Are the toxins in Botox the cause of the anxiety/panic attacks, or is this a result from the blocked nerve?

It might be the botox, in which case, Xeomin, or Dysport would not be different.  On the other hand, the problem may be the emotional effects of the treatment your injector is doing.  We know that botox relaxes certain facial muscles and this has an effect on facial feedback and our emotional state.  It is thought that for this reason, people are "disproportionately" happy after a good botox service.  For this reason, Botox has been successfully used to treat people with clinical depression.  On the other hand certain treatment patterns, like dense forehead treatment might be the basis for your anxiety. I have an entirely different method of administering botox called the Microdroplet Lift. You might consider trying this type of service before throwing in the towel on cosmetic botulinum toxin.

I think there is something else going on unrelated to the Botox injections which is triggering your anxiety/panic attacks.  I am unfamiliar with glabellar frown relaxation which employ heat technology used in the skin-tightening treatment Thermage, to selectively weaken nerve function. I would recommend that you make an appointment with your PCP and discuss the possible causation of this behavior within 24 hours of a Botox injection.  If you have been using the same injector for the past six years, discuss your recent anxiety with him or her.  Perhaps a sedative can be prescribed prior to the treatment.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

It is unlikely that Botox is causing your anxiety. However, Xeomin/Dysport, fillers, lasers and microneedling/prp can be used as alternatives. See an expert. Best, Dr. Emer