Wrinkle relaxers are FDA-approved neuromodulators that temporarily relax facial muscles to smooth dynamic wrinkles. Botox is the original brand, but Dysport, Xeomin and Jeuveau are all clinically equivalent — the choice depends on onset, duration, dosing units and your provider’s expertise. Results last 3 to 5 months on average.
What are neuromodulators / wrinkle relaxers?
A neuromodulator is a purified neurotoxin (botulinum toxin type A) that, when injected in very small doses, blocks the signal between a nerve and a muscle. The muscle stops contracting for several months, softening the dynamic wrinkles caused by repeated movement (frown lines, crow’s feet, forehead lines).
Wrinkle relaxers do not fill volume — that is the role of dermal fillers (hyaluronic acid, etc.). The two are often combined for a comprehensive result. For a deep dive into fillers, see our Juvéderm lip injection cost guide.
The four FDA-approved options
| Product | Manufacturer | First FDA approval |
|---|---|---|
| Botox Cosmetic | Allergan / AbbVie | 2002 |
| Dysport | Galderma | 2009 |
| Xeomin | Merz Aesthetics | 2011 |
| Jeuveau | Evolus | 2019 |
All four contain botulinum toxin type A. They differ in molecular structure (carrier proteins), spread, dosing ratios and price.
Comparison table — onset, duration, units, cost per area
| Factor | Botox | Dysport | Xeomin | Jeuveau |
|---|---|---|---|---|
| Onset | 3–5 days | 2–3 days | 3–4 days | 2–3 days |
| Full effect | 10–14 days | 7–14 days | 7–14 days | 7–10 days |
| Duration | 3–4 months | 3–4 months | 3–4 months | 3–4 months |
| Spread | Localized | Wider | Localized | Localized |
| Carrier proteins | Yes | Yes | No | Yes |
| Units / glabella | 20 | 50 (1:2.5) | 20 | 20 |
| Price / unit 2026 | $13–$18 | $5–$7 | $11–$15 | $9–$13 |
Cost per area tends to be similar across all four because Dysport’s lower per-unit cost is offset by its higher unit requirements.
Case study: 35-year-old first-time patient, glabella + crow’s feet
A 35-year-old marketing director, first-time Botox patient, came to Esthetica wanting to soften deepening glabellar lines (“11s”) and early crow’s feet that showed even when not smiling. Concerned about looking “frozen”. Goals: subtle, natural look for client-facing professional environment.
- Assessment. 45-minute consultation with NP injector. Photos at rest and during expression (frown, smile, squint). Discussed muscle anatomy and what to expect at days 3, 7 and 14.
- Treatment plan. Botox: 20 units glabella + 8 units per crow’s feet side (16 total). Conservative dosing for first time. Total 36 units at $16/unit = $576.
- Day 7 follow-up: noticeable softening of glabella, partial effect on crow’s feet. Mild brow heaviness reported — expected at this stage.
- Day 14 final assessment: patient very satisfied. Glabella effectively immobilized, crow’s feet softened but with natural movement preserved.
- Maintenance: patient returned at month 4 for retreatment, slightly higher dose (24 + 16 = 40 units) based on observed wear-off pattern.
The key was conservative first-time dosing. Going “too much, too soon” creates the frozen look patients fear and requires waiting 3–5 months for it to wear off. Better to under-dose initially and adjust upward on next session.
How to choose the right wrinkle relaxer for your goals
- How quickly you need the result. Dysport and Jeuveau may show earlier onset for events.
- Spread profile. Dysport diffuses slightly more — useful for larger areas like the forehead, less ideal for precise spots like crow’s feet.
- Allergies and prior reactions. Xeomin is “naked” (no carrier proteins) and is preferred for patients who developed resistance.
- Budget. Per-area costs are similar but providers may offer brand promotions.
There is no clinical evidence that one product produces visibly different results when injected correctly. The injector’s technique matters more than the brand.
Treatment areas
| Area | Typical units (Botox equiv.) | Goal |
|---|---|---|
| Glabella (“11s”) | 20 | Soften vertical lines between brows |
| Forehead | 10–20 | Smooth horizontal lines |
| Crow’s feet | 12 (6 per side) | Soften smile lines around eyes |
| Lip lines | 4–6 | Reduce vertical lip lines |
| Bunny lines | 4 | Soften scrunching lines |
| Chin (mentalis) | 4–6 | Soften pebbled chin texture |
| Masseter | 30–50 per side | Slim jaw, reduce clenching |
| Neck bands | 25–50 | Soften vertical neck cords |
| Underarms (hyperhidrosis) | 50 per side | Reduce sweating |
Preventative Botox: when (and when not) to start
Preventative neuromodulator use — starting in the late 20s or early 30s before lines are deeply etched — is increasingly common. The theory: relaxing the muscles that fold the skin reduces the depth and permanence of wrinkles long-term.
- Good candidates. Patients with visible dynamic wrinkles at rest (after smiling, the lines don’t fully smooth), strong family history of deep glabellar or forehead lines, or jobs requiring extensive facial expression (teachers, performers, broadcasters).
- Not yet candidates. Patients under 25 with smooth skin at rest and during expression. There is no benefit, and continuous use beginning too early may lead to muscle compensation patterns.
- Dosing. Preventative protocols use lower doses (10–15 units glabella vs 20 standard) and longer intervals (5–6 months between sessions vs 3–4).
- Realistic expectations. Preventative Botox slows the deepening of expression lines. It does not stop aging from sun exposure, collagen loss or volume depletion.
Combining wrinkle relaxers with fillers
Most patients over 40 benefit from a combined protocol: relax the muscles that cause dynamic wrinkles, and restore volume lost in cheeks, lips, jawline or temples. The two work together because:
- Filler placed in an actively contracted area migrates or dissipates faster. Relaxing the muscle first improves filler longevity.
- Wrinkle relaxers alone cannot address volume loss — hollowed cheeks or thinning lips need filler.
- Filler alone in dynamic-wrinkle areas (perioral, around eyes) often shows lumps when the muscle contracts. Botox first prevents this.
Order matters: wrinkle relaxer first, full effect at 14 days, then filler. Same-day combined treatment is possible but less precise.
What to expect during your appointment
- Consultation and facial assessment. The injector studies your muscle activity at rest and during expression.
- Marking. Injection points are mapped with a surgical pen.
- Injection. A tiny insulin-gauge needle delivers the product.
- Aftercare. No lying flat for 4 hours, no strenuous exercise for 24 hours, no rubbing.
- Result. Onset 2–5 days, full effect 7–14 days.
Total appointment time is 15–30 minutes. No anesthesia is needed.
Cost guide 2026
| Area | Typical cost (2026) |
|---|---|
| Glabella alone | $260–$360 |
| Glabella + forehead | $400–$600 |
| Triple area (glabella + forehead + crow’s feet) | $550–$850 |
| Lip lines | $80–$120 |
| Chin | $80–$120 |
| Masseter (both sides) | $750–$1,400 |
| Hyperhidrosis (both underarms) | $1,200–$1,800 |
Common mistakes with neuromodulators
- Going to a bargain provider. Cheap unit price often means diluted product. A cubic centimeter of Botox costs the same wholesale everywhere; if the per-unit price is far below market, ask what concentration.
- Skipping the consultation. Same dose on different faces gives very different results. Personalized mapping matters.
- Treating asymmetric muscles symmetrically. Most faces have asymmetric muscle strength. Dosing must reflect that.
- Lying flat or exercising too soon. Can migrate the toxin to unintended muscles (eyelid ptosis, brow drop).
- Self-prescribing dose for next session. Each session should be calibrated to observed wear-off, not copy-pasted from the previous.
Safety, side effects, contraindications
Common side effects (transient): mild bruising, headache for 24–48 hours, heaviness in treated muscles for the first week. Uncommon side effects, usually caused by injector error: eyelid ptosis, brow or smile asymmetry.
Contraindications: pregnancy or breastfeeding, active infection at the site, myasthenia gravis or related neuromuscular disorders, hypersensitivity to any component.
Botox myths debunked
- Myth: It freezes your face forever. Effect wears off in 3–5 months.
- Myth: Once you start, you can’t stop. When you stop, your face returns to baseline.
- Myth: It’s the same as fillers. Wrinkle relaxers immobilize muscles; fillers restore volume.
- Myth: Only women use it. Male wrinkle-relaxer treatments grew significantly over the past five years.
Frequently asked questions
How long does Botox last?
3 to 4 months on average. Some patients see effect up to 5 months.
What’s the difference between Botox and Dysport?
Both are botulinum toxin type A. Dysport may show effect 1–2 days earlier and has slightly wider spread. Final cost per area is similar.
How much does Botox cost in 2026?
$13 to $18 per unit. A standard glabella is around 20 units, or $260–$360.
Is Xeomin better for antibody resistance?
Xeomin is “naked” — no carrier proteins — so it has a lower theoretical risk of developing neutralizing antibodies.
Does Botox prevent wrinkles?
Used preventatively, neuromodulators reduce repeated muscle contraction.
Can men get wrinkle relaxers?
Yes. Dosing is higher and goals are usually softer.
Can I exercise after Botox?
Yes, after 24 hours.
Can wrinkle relaxers be reversed?
No. Effect cannot be reversed but wears off naturally over 3–5 months.
Are wrinkle relaxers covered by insurance?
Cosmetic use is not covered. Medical indications may be.
Can I combine wrinkle relaxers with fillers?
Yes. They address different problems.
How young can I start preventative Botox?
Typically 28–35 depending on family history and visible dynamic wrinkles at rest.
What if I don’t like the result?
Botox is not reversible, but adjustments can be made at follow-up to balance asymmetry or strengthen movement in over-treated areas. Effect wears off in 3–5 months regardless.
Book a wrinkle relaxer consultation
Our injectors are board-supervised RNs, NPs and PAs who train continuously on Botox, Dysport, Xeomin and Jeuveau.
