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4th Day Post Xeomin. Muscles Still Active. When Will the Toxin Start Acting? Will It?

When will the toxin start acting? Will it? Visiting Europe. Just had Bocouture (Xeomin) injected 4 days ago. Product didn´t feel like Vistabel when injected and it seems to take longer than my usual Botox to work. Had used Vistabel 3 times before and my experience was that by day 4 my forehead was done with the overactive expressions. On my 4th day post Bocouture now and my forehead has a life of its own. What can I expect? What can I do besides waiting? thnx

Doctor Answers 11

Xeomin sets up like any other neurotoxin

There is a commonly held misconception, which is also perpetuated by many injectors, that because Xeomin doesn't have complexing proteins and is a "naked molecule" that it should "set up" quicker in all people.  This has not been seen in the clinical studies that have been done, and while in some people Xeomin might set up overnight, just like Botox might for some people, the majority of people do not see full results of any of the neurotoxins for 5 to 7 days after injection.

Xeomin or Botox for wrinkle treatment

Xeomin and its product for cosmetic use Bocouture made in Germany by a company called Mertz. Compared to Botox and its cosmetic  preparation Vistabel, it contains less stabilising proteins. Hence it is considered to cause less allergies. It is also temperature insensitive before reconstitution. Otherwise all comparative studies of these preparations showed them to be equally effective.

3% of botulinum toxin users eventually start producing high level of anti-bodies to the toxin, and the treatment stops helping to reduce their wrinkles. The other explanation of failure of the treatment might be that the injector was not using adequate doses or Xeomin was already inactive if it had been reconstituted  longer that 1 week .

Xeomin Takes 2-3 Days Until Effective

As with all the neurotoxins, Xeomin usually takes its effects within 2-3 days after the injection and usually has its effects noted by 5-7 days, with maximum correction by day 14 in most. As will all toxins, this is variable and some may not notice an effect like what you are describing. It is why we ask patients to return to the office 2 weeks after the injection, so we may evaluate, with them, how things are going.

Xeomin is a very good filler, and in the next patient injected, the effect may be in 2 days.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 11 reviews

Reaction to Xeomin

Really Xeomin can take up to 7 days to fully take effect. If after 7 days, you can still move your forehead mare than you want, then you can have more product injected into the forehead.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.5 out of 5 stars 15 reviews


Xeomin can take 7-10 days to see the full effect.  I would wait a full 10 days and follow up with your doctor if you are still not seeing results.  Good Luck.

Jessica Lattman, MD
New York Oculoplastic Surgeon
5.0 out of 5 stars 10 reviews

4th Day Post Xeomin. Muscles Still Active. When Will the Toxin Start Acting?

Xeomin takes 7-10 days to see full result. Contact you medical provider if you are still not seeing any difference, you may need a touch up or more units applied to the area 

4th Day Post Xeomin. Muscles Still Active. When Will the Toxin Start Acting?

I my experience, Xeomin (along with the other neuromodulators, Botox and Dysport) start working within two days of the treatment.  It can, of course, take a little longer but if you have not seen any or adequate results by 7-10 days after the procedure you should speak with your plastic surgeon and see what options there might be for some additional treatment.  That is handled differently in each practice so you'll have to go in with an open mind and ask what the choices might be.

I hope that this helps and good luck,

Dr. E

Botox and Xeomin Injections - Options for treatment of facial wrinkles

Xeomin should take effect within 5 days of treatment.  This has been my experience in my Los Angeles plastic surgery practice.  Xeomin results are long lasting and there is a high level of safety for the treatment of facial wrinkles. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 61 reviews

Xeomin and Botox start to work within 1-4 days

Patients typically start to notice an effect from Xeomin or Botox within 1-4 days. Sometimes, it can take as long as a week. Usually, I invite my patients to come back at 2 weeks so that we can do touchups, if necessary.

Xeomin and Botox are fairly similar

Xeomin, similarily to Botox, works in about 4 to 7 days for most patients.  I typically recommend patients wait a week to determine how effective their dose was.  If the dose was inadequate,  additional botulinum toxin may be necessary.  Although there are guidelines for botulinum toxin dosing, dosing and location must be individualized to each patient's anatomy for optimal results.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 94 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.