Muscle Relaxing Injections – Are All Brands The Same?

Muscle Relaxing Injections – Are All Brands The Same?

Injectable skincare is in high demand for three reasons:

  1. Immediate results
  2. It gives the “ageing naturally” appeal
  3. It is cost-effective

A Little History
Muscle relaxing injections was initially used to treat hemifacial spasms also known as facial spasms or face twitching and for pain management.

Let’s go back in time when muscle relaxing injections was discovered accidentally in Vancouver, BC, Canada.

Maclean’s interview snippet:
“Vancouver ophthalmologist Jean Carruthers and her husband, Alastair Carruthers, a dermatologist, pioneered the cosmetic use of (Term Forbidden by TGA), or Botox, in the late 1980s. It’s now been over 25 years since the FDA approved the use of the toxin, and the couple has strong views about the world’s most common cosmetic procedure and how it changed the world.
Q: Jean, you stumbled onto a cosmetic use for (Term Forbidden by TGA) when treating a patient with eye spasms. Was there any indication before that it could be used cosmetically?
Jean Carruthers: Alan Scott in San Francisco, with whom I went to work in 1982, had the great idea to use (Term Forbidden by TGA) A to treat people with benign blepharospasm, though there’s nothing benign about your eyes spasming. In three days, those people were driving again. Alan observed it relaxed frown lines, but that didn’t interest him. Then [in 1987] one of my blepharospasm patients got angry with me. She said: “You didn’t treat me here,” pointing between her brows. “When you treat me there I get this beautiful, untroubled expression.”
Alastair Carruthers: The next day Jean injected our receptionist, Cathy Bickerton, who had a deep line [between her brows] which was like a crevasse by about two in the afternoon; she was quite frightening to look at. Three days later, I looked at the result, and I said, “Wow!” We didn’t have anything to treat those lines. So, we started collecting patients and treating them. By 1990, we had ten patients; a year later when we presented data, we had 18.”

Its cosmetic applications have risen consistently since 2000. The treatment is used to soften the lines caused by facial expression and can be adjusted to ensure natural results. The duration of results is variable in between individuals but ranges from three to six months.

Medically speaking, it is still currently used to allow people living with cerebral palsy to have more freedom of movement.

Are There Any Differences Between Muscle Relaxing /Anti Wrinkle Injection Brands?

Forgive us for the fact that this article may appear a little cryptic. In Australia, the TGA does not allow S4 drug names to be advertised.  In this article the different brands will be known as;




Summary of Differences Between Brand X vs. B vs. D

1. The main difference between X and B or D, is that X contains just one ingredient: (Term Forbidden by TGA) A.

2. The manufacturing process is slightly different with all 3, which leads to some potential, subtle differences in clinical practice.

3. X is a “naked injectable,” meaning that it does not contain any additives. A benefit of a pure-form injectable is that the human body is less likely to become resistant to it. Some patients have developed antibodies to B and D.

4. X is the only one of the three (X, B, and D) injectables that do not need to be refrigerated before use, due to its lack of additives.

5. The cost of X is roughly the same as for B at $17 per unit. D is $6 per unit, (ACM price).

6. Patients average 20 units of X per visit, vs. 20 units of B and 40 units of D.

7. The average retail cost to a patient in Australia for  X treatment is between $250.00 – $400.00 every three months based on the recommended dose of 20 Units per treatment session, (ACM price).

8. X might have the slowest “onset” of action of the 3 (D onset in 24 hours, B onset in 72 hours, and X onset in 4 days).

9. X may be “mildly more convenient” than B or D, as the “product’s lack of complex proteins will help prevent antibody formation, or resistance to neuromuscular treatment with botulinum type A toxin, in patients being treated for neuromuscular conditions.”

10. Neurotoxins diffuse differently, in part because B and D have protective proteins clustered around the active part of the molecule, while X has no protective proteins.

11. B has a full complement of protective proteins and weighs about 900 kD. D is a mixture of 500 kD and 300 kD complexes of protective proteins and (Term Forbidden by TGA) A. Being heavier, these complexes migrate more slowly than X/NT-201, which is BTX-A without protective proteins. Conversely, you will have less precision.

12. D has been shown to “drift” or diffuse more than B, increasing the chances of an accidental droopy eyelid or unintentional relaxation of a neighbouring muscle due to diffusion of the product.

13. B and D are not interchangeable because the products are dosed and injected differently.

14. B, D, and X are safe for all skin types and skin colours. However, people who are pregnant, breastfeeding, or have any neurological diseases should not use these injectables unless approved by a qualified cosmetic doctor.

15. When considering cosmetic injectables as your skincare treatment, make sure you go to a highly regulated injector. We recommend going to a cosmetic physician.

Dr Targett is a trusted and leading cosmetic physician in Adelaide, call 0403 690 031 to schedule your appointment.

Source: International Association for Physicians in Aesthetic Medicine and Maclean’s Magazine
Photo credit: Allure Magazine

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