Botox Alternatives in Richmond VA

Botox has become the most widely used product for nonsurgical facial rejuvenation for good reason: Botox is very effective when used properly, and more importantly, very safe.

The number of patients seeking Botox continues to expand every year, and shows no signs of slowing.

Botox Alternatives

With the widespread use of Botox, it has become the Kleenex of facial injectables, with strong brand recognition. However, there are currently 2 FDA approved products available which use the same botulinum toxin A found in Botox to produce similar results: Xeomin and Dysport.


Dysport is made by the same company that makes the popular filler Restalyne. Dysport uses the same botulinum toxin A found in Botox, with a very small difference in the protein. Dysport is called Abobotulinum and Botox is Onabotulinum. Both have the same effect of paralyzing the muscles in the face which cause dynamic wrinkles. The advantage of Dysport is that many patients find that it works faster (often in 1 day) and that it lasts a bit longer than Botox.  Dysport is also less expensive than Botox by 10-20%.

Due to its efficacy, safety and value, I am a big fan of Dysport and recommend it with confidence.

97% of patients who have tried Dysport say they would use it again instead of Botox.


Xeomin is a lesser known Botox alternative and the protein is known as Incobotulinum. Like Botox and Dysport, it is FDA approved to treat dynamic facial wrinkles. Xeomin is often less expensive than Botox.

The main advantage of Xeomin is quite simply value: equivalent results for 20% of the price of Botox.


Platelet Rich Plasma

Platelet rich plasma (PRP) takes advantage of natural products found in our blood’s platelets known as growth factors which encourage healing. Some studies have also shown an ability for PRP to stimulate stem cells. On the face, PRP can be injected or used topically with micro needling to reduce wrinkles and improve overall skin tone.

Click here to watch a video about PRP

More information on PRP

Radio Frequency nerve ablation

A new product called Thermi Raise has gained FDA approval for treatment of wrinkles in the upper face. It works by using radio frequency energy to block the transmission of nerve impulses in the face which pull muscles and cause wrinkles. The effects can last one year or greater. Like Botox injections, there is no downtime with this procedure.

Thermi website

Botox Cream

A company known as Revance Therapeutics has a gel form of botulinum A in clinical trials. I have been following the study and the results seem promising. A release date is not known at this time, but will be exciting.

Laser Delivery of Botox

I have read some very interesting articles in the medical literature where lasers were first used on the skin to make microscopic channels into the tissue. Botox was then applied onto the channels which delivered Botox to the muscles and achieved smoothing of crow’s feet wrinkles. This may prove an interesting topic in the future.

I have used laser assisted delivery for platelet rich plasma and Sculptra filler with excellent results, and I think this represents a great potential as we look to the future of facial rejuvenation.