The Science

Although a ubiquitous part of cosmetic dermatology today, the medicinal aspects of botulinum toxin (the compound used in most of today’s toxins) weren’t discovered until the 1950s. Researchers discovered that, when injected into a hyperactive muscle, the compound blocked the motor nerves from releasing a certain chemical that allows the muscle to function. Over time, when the compound wears off, the muscle activity will recover.

Today, there are different forms of purified botulinum that are subtly designed to have a range of strength and spread (the size of the area affected by an injection). These differences are useful in our practice, since all muscles have slight variations.

Our Approach

Unlike fillers, which are used to fill deep creases and lines in order to restore volume, toxins are a bit more subtle in their effects. By relaxing muscles, the aesthetic result is smoother skin with fewer lines. At Wexler Dermatology, we use toxins judiciously in order to allow natural movement and expression, while also restoring a younger, more relaxed visage. “Too much Botox can extinguish facial movement and expression,” warns Dr. Patricia Wexler.“It can take away the arch of the brows, and injecting every crow’s-foot will prevent your cheeks from elevating when you smile.”

In addition to treating wrinkles and fine lines, we also use toxins to treat excessive or unwanted sweating, or to correct imperfections in symmetry. By strategically targeting muscles, our dermatologists can improve facial aesthetics by raising certain areas (like eyebrows) or lowering others (like the upper lip, creating a less gummy smile).

The 3 main toxins we use at our practice are Botox, Dysport®, and Xeomin®.

What to Expect

Length Of Procedure

Toxin injection only takes about 15 to 30 minutes, which is how it gained the reputation as the “lunchtime procedure.” When combined with other procedures (like filler injections, for example), it can take longer.


While patients may see some relaxing and wrinkle reduction in the first 24 to 48 hours, don’t be surprised if it takes as long as 2 weeks to see final results.

For those who are considering toxin therapy for excess sweating, within 5 days of treatment, underarms will stop sweating and scalp line will no longer become frizzy after exercising. “This is for someone who wants their gown to stay bone dry while dancing all night, or to keep hair from frizzing around the hairline,” says Dr. Wexler.


Outside of a slight degree of redness around the injection site, there are almost no noticeable side effects after a toxin injection procedure. Occasionally, some patients may experience mild bruising. This can be minimized by following our patient guidelines and physician instructions. We also have devices on hand that can help reduce bruising. Many patients report feeling comfortable returning to work after the procedure.

For the best possible results, please keep your head upright for the next 4 to 5 hours. Avoid irritating the surface of your skin with makeup, haircare (including washing, drying, or coloring), heat, or exercise. For a full list of aftercare guidelines, please visit our FAQ or Resources pages.

Number of Treatments

For wrinkle and fine line reduction, toxins can last up to 4 months. We recommend our patients schedule a follow-up seasonally to maintain their results.

When used to treat unwanted sweating, 1 treatment can last from 6 months to a year.

Read More About Toxins