I can't have Botox, Dysport or Xeomon due to bad reaction. Need options!

I am a 47 y.o. woman who had Botox 6 times in the past and loved it. Unfortunately, 3 days after the last treatment 2 yrs. ago, I got flu-like symptoms that lasted for many months. Blood work was normal. Neurologist (who uses Botox) thought I was having rare side effects and told me never to get it again. I don't know for sure if it was the Botox but I don't ever want to be that sick again. How do I manage my aging face without Botox? My concerns are dynamic crows feet, fine lines and "11"s.

Doctor Answers 5

Botox and Flu Like Symptoms

I have had one patient in over ten years of Botox experience that had the same reaction. About a year later and saying she will never have it again, she had it again and she did fine.

The alternative to a neurotoxin is a hyaluronic filler like Perlane. It doen't work as a neurotoxin, it works by taking up space and not allowing the muscle to contract.

My office is in West Orange. 

Best wishes

West Orange Plastic Surgeon
4.8 out of 5 stars 22 reviews

Xeomin Makes A Great Substitute For Botox- And Dysport-Sensitive Individuals

I have been injecting Botox for aesthetic purposes since 1991. In all that time, I have only had one patient who developed flu-like symptoms following the treatment of the dynamic expression lines of her upper face. With the patient's permission, she was retreated (essentially re-tested) several months later with Botox and experienced a repeat of her flu-like symptoms. 

More recently, she agreed to a trial of Xeomin (which amounts to a Botox molecule stripped completely of all potentially allergenic proteins). Happily, she did not experience the flu-like reaction and was gratified with her aesthetic improvement.

Since the problem described clearly seems to relate to the muscles of facial expression, treatment needs to be directed to them. Accordingly, it would seem that the simplest solution would be a trial of Xeomin, as I did with my patient. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

ThermiRase is an option

There is a procedure that I do using thermal energy that is used to treat the vertical glabellar lines. It is toxin free and is approved by the FDA. It is done under local anesthesia and  is either long lasting or permanent.  No toxin is used.


Under local a tiny needle is inserted and the nerve is treated.  

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Ulthera as an alternative for neurotoxins

Ulthera can be a great, and more permanent alternative to the neurotoxins (botox, dysport, etc). It is a non-invasive procedure that uses ultrasound energy to tighten and lift the skin on the face and neck. Many women prefer it to neurotoxin because it lasts several years.

Julie E. Russak, MD
New York Dermatologist
5.0 out of 5 stars 2 reviews

Botox reaction

Have you tried any of the other neurotoxin products on the market?  Xeomin for example, is processed much differently than Botox or Dysport and does not include the extra proteins that the other products have. This may have a lower risk of having any reaction--potentially.  If you truly want to avoid any further injections, there is a surgical procedure that is in the pipelines that you may be a candidate for where the specific nerves are "stunned" with a radiofrequency probe under the skin and is thought to have a response similar to use of neurotoxins.  My understanding is the results can last for upwards of 2 years but it isn't yet available for mainstream use.  

Megan Jack, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 15 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.