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Botox, Dysport, Jeuveau, and Xeomin in Palo Alto, San Jose, and the Bay Area

When administered by an experienced specialist, these treatments can achieve a beautifully natural-looking youthfulness. If you’re in Palo Alto, San Jose, or the Bay Area and are interested in this treatment, we have you covered. 

Commonly treated areas with neuromodulators

  • Furrows between the brows
  • Forehead lines
  • Crow’s feet
  • Frown lines
  • Chin dimpling
  • Bunny lines across the nose
  • Fine lines and wrinkles
  • Lipstick lines at the mouth
  • Neck bands
  • Future wrinkles

How neuromodulators work

Neuromodulators are medications that change the way signals are transmitted between nerves and muscles. When a neuromodulator is injected, it blocks the signal from the nerve cell that is telling the muscles to contract. This results in less use of those muscles that make wrinkles appear. You’ll still be able to make expressions; they just won’t be as extreme.

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What kind of wrinkles do you have?

No one is exempt from wrinkles. Unfortunately, they are a part of life — and no matter how careful you are about the sun or smoking, or what type of products you use, if you live long enough, your skin will eventually develop wrinkles. However, we’re very lucky to be alive during a time when there are more advancements in wrinkle treatment and prevention than ever before. Anti-aging treatments and wrinkle-fighting procedures are helping in big ways like never before. However, in order to truly improve these areas of concern, it’s important to understand exactly what type of wrinkles you have. 

There are three different types of wrinkles: dynamic wrinkles, static wrinkles, and wrinkle folds. While neuromodulators (Botox, Dysport, and Xeomin, and Jeuveau) are excellent for static and dynamic wrinkles, a better option for wrinkle folds would either be dermal fillers or a surgical procedure, such a as mid facelift.

Dynamic wrinkles are caused by your everyday facial expressions such as laughing, raising your eyebrows, and squinting. They can fade as quickly as they appear. The most common forms of dynamic wrinkles are forehead lines, crow’s feet, and smoker’s lines around the mouth. 

Static wrinkles develop because of prolonged dynamic wrinkles. If you tend to constantly raise your eyebrows or squint, static wrinkles will eventually become visible even when you’re not making those expressions. They will be etched onto your face. Static wrinkles can also occur due to sun exposure, genetics, and smoking.

Wrinkle folds happen as a result of the skin sagging within specific facial structures, which causes grooves to develop and make the face appear older. The most common areas for wrinkle folds are the nasolabial folds and marionette lines around the mouth. 

Types of neuromodulators we use at Hessler Plastic Surgery

At Hessler Plastic Surgery, we use Botox®, Dysport®, and Xeomin®, Jeuveau™ to get beautiful anti-aging results for our patients in the Palo Alto, San Jose, and Bay Area. During your consultation with Dr. Hessler, she will help you decide which neuromodulator will be best for your personal aesthetic goals.


Botox was one of the very first FDA approved neuromodulators, and was the first anti-wrinkle injectables available. Since 2002, it has become one of the most popular and in-demand cosmetic injectables in the world. In addition to cosmetic uses, Botox can also address medical issues such as excessive sweating, migraine, muscle spasms, Bell’s palsy, and eye twitching. Botox results are noticeable within 10 to 14 days following treatment, and can last 3 to 6 months.


Dysport works very similarly to Botox but is different because of its molecule size, which is smaller than that of Botox. Dysport’s thinner formula diffuses more easily and produces the smoothing effect faster. Because of this, Dysport is especially effective for forehead lines. However, because of how thin the formula is, more Dysport may be needed than Botox. Dysport results are noticeable within 2 to 3 days following treatment, and can last 4 to 6 months.


The main difference that makes Xeomin stand out from other neuromodulators is that it has no additives, which means there is less risk of developing a tolerance to it. Another advantage is that fewer units may be needed with Xeomin. In addition, patients who do not have luck with Botox and Dysport may find success with Xeomin because of the purified state of BoNT-A. Xeomin results are noticeable within about 10 days following treatment, and can last up to six months. Prior to the official launch of Xeomin, a few select plastic surgeons were chosen by Mertz Aesthetic to use it before it became available to other physicians. Dr. Hessler was selected as one of these few.


Approved for cosmetic use in 2019, Jeuveau is still relatively new in the world of injectables. The formula is very similar to Botox, but is used around the eyes more than Botox. Jeuveau was also developed for cosmetic use only, while Botox is used to treat a host of medical conditions. Initial Jeuveau results are noticeable within 2 to 3 days following treatment, and final results are apparent in 7 to 10 days. Results can last 5 to 6 months.

What is the “Botox brow lift”?

When seeing her Palo Alto, San Jose, and Bay Area patients, Dr. Hessler frequently uses Botox injections to lift the brow. This is often referred to as the “Botox brow lift” or a “chemical brow lift”, meaning the brow can be lifted with Botox instead of surgery. 

To do this, Dr. Hessler will study your face and determine the precise location to place the injections to create the effect of a facelift, without any recovery time. Dr. Hessler also performs traditional brow lift surgery for patients who require more extensive enhancement.

Dr. Hessler is amazing. I found her in New Beauty magazine, and she is an Expert Injector, too. There are more then 12 million doctors who are allowed to perform injectables and fillers in the U.S., but less than 3% are qualified to be an expert injector.

Sam G.

Before, during, and after treatment

Before a neuromodulator treatment, avoid any medications that can affect the blood for one week prior to your treatment. This will help decrease the risk of bruising; however, Dr. Hessler uses the smallest possible needles for injections, so the risk of bruising is already minimal. Some patients take arnica montana to prevent bruising as well.

Treatment takes about 15 minutes, and you can immediately go back to your regular day afterwards. During your appointment, your face will first be cleansed, and then the treatment will be administered via a series of injections. They will be administered precisely the right areas to achieve optimal results for your specific areas of concern.

After treatment, it’s important to stay sitting upright for four hours. Be very gentle with your face for the next four days. Refrain from strenuous exercise for a few days, as this can increase the chance of bruising.

Which neuromodulator is right for you?

The decision on whether Botox, Dysport, Jeuveau, or Xeomin is right for you will depend on your medical history and allergies; your areas of concern and aesthetic goals, and Dr. Hessler’s expert opinion. She will be able to determine which one is ideal for you during your consultation by assessing the strength of your muscles, the quality of your skin, your desired amount of relaxation, and your eyelid and brow position.

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At a glance


Benefits: Great for treating all areas, especially small ones
Visibility: 10 to 14 days
Results: 3 to 6 months
Possible side effects: Bruising; swelling or pain at the injection site; flu-like symptoms; headache; nausea; redness; temporary facial drooping


Benefits: Good for last-minute treatments because of faster onset time; ideal for treating larger areas (i.e. the forehead) because of diffusion
Visibility: 24 hours to 3 days
Results: 4 to 6 months
Possible side effects: Bruising; swelling or pain at the injection site; flu-like symptoms; muscle weakness; headache; nausea; redness; temporary facial drooping; muscle pain or stiffness; neck or back pain


Benefits: Ideal for patients who have stopped responding to Botox® or Dysport®
Visibility: 10 days
Results: 6 months
Possible side effects: Bruising; redness; swelling or pain at the injection site; flu-like symptoms; headache; nausea; redness; temporary facial drooping; neck pain; dry eyes; tired feeling; blinking less than usual


Benefits: Cosmetic nature eases government pricing regulations, which may lead to more affordability
Visibility: 7 to 10 days
Results: 5 to 6 months
Possible side effects: Bruising; swelling or pain at the injection site; flu-like symptoms; headache; nausea; redness; temporary facial drooping; loss of strength and muscle weakness all over the body; double vision; blurred vision and drooping eyelids

Hessler Plastic Surgery for neuromodulators in Palo Alto, San Jose, and the Bay Area

At Hessler Plastic Surgery, we love cosmetic injectables because we see the incredible results they get. With Botox being one of our top injectable treatments, Dr. Jill Hessler is known for her expert skill at administering neuromodulators. With Dr. Hessler, you are in great hands: she is an award-winning, double board-certified facial plastic surgeon who is also a trainer for Allergan and Galderma. She leads many trials regarding cosmetic injectables, and frequently speaks at plastic surgeon conferences on the subject. She is a widely recognized leader in her field who is dedicated and passionate about achieving the best results for her patients. If you’re in Palo Alto, San Jose, or the Bay Area and you’re interested in neuromodulator treatments, please schedule a consultation with us today. 


What is the most common age for people to start using neuromodulators?

People of many ages are treated with neuromodulators, but the most common age for patients to begin using them is 30.

How old do I have to be to have cosmetic neuromodulators?

Doctors suggest that patients be a minimum age of 20 to benefit from neuromodulators.

Can men benefit from neuromodulators?

Yes. Many men choose to have neuromodulator treatments, and love their results.

If Botox is so great, why do so many celebrities look bad?

Everyone has seen some scary Botox. So why does this happen? Why do some people look great, and others don’t? This usually happens as a result of a client requesting too much of a good thing. It can also happen if you get Botox from someone who doesn’t really know what they’re doing. If they’re inexperienced, they may inject it incorrectly or inject the wrong area. In order to get the best results from Botox, you must choose an experienced, board-certified surgeon — preferably a facial specialist like Dr. Hessler. It’s also important to have realistic expectations for Botox. Don’t convince yourself that the more you get, the more perfect you’ll look. Botox is available to improve your appearance, not make you 100% perfect. That does not exist.

I see that neuromodulators are administered with a needle. Does it hurt?

A needle is used, but it is very small. Many of our patients never complain, or even worry about it. It’s often compared it to the feeling of a series of small, sharp, quick pinches. If this sounds like something you can’t handle, you can ask us for numbing cream or cold pack before your treatment.

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