double-board certified specialist in plastic surgery of the face and neck
la Jolla - San Diego, California 858.658.0595


Botox, Xeomin, and Dysport  Injection in San Diego CA, La Jolla

*Before and after photos and testimonials on this website are from actual patients who have given permission to have their photos/testimonials published. These photos and testimonials are for illustrative purposes only and no prediction of outcome is implied. Individual results may vary.

Botulinum toxin type A is currently available in three formats or subtypes in the United States: Botox, Dysport, and Xeomin. After extensive testing and evaluation, our medical spa offers all three products, and our experienced staff is available to help you choose the best product for you.

*Botulinum toxin type A is used to soften or eliminate wrinkles in the face. It  is injected around the muscles in the face which produce “frown lines” (glabellar rhytides), “crow’s feet” (periorbital rhytides), and forehead lines. Our skilled nurses and doctor have performed thousands of injections for our San Diego clients, and worldwide, close to 3 million treatments are performed yearly in the US and worldwide. Many clients returning regularly for maintenance therapy several times per year. Our clients experience little discomfort with injections, and optional numbing cream is always available. While many clinics and “spas” perform botox injection, it is important to realize that treatments should be performed only in a doctor-supervised setting following strict protocols for dilutions, safety, and sterility. Experience matters with botox injection: while you may get a cheaper price per unit from a “spa,” an experienced injector can save you much more money by using less units in the right spots. All of our nurses are certified injectors who have been trained by Allergan, Merz,  or Medicis, and are supervised by Facial Plastic Surgeon Dr. Roy David.

*Why consider botox, xeomin, or dysport injection? While even infants have dynamic lines of expression, these lines can become etched and even scarred into our skin as we age. At this point they are no longer dynamic expression lines but static wrinkles. Twin studies performed in which one twin received botox treatments and other effects were controlled over ten years demonstrated significantly more wrinkles in the non-treated twin.

sivan botox pic

“Even toddlers have normal lines of facial expression. In adults, these lines may become more pronounced and lasting”

Botox®(onabotulinumtoxinA) is produced by Allergan. It has been used since 1989 to treat blepharospasm and was approved in 2002 for cosmetic use.  The name Botox has become somewhat synonymous with botulinum toxin type A,  due to its time on market. Dr. David has been injecting Botox since 2002. Many of our clients remain loyal to Botox due to it’s extensive customer rewards program and track record.

Dysport(abobotulinumtoxinA), from Galderma,  the makers of Restylane, launched in 2009 and quickly was found in our practice to be as effective as Botox for relaxing wrinkles. The molecular mechanism of action is the same, however Dysport is packaged differently and quantified differently from Botox. Some practices charge more for Dysport because it is thought to work more quickly than Botox, and spread out slightly more.

Xeomin( incobotulinumtoxinA), from Merz, makers of Radiesse, was released in 2013 and has likewise been found very effective for wrinkle reduction. Xeomin units correspond directly to Botox units for preparation purposes, and xeomin is  considered a more purified version of Botox (less adjunctive proteins). Some clients feel they have built resistance to botox and have tried xeomin with success.

*The effects of botox generally appear in 3-10 days and are fully evident within two weeks. Patients can expect a relaxed forehead, and smoother eyelid skin, which will last for 3-4 months on average. Scientific studies using data from identical twins have shown that consistent use of Botox can actually delay onset and lessen severity of facial wrinkles.

*Over many years of use and millions of patients across the globe, botox has proven itself safe and effective, with minimum side effects (see below). The American Society for Aesthetic Plastic Surgery ranked BOTOX Cosmetic as the most popular physician-administered aesthetic procedure in the United States for the fourth year in a row (surgical and non surgical combined). Indeed, we currently have no other medical or surgical treatment capable of predictably emulating the effect of the botulinum protein on deeper motion wrinkles.

In our San Diego office, strict guidelines are followed regarding storage and dilution of botox. By minimizing dilution and disposing of unused material after several days, we are able to provide our patients with consistent, long lasting results. All botox injections at the Roy David MD, Cosmetic Surgery & Medical Spa are administered by our facial plastic surgeon or our skilled, highly – trained nurses.

Mechanism of Action of Botox

Botox Cosmetic is a purified protein produced by the Clostridium Botulinum bacteria that prevents the the action of wrinkle-forming muscles. This botulinum protein was initially used successfully to treat muscle spasm in the face and neck, and the cosmetic effect of diminishing wrinkles was noticed as a side effect.

The botulinum protein, following injection into the skin and muscle, is absorbed by nerve endings (nerve terminals) , where it blocks the release of the neurotransmitter acetylcholine by those nerve endings. Acetylcholine is the neurotransmitter responsible for making muscles contract. After several months, the nerve terminals recover and begin releasing acetylcholine again, and muscle function recovers.

Side effects of Botox:

*Many first-time San Diego botox patients wonder if botox will prevent them from making or conveying facial expressions. In reality, you will still be able to make facial expressions- just without the accompanying wrinkles and lines.

*Side effects of the injection are relatively rare in skilled in hands, but may include bruising at the injection site, or temporary eyelid drooping. Patients who are pregnant or breast feeding should avoid treatment, as should patients with any active infection around the injection site. Botox is contraindicated in patients with underlying muscle weakness diseases such as myasthenia gravis.

Botox Frequently Asked Questions:

1. How long do the effects last?

A: *Most clients return every 3-4 months for repeat treatments. The duration of botox depends on various factors such as muscle strength and metabolism.

2. How long before I see the results of my botox injection?

A: *Our clients in San Diego generally see botox results within 3-7 days. We recommend waiting 2 weeks for full effect.

3. Will regular botox injections keep my lines from getting worse?

A: *This is very likely. From studies in twins, we have found that when all other factors are controlled, the twin who has regular botox injections has fewer facial wrinkles 5-10 years later.

4. How can I save money on Botox?

A: By being a VIP client! Your rewards card will save you money each and every time you visit Roy David MD, Cosmetic Surgery & Medical Spa . In addition, you can join Brilliant Distinctions from Allergan for even MORE savings. Finally, check your email and like us on Facebook to hear about monthly specials.

For more Botox Q&A click here.

For Botox Injection in San Diego or La Jolla contact Roy David MD, Cosmetic Surgery & Medical Spa today at 858.658.0990.

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