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 20

Wait a week

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In my practice I have found that Xeomin takes about 7 days to become fully active.  The muscles weaken over the course of the week, and you will see the full effect 7 to 10 days post treatment.

Phoenix Facial Plastic Surgeon


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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
4.7 out of 5 stars 28 reviews

Xeomin sets up like any other neurotoxin

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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.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Xeomin or Botox for wrinkle treatment

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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 and Botox are fairly similar

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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
4.8 out of 5 stars 177 reviews

When will Xeomin start working?

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You should see results starting on the third day with full effect of the toxin being noticed on the 7 th day. Give it another few days.

4 days post Xeomin

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At 4 days post-injection with Xeomin, patients are counseled just to be patient and see what the final results will be. Some patients will not even be responding at 4 days. By 10-14 days post-injection, the final results should be evident, and a determination can be made on how to proceed.

Always see an expert physician injector.

All the best,

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Muscles still active 4 days after Xeomin

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Thank you for your question in regards to Xeomin. Botox and Xeomin are consistent with each other as far as how long it will take to see results (up to 14 days to see full relaxation). The amount of units and injector could be possible factors, although it is still too soon to see full correction. To be sure, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews


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From my experience, it takes xeomin about 5-7 days to become fully active.  I typically tell patients to wait a good 10 days before they decide that they want additional product.  If you over inject a toxin you're essentially wasting your money - your body disposes extra toxin as waste.  Be patient and give it time to kick in.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews


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It usually takes 4-7 days for Xeomin to start working. So be patient. It takes about 2-3 weeks for the full effects to take place.

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.