21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS

Jeuveau is commonly referred to as Newtox.

Do you find people asking you if something is wrong even though you feel great? If so, you could be an ideal candidate for a neurotoxin procedure such as Botox®. It’s a fast, simple way to relax the dynamic muscles in the face including those “11” lines between the eyebrows that may be making you look unnecessarily angry or worried. In fact, neurotoxins are so versatile and effective for treating any number of issues that it is the number one aesthetic procedure in this country. Though Botox® is the most recognized neurotoxin, it is not the only game in town. The newest player in on the field is Jeuveau®, commonly referred to as Newtox. So, Botox® or Newtox — which is best?

What is a Neurotoxin?

At Boston Center for Plastic Surgery, part of our practice philosophy is always being honest with our patients about what any given procedure can and cannot achieve. With Botox®, for example, this begins with explaining: What is a neurotoxin? We have found that many patients think that a neurotoxin like Jeuveau® and a filler like Juvéderm do the same thing when they actually work quite differently.

Since they are administered through a very fine needle, all neurotoxins and fillers fall under the procedure category of “injectables”. However, a neurotoxin works by temporarily relaxing the underlying dynamic muscles in the treatment area. This allows the surface of the skin to smooth out so that you look more rested, refreshed and vital. A filler works by literally filling in lost volume in a fine line, wrinkle or hollow area. The two work synergistically, however, and are often administered together as part of a non-surgical facial rejuvenation procedure.

Not All Neurotoxins Are Created Equal

Currently, there are four FDA approved neurotoxin options for addressing expression lines such as:

  • 11 lines between the eyebrows
  • Crow’s feet around the eyes
  • Brow furrows
  • Frown lines

We are proud to offer our patients all of these options including:

  • Botox®
  • Jeuveau®
  • Xeomin®
  • Dysport®

Though each works to relax your dynamic muscles, not all neurotoxins are created equal. There are subtle differences, making one perhaps better for a specific patient or area of the face. This is one of the many reasons why it is so important to see a really qualified injector.

Formulation Affects Performance

All neurotoxins are comprised of purified botulinum toxin formula type A. This is the mechanism that temporarily softens the activity in your dynamic muscles. But while Xeomin® is formulated with 150 kDa molecule weight, and Dysport® comes in a range of molecule weights, Botox® and Jeuveau® are both formulated with the same 900 kDa molecule weight. This is why Jeuveau® goes by the catchy name Newtox because they are the most closely related of the four.

The formulation affects the:

  • Required dosage
  • Product spread
  • How fast you will see results

Botox® vs. Jeuveau®

Originally designed and marketed as a less expensive option for younger patients, the main difference between Botox® and Jeuveau® is that the latter may have a faster onset of action of only 2-3 days. This can make it an ideal option for any patient who doesn’t have two weeks between an upcoming event such as a wedding or work presentation, and his or her Botox® procedure.

Another benefit of Newtox is that the results may be longer lasting in certain cases. This can also make the procedure slightly less expensive when you amortize the cost of your injectable procedure against the duration of your results. All of these options will be discussed with you in detail during your initial consultation after one of our Board-Certified plastic surgeons or our Board-Certified dermatologist assesses your skin and tissues in person.

Is Off-Label Use Safe?

While all four neurotoxins are FDA approved, Newtox only has this approval for treating the glabellar lines between your eyebrows. However, it is often used off-label to treat other areas of the face. Off-label is a term that refers to the use of a product in an area or way in which it was not intended or, in this case, for which it has not yet gained FDA approval.

Some patients get worried and wonder if off-label use is safe? Yes, in the hands of skilled injectors such as our talented team, off-label use of a product is definitely safe. When Botox® was first brought to market, it also was only FDA approved for the “11” lines. But the FDA approval process is slow, and our field is known for its innovation. This is why injectors have safely used Botox® and other neurotoxins off-label for years.

Skill of Your Injector is Critical

Insuring a safe, remarkable, and natural looking result with your injectable procedure is less about choosing the right neurotoxin, and more about choosing the right injector. The skill of your injector is critical. Having a team that is Board-Certified means that all of us at Boston Center for Plastic Surgery have the training, skill and years of experience to match the right product to your unique anatomy, needs and lifestyle. 

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To find out more about Botox®, Jeuveau® or any surgical or non-surgical procedure with Dr. Leonard Miller at Boston Center for Plastic Surgery, check out our website or call (617) 735- 8735 to schedule a consultation.


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