Botox®and Other Neuromodulators

Treatment – Forehead, Glabella & Eyes


As we age, our skin loses some of its elasticity and ability to ‘snap back’ with stretching. With years of continued use, the muscles responsible for facial expression can become quite strong or enlarged. The combination of both of these processes can ultimately lead to the formation of dynamic expression lines on our face (which we usually refer to as “wrinkles”). Their presence gives the face an aged appearance, and the frown lines between our brows may be misinterpreted by others as anger or worry. To many deep wrinkles, crow’s feet, and under eye wrinkles are an unwelcome reminder that our faces are changing without our permission.

Neuromodulators are medications used cosmetically to correct deep facial expression lines. By temporarily blocking nerve impulses to these facial muscles, the muscles are weakened. And without their continued movement, the overlying skin is allowed to flatten and smooth.  Longevity is prolonged if treatments are given at regular intervals (every 3 to 3 1/2 months) during the first year.  There is nothing else that can eliminate dynamic facial lines as well as neuromodulators. They have truly revolutionized the way we treat effects of facial aging and continue to be the most requested cosmetic treatment world-wide!  Properly administered by one of the best wrinkle doctors in Lancaster County, Dr. Cohen’s advanced training and complete understanding of facial anatomy and muscle movements, will ensure that the neuromodulators you receive are safe, very effective and yield natural-looking results.

Neuromodulators can be used for:

  1. Expression lines
  2. Lip Eversion (Lip Flip)  A reduction in the tone of the Orbicularis Oris muscle allows the upper lip to evert or ‘flip’.
  3. Skin Tightening  (MicroTox)  Hyperdiluted Botox to the skin (not underlying muscle) effects a tightening.
  4. Erectile Dysfunction (Bocox®)  A benefit to those who have either not responded or have stopped responding to Viagra or Cialis.
  5. Hyperhidrosis (Excess Sweating)  Small amounts of Botox injected just under the skin of the underarms dramatically reduces sweating for 4 – 6 months.
  6. Migraine Headache

Botox® Injections

Being FDA approved for cosmetic use in 2002, Botox® Cosmetic is the most commonly used neuromodulator in the U.S.  It has enjoyed an excellent safety record. Many physicians claim this highly purified medication to be one of the safest medications currently in use because it has been so widely studied. Of interest, 80% of all Botox in the U.S. is used medically. Following virtually painless injection, the relaxation of the muscle(s) is noted in about three to seven days. This effect lasts for three to four month.  Side effects are rare and always transient.

Dysport™ Wrinkle Treatments

This neuromodulator was FDA approved in April 2009. It has been safely used world-wide since 1991 and is perhaps the most used neuromodulator throughout the world. Following virtually painless injection, the relaxation of the muscle(s) is noted in about 48 hours and lasts for about four months.  Side effects are rare and always transient.

Pure Xeomin®

After years of use in Europe and throughout the world, Xeomin arrived in the U.S. in 2011.  Numerous studies have shown it to be all-but-identical to Botox: It has the same safety profile, the same results and the same duration of action.  Unlike Botox however, it lacks a complexing protein which makes it a more purified neuromodulator.  Xeomin is a good option for those who have stopped responding to Botox.