiful result of non-surgical face lifting. Accordingly, having worked in this technique for several years, I can guarantee my patients not only an aesthetic, but also a safe and comfortable result, simultaneously correcting all the muscles that need correction with botulinum toxin.

Overdose

High doses of Xeomin can lead to the development of severe muscle paralysis in areas remote from the injection sites (in particular: general weakness, ptosis, diplopia, difficulty speaking and swallowing, as well as paralysis of the respiratory muscles, leading to the development of aspiration pneumonia).

In case of overdose, hospitalization with general supportive measures is necessary. In case of paralysis of the respiratory muscles, intubation and artificial ventilation of the lungs are necessary until the condition normalizes.

Have you encountered any complications when using botulinum toxin type A drugs?

Those who do not work do not suffer complications. Of course, I have encountered it more than once. They were mainly associated with technical errors in botulinum neuroprotein injections. But some patients developed insensitivity to “first generation” toxins of acquired origin. I would like to note that such a common undesirable phenomenon as the formation of secondary post-injection swelling occurred much less frequently in patients after Xeomin® compared to other botulinum toxin preparations; patients complained less of drooping eyebrows and a feeling of heaviness in the lower eyelid.

I have encountered complications from botulinum toxin medications. Most often this is drooping of the upper eyelid area. The reason for this is either the use of low injection points or an incorrectly selected dosage. But with Xeomin®, such a phenomenon is extremely rare, since the drug is very mild, and, again, complications are extremely rare.

Of course, I came across it. Do not believe those doctors who say that there are no complications in their practice; at least they will not be completely honest with you. Why? Because the doctor who doesn’t work has no complications. Perhaps, at first, the presence of complications in a doctor’s daily practice is associated with a lack of skills, sometimes it can be a deviation in the structure of the muscles or facial skeleton of patients, but most often the presence and number of complications is associated with technical flaws during administration. Complications have been described when working with the muscles of the upper third - ptosis of the upper eyelid, which has an unpleasant effect on the quality of life. Fortunately, all complications associated with the administration of botulinum toxin type A are reversible, and excellent schemes for correcting the development of adverse events have been developed that help quickly restore the quality of life and socialization of patients.

special instructions

Injections very rarely cause complications. They can occur when the procedure is performed incorrectly, when injury to blood vessels and nerves occurs with a needle.

Anaphylaxis can happen, so you need to have medications to treat anaphylactic reactions.

The effect of the drug is reflected in the concentration and speed of reaction. This will affect your ability to drive and operate machinery that requires special attention. Therefore, it is better for patients who received Xeomin injections to abstain from certain types of activities. The body must be completely restored to normal.

Tell us about your original methods of using Xeomin®?

I individualize botulinum therapy based on the method of palpation of facial muscles, individually select doses and dilute the neuroprotein solution.

I use Xeomin® in combination with other techniques. Our clinic performs a non-surgical blepharoplasty procedure using Xeomin® and Ultherapy®. How do I do it? First, I inject Xeomin® into the forehead and between the eyebrows, that is, I gently block the upper zone so as to lift the upper eyelids. After 1–1.5 months (when fixation has occurred), I perform Ultherapy®. Thus, the patient’s results last for a year and a half. Today it is known that any botulinum toxin has the ability to be eliminated quickly (4-5 months), and my technique allows you to prolong the effect.

I use techniques the need for which was determined by the requests of my patients. This is correction of the lower third, correction of young patients or patients who are indicated for surgical correction of excess soft tissue of the face. Nevertheless, due to variability, I use different dilutions of Xeomin® and do this legally in terms of the legal field of application of the technique. This allows you to breed 100 units. Xeomin® from 0.25 to 5 ml of saline solution, respectively, I vary dilutions to correct difficult areas (lower third), in the eyebrow area I use a hyper-concentrated Xeomin® solution, when working with flat muscles I use standard recovery (2 ml per 100 units of botulinum toxin ) and sometimes hyper-dilution with a lower concentration of botulinum toxin to correct platysma and to perform the Nefertiti lift technique. This “game” with breeding helps me have a more targeted “jewelry” effect on small muscles; more pronounced dilution and active administration of saline solution contributes to a more pronounced distribution of the drug in soft tissues, which is important for such large muscles as, for example, the platysma. Accordingly, using one drug, you can target each zone according to its needs and muscle relaxation requirements.

FAQ

Xeomin or Botox, which is better?

Xeomin or its analogue Botox should be preferred in a particular case, the doctor decides, because:

• The first one causes fewer negative reactions and is stored longer. But it provides a softer correction than the second one. Therefore, it keeps the face natural and does not smooth out all the wrinkles. Xeomin is also ineffective in the treatment of hyperhidrosis. But it is not addictive.
• Botox has more side effects and allergies are more common. But it eliminates deep wrinkles better, and the effect of use lasts longer. You can forget about increased sweating with Botox for several months.

What is better - the introduction of Xeomin or Dysport?

The patient needs the introduction of Dysport or Xeomin - the cosmetologist also decides, keeping in mind age and problems, preferences, area of ​​​​use of the product. The first drug provides more pronounced rejuvenation, but can penetrate beyond the corrected zone. It is cheaper, but to be effective you need to inject a larger volume than Xeomin. The duration of action of each product is approximately the same.

Is it possible to get facial injections during pregnancy?

Xeomin injections are not given to pregnant women because:

• the main active ingredient, although used in microscopic doses, is still toxic,
• its negative impact on the body of the expectant mother or fetus has not been confirmed, but it has not been refuted either.

Therefore, the facial procedure, as well as Dysport, Botox, will have to be postponed until breastfeeding is completed. After all, the effect of drugs has not been tested during lactation, which means it can be dangerous.

Are injections allowed for children?

Botuloxin injections, if indicated, are given to a child if he is 2 years old. But first, the doctor will evaluate the pros and cons, since the drug is not the “gold standard” in the treatment of diseases.

We recommend reading about how Dysport works after injection. From the article you will learn about the composition of the drug, indications and contraindications for injections of the drug, methods of carrying out the procedure, and results.

And here is more information about which drug is better, Xeomin, Botox or Dysport.

Xeomin is a new generation product that has already proven itself well. There are favorable reviews about it from both cosmetologists and patients. Therefore, if the doctor thinks that it is better to use this particular drug, it makes sense to listen to the advice.

What methods do you combine Xeomin® in one procedure?

I really like to combine Xeomin® with Belotero® Soft or Belotero® Balance using the blanching technique. This protocol is indispensable for the correction of linear wrinkles of the upper and middle thirds of the face or, for example, ring wrinkles of the neck. If we talk about the lower third of the face, the combination of Xeomin® with vector lifting with Radiesse® is excellent for forming an ideal oval.

I combine Xeomin® with almost all methods, but the main thing is that I do not work in one zone. I can do Xeomin® and contouring with the Belotero® line of drugs. I can combine Xeomin® with devices.

In one procedure with botulinum therapy, I use various techniques: this is contour plastic surgery, and the introduction of drugs to improve the quality and structure of the skin, I often introduce Xeomin® simultaneously with the drug Radiesse® into various zones, I work with Radiesse® in dilution, and hardware techniques. My favorite comprehensive treatment protocol: after using the Ulthera® ultrasonic SMAS lifting procedure, I inject Xeomin® into the Musculus platysma and perform injections of the drug using the Nefertiti lifting technique in almost all patients for a more dramatic clinical result in non-surgical soft tissue lifting.

Detailed procedure and dosage

The drug is administered to the skin using injections. Before the procedure, the points where injections will be made with Xeomin® must certainly be treated with a cream with an anesthetic effect.

Which is better: Relatox or Botox?

To preserve the beauty and youth of the skin, for several decades, beauty salon specialists have been offering their clients injections of botulinum toxin.

The container in which the drug is supplied must be equipped with a sealed stopper, to open which the protective cap must be removed. The plug itself is not removed, and sodium chloride is injected into the preparation before collection (using a carefully sterilized needle). The resulting contents of the bottle should be a completely homogeneous and pure liquid, without any undissolved particles visible to the naked eye.

Injections are made strictly according to the scheme outlined by the cosmetologist, observing the individual dosage, which is determined depending on the characteristics of each organism, the characteristics of the skin and other nuances. The maximum allowable amount of the drug per injection should not exceed five units.

The first obvious effect of Xeomin® should be expected after 2 or 3 days after the procedure. It fully manifests itself on days 12–14. The next course of injections can be prescribed for at least 5 months of the drug’s effect.

The rejuvenating effect, as a rule, lasts up to six months.

Do you use the drug in the lower third of the face?

Yes, I use it and get impressive results. I am especially inspired by the results in young patients with isolated masseter hypertrophy and bruxism. We not only improve facial aesthetics, but also improve the quality of life! My patients are inspired by the results of Xeomin®, they actively write reviews on social networks and public pages; There is high compliance with therapy.

I use it quite often. Today, in most cases I use Xeomin® and after a while I combine it with hardware technologies.

Yes, I definitely use it to correct hyperactive facial expressions in the lower third of the face. Xeomin® is one of the few BTA drugs registered for the correction of muscle hyperactivity in this area, therefore, I can use it within the legal framework and enter all the data about the procedure into my patients’ records.

pharmachologic effect

Xeomin acts selectively on peripheral cholinergic nerve endings, inhibiting the release of acetylcholine. Entry into cholinergic nerve endings occurs in three stages: binding of the molecule to external membrane components, internalization of the toxin by endocytosis, and translocation of the endopeptidase domain of the toxin from the endosome to the cytosol. In the cytosol, the endopeptidase domain of the toxin molecule selectively cleaves SNAP-25, an important protein component of the mechanism that controls the membrane movement of exo-vesicles, thus stopping the release of acetylcholine. The end effect is relaxation of the injected muscle.

The effect of the drug begins within four to seven days after the injection. The effect of each procedure usually lasts three to four months, although it can last significantly longer or shorter.

In what age patients do you most often use Xeomin®?

I don't make age distinctions. At every age, Xeomin® gives excellent results if used according to indications, in the correct doses and using the correct technique. I am for safe and natural correction results!

I work with all botulinum toxin preparations that are on the market today. I use Xeomin® for patients 25–45 years old who do not have active facial expressions and want a gentle correction. There are also older patients, but I proceed from what problem the patient wants to solve. If he asks to completely block the activity of facial wrinkles, then I will use another botulinum toxin drug. But to get a soft result, it’s always Xeomin®. I would also like to especially note that Xeomin® is a drug with a predictable duration of effect. With adequate dosage, the effect can be observed within 5–6 months.

I have been using Xeomin® in my practice for about seven to eight years and I can say that it works for different groups of patients. These can be men for whom a natural result is important, and young patients, and patients of an older age group who always have a risk of developing ptosis (due to excess soft tissue), and patients with a fine-wrinkled type of aging who require more detailed micro-point correction , and edematous patients, with whom we also successfully work. Xeomin® (compared to other botulinum toxin preparations, Xeomin® “wins” due to the low content of the protein component). Accordingly, the huge number of patients whom we have injected over the past 8-9 years speak about the effectiveness of this drug, which has proven itself to be the best in terms of clinical effectiveness and safety of the chosen technique.

Contraindications

Xeomin is a specific drug that cannot be purchased at a pharmacy or online. It is distributed only among cosmetologists, since it is necessary to have experience in its use. This product has a fairly impressive number of contraindications:

• allergic reaction to the components of Xeomin;
• diseases of the nervous and muscular system, characterized by muscle weakness (myasthenia gravis, post-stroke phenomena, etc.);
• pregnancy;
• breastfeeding period. After finishing feeding, the drug is not recommended for use for another 3 months until hormonal levels are restored;
• age under 18 years;
• herpes;
• low blood clotting;
• acute infectious diseases;
• feverish condition;
• mental illness (for example, epilepsy);
• inflammation and purulent formations on the skin;
• postoperative rehabilitation period;
• taking antibiotics and anticoagulants. These drugs can interact with Xeomin, which is likely to cause the most unpredictable consequences;
• diabetes mellitus in decompensated form;
• ophthalmological diseases (glaucoma);
• malignant tumors;
• diseases of a somatic and autoimmune nature;
• alcoholism and drug addiction. The components of Xeomin act on neuromuscular transmission, and alcohol reduces muscle tone. If you drink alcohol at the same time as injecting the drug, unpleasant consequences may occur in the form of bruises and redness, the development of allergies, inadequate muscle response, chills, elevated body temperature and headaches.

It should be noted that after Xeomin injections you should not play sports, visit saunas and solariums, or massage your face.

According to cosmetologists, the drug should “stand up” within 2 weeks. It is during this period that all of the above must be abandoned.

Before and after Xeomin injections, you should not drink alcohol

Many people are interested in whether it is possible to inject Xeomin on your own? Under no circumstances should this be done! Such procedures can only be carried out by a qualified, experienced specialist.

Xeomin®

Based on constantly improving knowledge, a huge amount of fundamental research, an in-depth understanding of the structure and mechanism of action of botulinum toxin, the pharmaceutical company Merz has developed Xeomin® (Incobotulinumtoxin A), a new generation botulinum toxin type A preparation that contains only pure neurotoxin, which leads to an increase in its specific biological activity. During its production, it is possible to avoid destruction of the active substance, therefore it is the only drug containing the active form of botulinum toxin type A (molecular weight 150 kDa) without impurities of protein of bacterial origin.

Xeomin® provides predictable, consistently reproducible and long-lasting results. The drug can be injected at flexible time intervals, responding to the individual needs of the patient. In addition to its effectiveness and safety, Xeomin® is shelf stable. Xeomin® has a large evidence base: 80 large-scale clinical studies and more than 100 publications.

Recommendations for rehabilitation

Xeomin® may also cause side effects. It is not difficult to minimize the likelihood of deterioration in well-being and other possible undesirable effects of the drug on muscle fibers. To do this, you should strictly follow the recommendations for behavior during the rehabilitation period after injections.

Necessary:

• observe an interval of 4 months between consolidation procedures;
• refrain from injections during the hot season (since direct exposure to sunlight on the skin can significantly reduce the effect of the drug);
• exclude all possible contacts with skin (smoothing or massaging the injection sites): as in the case of botulinum toxin, after using Xeomin® this will most likely lead to the most unpleasant consequences;
• refrain from any types of makeup (at least two days after the procedure);
• exclude bath procedures and any activities related to thermal effects on the skin;
• avoid heavy physical activity, including playing any sports;
• do not use antibiotics (min. 14 days), as well as any medications designed to regulate blood clotting processes.

Allergy to Botox

Allergy to Botox is a rare complication.

In addition to the above, you should also remember about the toxicity of the drug. Thus, drinking alcohol will significantly increase the likelihood of edema occurring after Xeomin® injections.

You should also carefully monitor your blood pressure, since increased blood flow can lead to the transport of the drug to those places where its effect is extremely undesirable. This is why Xeomin® and alcohol are incompatible.

Analogs

Xeomin has 2 analogues that are similar in composition:

1. French drug Dysport.
2. Russian-made product Relatex.

Some of the most studied and tested drugs based on botulinum toxin are Refinex, Lantox, Botox Allergan, Relatox, Neuronox, as well as Korean-made products. These medications are used in many cosmetology clinics and have proven themselves well.

What it is?

Xeomin, whose action is based on blocking nerve impulses with botulinum neurotoxins, is part of the group of injection cosmetology. Injections help smooth out wrinkles caused by facial expressions. Traditionally, it is most effective for the upper third of a woman’s face, where muscle spasms are the main source of the formation of creases and folds of the epidermis.

After injections of the drug, temporary paralysis of the neuromuscular endings occurs, due to which impulses between the nerve endings and muscle receptors are blocked. Muscle contractions do not occur in response to conscious or unconscious orders from the nervous system. Over time, the endings are restored, the treatment must be applied again.

Xeomin is used in traditional medicine and cosmetology. In the first case, it treats muscle spasms, in the second, it fights the so-called “hyperkinetic folds” of the face (expression wrinkles).

Xeomin, unlike Botox, is not used to treat children and adolescents under 18 years of age.