Daniel McCauliffe, MD

I have had one patient who developed resistance to Dysport that responded to Daxxify. She never had treatment with Botox, Xeomin or Juveau. Immune resistances are variable so this patient's response to Daxxify would not guarantee that Daxxify would work for you but it would be worth a try.

Sodium bicarbonate ("bicarb") is often added to lidocaine anesthetic to make it less painful when injected, but its use with Daxxify has not been studied to my knowledge and it may have been the reason for your poor results. It would be informative to know how Daxxify worked if you subsequently had treatment with Daxxify that was prepared according to the manufacturer's recommendation with sodium chloride.

The risk of Daxxify migrating to other areas and relaxing muscles distant to the treated site can be minimized by two major things:
1) Get treatment from an experienced injector, as injection technique matters.
2) Do not massage, rub or put pressure over the treated area(s) for several hours after treatment as it may cause the product to drift to unwanted areas, such as below the eyebrow where it might temporarily cause a droopy eyelid by weakening the eyelid muscles.
In my experience, and in the published Daxxify studies, the risk of getting a droopy eyelid from Daxxify was very low, as it is with the other botulinum neuromodulators (Botox, Dysport, Xeomin, and Jeuveau).

Do not massage, rub or put pressure over the treated area(s) for several hours after treatment as it can cause the product to drift to unwanted areas, such as below the eyebrow where it might temporarily cause a droopy eyelid by weakening the eyelid muscles. Avoid taking aspirin 10 days before treatment and naproxen and ibuprofen for 5 days before treatment as these medications increase the risk of bruising. No aftercare is really necessary and there really is no healing time after treatment. That is why botulinum neurotoxin treatments are often referred to as a "lunchtime" procedure as there usually is no significant recovery period as there is with surgical procedures. Some injectors have recommended patients actively move the treated muscles with facial expressions after treatment though I find that that isn't necessary to get the full effects.

I am frequently asked to remove facial moles for cosmetic reasons. The size, location, pigment, and presence or absence of hair within the mole helps determine what procedure is best. Also be aware that what some patients assume is a mole (nevus) may not be a mole, but an age spot, skin cancer, or another benign growth. You should see a dermatologist and determine the nature of the spot first. If it is a mole (nevus) then answer the above questions. Most small benign moles (nevi) can be shaved off or excised. If they are heavily pigmented or have hair in them that you want to get rid of it may be best to excise them as shaving may not remove all the pigment and will not remove the hair root. From your photos, you should do well with either a shave procedure or an excision. Be aware that a shave removal runs the risk of leaving a depression so it must be done very carefully, and excision may leave a small detectable line scar but should be much less noticeable than the mole. Hope this helps. My mole removal fees are posted on my website but the cost depends on where you have it done. Hope this helps you in making your decision.