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Botox vs Xeomin

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Botox® or Xeomin®: Which is Right for Me?

There are few other products that have made an impact on the cosmetic industry like Botox® has. In fact, the chances are pretty good that someone you know has had Botox treatments— some statistics put the number of Botox procedures performed each year in the several millions. With the wide popularity of Botox, then, it’s easy to imagine that there are alternatives on the market. Xeomin® is one alternative made by the same manufacturers of other non-invasive treatments like Radiesse®, Ultherapy®, and many more. Although Botox and Xeomin might just seem like competing carbon copies, there are a few things that set them apart— and even make them more ideal for some patients than others. If you’re looking at your options for cosmetic wrinkle reducers, then here are two excellent options to consider.

What are Neuromodulators?

Neuromodulators are made from different purified formulations of botulinumtoxin type A. This protein is created by fermenting certain types of bacteria that are known for causing side effects that weaken and prevent muscle movements. In small doses, derivations of botulinumtoxin type A can be effective for both cosmetic and medical treatments that benefit from reduced muscle movement. There’s no need to worry, though, since neuromodulators have been in use since the late 70’s and have undergone numerous studies regarding safety and effectiveness since then.

How do they work?

Neuromodulators work by temporarily blocking neurological signals from the brain to the muscles, which normally cause them to contract and move. This process is called neuromodulation. This is beneficial to your skin because, over time, these contractions can cause creases and lines in areas that commonly experience facial expressions. By injecting these products into the muscles, they can both relax furrowed expressions and prevent further wrinkle formation. For some patients, merely allowing the skin some time to recouperate without such intense dynamic movement will be enough to erase wrinkles, as the skin does some self-healing and “bounces back.” But for deeply set wrinkles, especially in older, sun-damaged skin, the damage is too deep for the skin to fully heal on its own, and in that case other treatments, like lasers and filler injections might be needed to get the best result.

What’s the difference between Xeomin and Botox?

Although Botox and Xeomin both function the same way and share the same end goal, there are a few differences that set them apart. When you’re considering your options, it can be helpful to decide which of these factors is most important to you and your treatment, so that our cosmetic physicians can guide you to the best choice for you. Here are some of the primary similarities and differences between these two options.


Although both options are made with the same core molecule, botulinumtoxin type A, but they differ slightly in their molecular makeup because of their different manufacturing processes. The process of making Botox has been a highly guarded secret, just like the Coca Cola recipe, because while the process to create botulinumtoxin type A is a well-known and documented process, the process of purifying it into a safe and controlled medication is very difficult and complex. That’s why for a long time, Botox was the only option.

Xeomin uses a different manufacturing process than Botox, but both do arrive at a very similar result, so similar that the results from each are very, very similar.

Treatment Areas

Both Botox and Xeomin have FDA-approval, but for different treatments. Botox is FDA-approved for cosmetic treatment in relaxing frown lines (between the brows), forehead lines, and crow’s feet (around the eyes). At Reflections Center, we treat many other areas with Botox that are considered off-label uses, but can be effective options in the hands of our expert injectors. Additionally, it’s FDA-approved for many different medical conditions, including chronic migraines, hyperhidrosis (excessive sweating), many types of muscle spasms, strabismus, and urinary incontinence. This makes it an effective and versatile option if you’re looking for a tried and tested solution for your cosmetic or medical concern.

Xeomin was FDA-approved much more recently than Botox, but can still address a few different cosmetic and medical concerns. Xeomin is only FDA-approved for cosmetic use in glabellar lines, also called frown lines, but it can still effectively treat many of the same concerns that Botox can, although this is considered off-label. Additionally, it can also be used on-label to treat conditions like cervical dystonia and blepharospasms.

Although it can seem overwhelming when looking at the treatment areas for each neuromodulator, it can be more helpful to focus on which area you would most like to address and how, so that our cosmetic physicians can guide you to the right choice.


It can be virtually impossible to distinguish between Botox and Xeomin before and after photos, so the quality of your results should only be a factor when looking at your options for an expert injector. Botox and Xeomin do differ when it comes to their results timeframes, however. This is because, after injection, it can take some time for the botulinumtoxin to take full effect. In Botox, this timeframe can be around three days. Xeomin takes the longest out of any neuromodulator, coming into effect at around four or more days. With both options, it’s important not to massage the treatment area during the 90 minutes following injection because it can cause the product to spread to unwanted areas.

It can be difficult to judge how long each injectable will last, since this can be unique to each patient and treatment area (depending on how quickly your body metabolizes the product). Generally, Botox both last between three to four months. Since your skin has had that time period to “heal” itself, the wrinkles don’t reappear immediately after the product stops working, but over time those repetitive motions will bring the wrinkles back. Because the goal is to keep skin protected from those repetitive motions, we recommend retreating before the product fully wears off, and at the very least when it first wears off, not after the wrinkles have had time to come back (and do further damage to the skin).


Although cost should never be your primary concern when it comes to selecting cosmetic treatments, it can be worth noting that Botox and Xeomin can sometimes vary when it comes to cost (measured in units). The cost per unit can be very similar between the two, but each can require slightly different dosages based on the treatment area. During a consultation with our cosmetic physicians, you’ll receive a full estimate of your costs with Botox or Xeomin.

We do charge the same fee per unit for Xeomin and Botox, at $16 (as of 2019). In New Jersey, pricing for Botox or Xeomin typically ranges from $15 to 20 per unit. Typically, a treatment for wrinkles on the face will range from $250 to $550+ at our practice. We’re not the least expensive practice in New Jersey, but for physician injectors who are consistently ranked in the top 250 nationwide, we feel this price is an incredible value.

Which one is right for me?

When it comes down to making the decision, you’ll greatly benefit from the guidance of our cosmetic physician injectors. This is because we can take a full assessment of your unique goals and medical history to guide you to the right option. However, there are some generalities to help you guide your decision-making process.

Botox is a tried and tested option that has been in use for many years, meaning it comes with a reputation backing it. If brand and reputation are important to you, then Botox can produce great results with low risks. It’s also highly versatile, meaning you have a lot of options for treatment. Alternatively, Xeomin is a more recent addition to the market that offers a slightly different treatment experience. If you think that you’ll opt for long-term treatment (especially in the case of medical conditions) or aren’t a candidate for surgical options, then Xeomin can be your best option because of its lower risk of becoming resistant to it. Additionally, if you have a history of reactions to certain additives, then Xeomin can be a safer option for you.

Ultimately, the differences between Botox and Xeomin can be subtle, requiring the expertise of an experienced injector to decipher which is best for you. As long as you focus on your goals and preferences, we can guide you to the right options.

Schedule a Consultation

At Reflections Center, we believe in highlighting and enhancing the individual’s unique beauty in such a natural way that it appears to be a genetic gift, not the result of a treatment. During your free consultation, we’ll discuss the best options for you based on your goals, and together we’ll create a plan that fits your budget and lifestyle, so that you can age gracefully and beautifully. If you decide to have Botox or Xeomin, you’ll be injected by an expert physician injector who has the experience to make the procedure comfortable and effective, with the natural-looking results you’re after.

We warmly welcome you to our offices for a complimentary consultation.