Botulinum toxin injections, commonly known by brand names like Botox®, Dysport®, and Xeomin®, are FDA-approved treatments engineered to temporarily relax hyperactive facial muscles.
At North Texas Facial Plastic Surgery, double board-certified facial plastic surgeon Dr. Colin Pero offers customized neuromodulator injections to soften unwanted expression lines and restore facial symmetry. His focus is on preventing deep creases while keeping your natural expressions completely intact.
Whether you're concerned about forehead lines, frown lines, crow's feet, or other dynamic wrinkles, treatment can be tailored to the areas you want to address.
Dynamic wrinkles are formed when muscles directly underneath the skin contract during facial expressions. Over decades, as natural collagen and elastin density decline, the skin loses its ability to bounce back, causing these active lines to become permanently etched into the dermis.
Botulinum toxin is a neuromodulator that targets the root cause of dynamic wrinkling. When injected into specific muscle fibers, it temporarily blocks signal transmission from local nerve endings to the underlying muscle. By reducing the strength of these repetitive contractions, the skin resting above the muscle relaxes, allowing existing lines to smooth out.
Botulinum toxin is most commonly used to soften dynamic facial lines caused by repeated muscle movement. Dr. Pero may also use neuromodulators in selected areas of the mid and lower face when muscle activity contributes to a concern.
The most common treatment areas include:
Horizontal lines that become more noticeable with repeated eyebrow movement.
Vertical lines between the eyebrows associated with repeated frowning or concentration.
Fine lines around the outer corners of the eyes that appear with smiling or squinting.
Depending on your facial anatomy, muscle activity, and goals, Dr. Pero may also consider botulinum toxin for concerns such as:
Not every area is appropriate for every patient. Treatment is planned based on the way your individual facial muscles move and the type of change you want to achieve.
Dr. Colin Pero believes aesthetic care should enhance your natural features rather than produce an overdone look. He specializes exclusively in cosmetic and reconstructive procedures of the face, head, and neck.
Botulinum toxin works best on dynamic lines, wrinkles that become more visible when facial muscles contract during expressions such as frowning, raising the eyebrows, or smiling. If a line remains visible when the face is relaxed, muscle activity may be only one part of the concern, and another treatment may be more appropriate.
Before recommending treatment, Dr. Pero evaluates the areas you want to change along with the way your facial muscles move and how those areas relate to the rest of your face. He considers:
This assessment helps Dr. Pero determine whether botulinum toxin is appropriate, which areas may benefit from treatment, and where treatment may not be necessary.
For deep static wrinkles that persist when the face is fully relaxed, Dr. Pero may discuss other options or a combination of treatments. Depending on the concern, these may include laser skin resurfacing to improve skin texture or selected dermal fillers to address volume-related changes.
Effective neuromodulator treatment involves more than injecting directly into a visible line. Dr. Pero evaluates how your facial muscles interact, adjusting placement and dosage to soften unwanted creases while preserving natural expression.
Facial muscle mass and movement dynamics vary for every patient. Rather than using standardized templates, Dr. Pero customizes unit dosages and injection points based on your specific brow position, perioral structure, and facial symmetry.
The goal of neuromodulation is to soften unwanted dynamic lines without unnecessarily restricting facial movement. Dr. Pero evaluates the precise degree of relaxation required for each muscle group, taking care to soften dynamic creases without causing a heavy brow, an altered smile, or a frozen appearance.
Facial muscles work together to create expression and movement. Dr. Pero considers these relationships when planning treatment so that reducing activity in one area does not unnecessarily alter the balance or movement of another. The goal is a refreshed appearance that remains consistent with your natural facial character.
At North Texas Facial Plastic Surgery, we offer three leading FDA-approved neuromodulators.
Botox® is a botulinum toxin product commonly used to temporarily reduce the appearance of dynamic facial lines. It may be used in areas such as the forehead, between the eyebrows, and around the eyes when appropriate.
Dysport® is another botulinum toxin product used to temporarily reduce targeted muscle activity. Like other neuromodulators, its use depends on the treatment area, patient factors, and the goals being addressed.
Xeomin® is a botulinum toxin product that can also be used to temporarily reduce activity in selected facial muscles.
While these products have a similar general purpose, they are not identical products, and their dosing conventions and approved indications differ. Dr. Pero can discuss which option is appropriate for your treatment plan rather than requiring every patient to use the same product.
Botulinum toxin treatment at North Texas Facial Plastic Surgery is performed in-office and typically takes only a short amount of time. Dr. Pero and his team guide you through each step, from the initial facial assessment and treatment planning to post-treatment care.
Dr. Pero examines your face in active motion, asking you to frown, smile, squint, and raise your brows, to map exact injection vector points.
Treatment takes approximately 10 to 15 minutes. Dr. Pero uses ultra-fine micro-needles to deliver precise doses, minimizing discomfort and bruising.
Most patients can return to their usual activities shortly after treatment. Dr. Pero will provide specific post-treatment instructions based on the areas treated and your individual circumstances.
Follow the practice's instructions regarding exercise, positioning, and avoiding pressure or massage of treated areas during the initial post-treatment period.
Botulinum toxin does not take effect immediately. Initial changes typically become noticeable within several days.
Results typically last 3 to 4 months, with longevity increasing over consistent maintenance.
The goal of neuromodulation is not simply to erase a line, but to achieve a balanced, natural outcome suited to your facial dynamics. The right treatment plan depends on how your facial muscles interact, the specific concerns you want to address, and your overall aesthetic goals.
To discuss your goals with Dr. Pero, contact North Texas Facial Plastic Surgery in Dallas or Plano at (469) 278-7958 or request a consultation online. Virtual telemedicine consultations are also available for out-of-town patients.
A natural-looking result depends on how treatment is planned and how much muscle activity is reduced. Dr. Pero evaluates your facial movement, anatomy, and aesthetic goals when determining the appropriate treatment areas and dosage. The goal is to soften unwanted dynamic lines while maintaining natural facial expression and movement.
Neuromodulators (like Botox®) temporarily relax the underlying muscles responsible for dynamic expression lines. Dermal fillers (like hyaluronic acid) add physical volume beneath the skin to restore lost structural volume, smooth static folds, or contour features like the cheeks and lips.
Initial softening begins within 3 to 5 days, with full results visible by day 10 to 14. Results typically last 3 to 4 months, after which muscle activity gradually returns. Regular maintenance sessions help prolong your results.
To ensure optimal placement, avoid lying flat or bending forward for at least 4 hours after treatment. Avoid strenuous exercise, saunas, facial massages, and rubbing the treated areas for 24 hours to prevent the product from diffusing into adjacent muscles.
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