Wrinkles that form on the forehead, around the eyes, and in other areas, can be a clear sign of facial aging. These creases are caused by a combination of facial movement and decreased collagen and elastin in the skin, and are further influenced by factors like genetics and sun exposure. There are effective non-surgical cosmetic treatments that can deliver a smoother, younger appearance to an aging face. One such treatment is medically known as botulinum toxin type A injections. These minute injections inhibit muscle contractions to soften or even eliminate wrinkles. The most well known of these injectables is Botox, but there are now several options of FDA-approved botulinum toxin type A formulations that each have their own advantages. With the help of an expert dermatologist, each patient can find the right dose and type of injectable to meet his/ her individual needs

Dr. Carin Gribetz is a renowned medical and cosmetic dermatologist. Board-certified by the American Academy of Dermatology, Dr. Gribetz is well-versed in the various forms of cosmetic injections and their benefits. If you are interested in learning more about cosmetic injectables, or would like to schedule a consultation with Dr. Gribetz, contact us here!


Botulinum toxin type A is a neurotoxin produced by the bacteria Clostridium botulinum. When delivered in extremely low doses, it has been found to have a number of benefits. When the neurotoxin is introduced to a muscle, it blocks neural activity, which then inhibits muscle movement. Botulinum toxin type A was originally created for medical purposes, and continues to be a safe and important treatment for a number of conditions. These medical purposes include treating cervical dystonia (severe spasms in the neck), stunting sweat glands, treating muscle stiffness, reducing the symptoms of migraines, and even addressing an overactive bladder.

As a cosmetic treatment, botulinum toxin type A injections work by blocking nerve impulses in overactive muscles that are causing dynamic wrinkles to form. Blocking these nerve impulses temporarily prevents the targeted muscles from contracting, allowing the skin directly above to relax and become smoother. Waiting too long to start treatments means that more injections at a higher dose may be required to smooth out deeper set dynamic lines, which is why it is important to see a dermatologist once you feel concerned about wrinkles.


Most people have heard of Botox, which remains the most commonly injected formulation of botulinum toxin type A injections. However, there are a number of alternatives available that work by the same mechanism. All of these options have consistently performed in clinical trials and have gained FDA-approval in the U.S. In addition to Botox available options include: Dysport, Xeomin and Jeuveau. Each formulation has something that sets them apart.


Botox is the most popular injection. Besides being versatile, it has been on the market the longest, which is why it has a greater name recognition. Since Botox uses an accessory protein (egg) to encase the botulinum toxin, it lasts potentially longer than other alternatives. Botox is also “heavier” and does not spread easily, making it more suitable for smoothing out deep wrinkles in areas where spreading needs to be minimal, such as specific applications like non-surgical brow lifting. The injections take only a few minutes to administer, and results are usually seen within seven to ten days after treatment. The injections themselves last for about 3-6 months.


Dysport is formulated at a different strength than Botox, and “spreads” more, which affects a larger area. This makes Dysport more suitable for treating dynamic wrinkles that have formed over a wider area. Patients may find that fewer injections are needed to cover the same area compared to other toxin formulas. Also encapsulated in an accessory protein, Dysport is a great alternative for patients who have stopped responding to Botox. Dysport may also deliver results at an earlier onset. Results typically last 3-6 months.


Xeomin is a particularly unique botulinum toxin type A injection because it’s considered a ‘naked’ neurotoxin. This means that Xeomin has only one ingredient, which is botulinum toxin type A, compared to the other formulations, which contain an accessory protein. This absence of protein additives makes it a more suitable option for those with allergic reactions, or for patients who build up antibodies more easily, which can affect the efficacy of their injections. Xeomin also typically lasts 3-6 months.

Out of all botulinum type A injections, Botox and Jeuveau are the most similar, Jeuveau, also known as “Newtox” is the most recent FDA-approved injectable, and was formulated solely for cosmetic use. Results can be seen within a week, and last 3-6 months.


When correctly administered, botulinum toxin type A injections are safe with minimal risks for complications. However, injecting the wrong muscles or delivering an inappropriate dose can lead to unwanted side effects like muscle weakening or the inability to move your face naturally. Some more serious but less common side effects include:

  • Flu-like illness
  • Rashes
  • Dysphagia, or trouble swallowing
  • Diplopia, or double vision
  • Bleeding/Bruising

Botulinum toxin injectables are formulated at different strengths and require specific techniques to administer them in a safe and effective way. That is why it is crucial to find a physician who has both the skills and artistic ability to determine the right dosage and delivery for your needs.

It is also important to note that while botulinum toxin injections can address dynamic wrinkles, they are not effective in treating static wrinkles that have formed as a result of volume loss. For these concerns, dermal fillers are a more suitable cosmetic injectable.

Dr. Gribetz will take the time to review your medical history and to understand your aesthetic goals in order to make the proper recommendations for treatment with injectables.


Whether you are looking to prevent the formation of frown lines, or want to soften the look of existing wrinkles, botulinum type A injection is an ideal treatment. With the proper guidance and recommendations from a skilled clinical dermatologist like Dr. Carin Gribetz, you will be able to benefit from the right formulation, administered in a safe, effective, and cosmetically
pleasing manner.

If you are interested in treating wrinkles and desire a fresher, less tired, more youthful appearance,. schedule a consultation with Dr. Gribetz, by calling us at 212-289-3300 or contact us here today!