By Lindsey Sikora, MSN, APRN, FNP-BC
Almost everyone who sits in my chair for the first time asks for “Botox.”
I get it. Botox is the name you’ve heard of. It’s become the word people use for all of it — the same way we ask for a Kleenex when we mean a tissue. So when I say, “Actually, what I’d recommend for you is Xeomin,” I watch the same look cross their face: Wait. What’s that? Is that the off-brand one?
No. And this is the conversation I have so often that I figured I should just write it down.
From what I’ve learned — and I don’t pretend to be an expert on everything, I just inject faces all day and I pay attention — the brand name matters a lot less than people think, and the plan matters a lot more. Here’s the honest version.
First: they’re the same kind of treatment
Botox Cosmetic and Xeomin are both wrinkle relaxers — injectable neuromodulators. They temporarily reduce activity in targeted muscles, which softens the lines that form when you frown, squint, or raise your eyebrows over and over.
Both contain botulinum toxin type A. Both are placed in small amounts into specific muscles with a fine needle. Both develop gradually, and for many patients results last approximately three to four months — though that varies by product, dose, treatment area, and the person.
So no, one is not “real” and the other is not fake. They’re two versions of the same tool.
So what’s actually different?
Formulation.
Xeomin’s formulation contains botulinum toxin type A without accessory proteins. That’s the difference, stated plainly, because that’s how it was explained to me and that’s what I tell my patients.
Botox is the familiar favorite — the one that built the category, and a perfectly good product. We carry it, and I use it. We also offer Dysport, Jeuveau, and Letybo, because different faces, different histories, and different preferences are real.
But Xeomin is our go-to at Shot Bar. It’s the one I reach for first, and the one I’d point to if you asked me, “What would you do?” That is a preference built from doing this work every day — not a claim that the others don’t work. Anyone who tells you one brand is magic and the rest are garbage is selling you something.
The thing nobody tells you: units are not units
This is where people get tripped up comparison-shopping, so please hear me on this one.
Units are specific to each brand and are not interchangeable. A unit count for one product does not equal the same unit count for another, so comparing “how many units” across different products can be misleading. If one place quotes you a number for Botox and another quotes you a different number for Xeomin, you are not looking at an apples-to-apples price or dose. You’re looking at two different rulers.
What actually decides your dose is your muscle strength, your anatomy, the area we’re treating, and the result you want. There is no universal number, and anybody who gives you one before they’ve watched your face move hasn’t assessed you yet.
“Will I look frozen?”
The question underneath the question. Almost always, yes, this gets asked.
Your treatment plan starts with how you want to look and how much movement you want to keep. Thoughtful dosing and placement can soften lines while preserving expression. I am a conservative injector — we can always add more, and I’d rather start with less and build than overshoot and have you wait it out. Smooth the lines. Keep the personality. That’s the whole job.
What I actually do in the room
You do not need to arrive with a brand picked out. Seriously. That’s my job, not homework for you.
Before treatment, we review your health history, medications, and any injectable treatments you’ve had before. Then I watch how your face moves — forehead, brows, eyes, smile, all of it works together — and we talk about what you want to soften and how much movement you like. We’ll discuss your previous experience and preferences, and I’ll explain the plan and the cost before we begin.
Treatment itself is quick: small amounts placed into the targeted muscles, brief pinches. Afterward you may have temporary bumps, redness, tenderness, swelling, or bruising at the injection sites, and we’ll go over aftercare and when to check in.
The fine print, because I’m a nurse practitioner first
Wrinkle relaxers work best on lines caused by muscle movement. Lines that are there at rest may soften, but they may not disappear — and texture, sun damage, and volume loss are different problems that may need a different treatment, or a combination.
Possible side effects include bruising, swelling, tenderness, headache, asymmetry, and temporary eyelid or brow drooping. Effects can rarely spread beyond the injection area and cause serious problems — seek immediate medical care for difficulty swallowing, speaking, or breathing. And treatment isn’t right for everyone: tell us about previous reactions to botulinum toxin, muscle or nerve conditions, swallowing or breathing problems, pregnancy, or breastfeeding, and treatment should not be performed through an active infection at the planned injection site. We’ll review all of that together before anything happens.
Some treatment areas are off-label depending on the product, and your provider — that’s me, or one of my nurses — will explain the proposed use, the expected benefits, and the relevant risks before treatment.
The bottom line
If you’ve only ever heard of Botox, you’re not behind — you’re normal. It’s the name that got famous. Xeomin is the one we love working with here, and now you know why it’s the first one out of my drawer.
But the brand is the smallest part of the decision. The assessment, the placement, and an injector who starts conservative and listens to you — that’s what decides whether you love your face in two weeks.
Come in and let’s look at your face together. We’ll make a thoughtful plan, with whichever product fits it best.
Shot Bar Medspa is in Lincoln Park, Chicago. Book a wrinkle relaxer consultation at shotbar.net/services/botox/ or call/text 872-273-6273.
