• Have you ever wondered what “BOTOX” is?
    Botox is the brand name of botulinum toxin. More specifically, it is Botulinum Toxin Type A (BoNT-A).

There are currently three brands of BoNT-A that are approved by our Ministry of Health:

    • BOTOX
    • XEOMIN

What is BTA?

  • It is a neurotoxin produced by the gram-negative, rod-shaped bacterium Clostridium botulinum. (Layman term: it is a deadly toxin)
  • It causes muscle paralysis through inhibition of acetylcholine release at the neuromuscular junction (it paralyzes the muscle)
  • History: In the late 1980s, during a clinical study for treating blepharospasm with BoNT-A, a Canadian ophthalmologist, Jean Carruthers, observed that patients participating in the study wanted to continue to receive BoNT-A injection despite the improvement of blepharospasm because glabellar lines and periorbital lines disappeared along with blepharospasm. Since then BoNT-A has 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 also been proven highly effective for hyperhidrosis of axilla, palms, and soles.
  • In 2010, it was approved to treat chronic migraine

As we have observed from the flow of history, there are many indications for
BoNT-A use.


Usage in Aesthetic

  • Wrinkles reduction such as glabellar lines and crow’s feet and muscle hypertrophy such as masseter, pretarsal roll, parotid glands, temple muscle reduction
  • Muscle hyperactivity such as mouth corner elevation, platysmal bands, gummy smiles body contouring such as shoulder (trapezius muscle), arm (deltoid muscle) and calf      (gastrocnemius muscle)
  • Hyperhidrosis of axilla, scalp, palms, and soles. Face lifting such as intradermal BoNT-A injection


All of these brands contain the same active ingredient which is botulinum toxin type A. 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 complex proteins. This is unique as during the manufacturing process, the complexing proteins are removed to produce “pure” form of BoNT-A. Some studies had shown that complexing protein plays an important role in BoNT resistance.

BoNT Resistance means the patient stops responding to the treatment. It is widely agreed that this is due to the production of antibodies against the BoNT-A molecules. And it was discovered that this risk increases with the number of complex proteins.

In conclusion, there is a clear superiority among these three brands since each brand has its pros and cons. It is more important to select one that works for you, and that will depend on your doctor as he will evaluate the suitability based on your medical history and desired results. 


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.