Neuromodulator (Botulinum Toxin)
Have you ever wondered what Botox® is? Botox® is the brand name of neuromodulator (botulinum toxin). More specifically, it is also called Botulinum Toxin Type A (BoNT-A or BTA).
There are currently three brands of neuromodulators (BoNT-A or BTA) that are approved by our Ministry of Health:
What is Neuromodulator (Botulinum Toxin)?
Neuromodulators are substances that are used to relax muscles by reducing the signals from the nerves to the muscles. It is commonly used in aesthetic medicine to reduce dynamic lines and wrinkles on the face. It is also used in other neuromuscular conditions.
Neuromodulator, produced by Clostridium botulinum, inhibits acetylcholine release at the neuromuscular junction, causing the muscles to not move despite instructions from the brain.
History of Neuromodulator
In the late 1980s, a Canadian ophthalmologist observed that patients receive BoNT-A injection had their frown lines and eye wrinkles disappeared along with blepharospasm. Since then, it has been tested on the wrinkles around the eyes with great success. BoNT-A has now become a byword for the treatment of wrinkles.
Before cosmetic usage, BoNT-A is used to treat other muscle-related diseases such as strabismus, blepharospasm, cervical dystonia, focal upper limb spasticity, neurogenic bladder, juvenile cerebral palsy, stroke, and anal fissure.
In 2004, BoNT-A has been proven highly effective for hyperhidrosis (accessive sweating) of axilla, palms, and soles.
In 2010, it was approved to treat chronic migraine.
Do I need it?
If you have wrinkles that are making you look old or sad, or it is affecting your self esteem, you can consider Neromodulator treatments.
What can Neuromodulators do?
- Wrinkles reduction: forehead lines, glabellar lines (frown lines), wrinkles around the eyes and the nose
- Muscle reduction: the muscles under the eyes (pretarsal roll), calfs,shoulder
- V-shape face: reduce the muscle of mastication, parotid glands
- Changes muscles dynamics: mouth corner elevation, platysmal bands reduction, reduce gummy smiles
- Treat Hyperhidrosis: Excessive sweating of the under arms (axilla), scalp, palms, and soles.
- Face lifting: Mesobotox, Microbotox to cause skin tightening
- Reducing pores: reducing oil production of the skin
Will Wrinkles Look Worse After Neuromodulators Wears Off?
Xeomin®, Botox®, Dysport®: How are they different?
All of these brands contain the same active ingredient: botulinum toxin type A (BoNT-A or BTA). There is only a slight difference in terms of onset, units in measurements, and cost.
However, one particular difference that should be highlighted for Xeomin® is that Xeomin® has no complexing proteins. Some studies had shown that complexing protein plays an important role in BoNT-A resistance1. BoNT-A resistance means that the patient has reduced response or stops responding to the BoNT-A treatment after a few treaments.
If you start observing that your BoNT-A is not working as well as before, do let your aesthetic doctors know about it.
In conclusion, each brand has its pros and cons. It is more important to select one that works for you. Consult your about the suitability based on your medical history and desired results.

FAQ
BoNT-A treatment will not affect your ability to smile or frown, it will simply lessen the appearance of facial creases during such actions. With less frown lines and wrinkles, you will appear younger, healthier and more attractive following the treatment.
The effects of BoNT-A are usually noticeable within 2-3 days following the treatment, with maximum effect visible after around a month
Re-treatment will be required around 4 months after the initial treatment, as the effects will gradually wear off during this time. However, the duration of the effect varies between individuals.
The treatment can be performed relatively quickly, with the whole procedure taking approximately 20 mins. It will take a longer time if you require numbing cream.
Patient can resume normal activities immediately after the treatment. The treatment can even be done during a lunch break. However, patient are recommended to avoid strenuous physical exercises, sun exposure and alcohol consumption for 24 hours following the treatment.
It is highly unlikely. However, patient might experience some downtime such as mild pain, stinging sensation, bruising, swelling, or redness around the injection sites. A small group of patients experienced headaches as a result of treatment. Usually, this condition will subside on its own without any intervention.