Considering jeuveau in houston? Start with a consultation.
Book Consultation(opens in a new tab)What it treats
- Frown lines between the eyebrows (the "11s")
- Forehead lines that show when you raise your brows
- Crow's feet at the outer corner of the eye
- Bunny lines on the bridge of the nose
- Some lip-flip and DAO (corner of mouth) work for patients who want a softer lower face
- Masseter slimming and jawline contouring for the right candidate
Products used in this treatment: Jeuveau (prabotulinumtoxinA-xvfs, manufactured by Evolus)
How Jeuveau is similar to Botox - and where it is different
Jeuveau is the same drug class as Botox: botulinum toxin type A. The mechanism is identical. Both work by temporarily blocking the nerve signal that tells a muscle to contract. When the muscle stops contracting, the overlying skin stops creasing, and the dynamic lines that formed there soften.
What is different is the manufacturing process and the formulation excipients. Evolus uses a proprietary purification process that some patients report gives them a faster onset than Botox. My anecdotal experience matches that: Jeuveau patients tend to see early effect within 2 to 4 days, with full effect by day 10 to 14. Duration is comparable to other neurotoxins in the class, typically 3 to 4 months.
The unit-to-unit conversion between Jeuveau and Botox is roughly 1:1. If you have done Botox before and we are switching you to Jeuveau, I can usually predict your dose pretty well from your history.
Conservative dosing - my actual practice philosophy
The single most common request I get from new neurotoxin patients in Houston is some version of: "I want it to work, but I do not want to look frozen." That is fair and it is also the way I prefer to inject. We can always add more at the two-week follow-up. I cannot subtract neurotoxin once it is in.
My first-treatment doses tend to be on the conservative side of the typical range published in the literature. If we are treating glabellar 11s on a new patient, I am usually in the 16 to 20 unit range. If we are treating forehead, I tend toward 6 to 12 units depending on muscle mass and the patient's eyebrow shape. If we are treating crow's feet, 8 to 12 units per side is typical.
We see each other at two weeks. If it is not enough, we add. If it is right, we plan the next visit in 12 to 16 weeks.
What the appointment is like
A neurotoxin appointment runs about 20 to 30 minutes, most of which is talking. Five minutes is the actual injection. I do not use topical numbing for neurotoxin because the needle is so small that most patients do not feel it as anything more than a pinprick.
You can go back to work the same hour. There is no real downtime. I ask patients to avoid lying flat or pressing on the treated areas for four hours, and to skip heavy exercise the day of the appointment to reduce the chance of product migration.
When I steer patients away from neurotoxin
Neurotoxin is one of the safest aesthetic procedures we have, but it is not for everyone in every situation. I steer patients away when:
- They are pregnant or breastfeeding.
- They have a neuromuscular condition like myasthenia gravis or ALS.
- They are on certain antibiotics (aminoglycosides) that can interact with neurotoxin.
- They have unrealistic expectations of what neurotoxin can do for static deep lines that are already etched into the skin. Those usually need a layered approach with filler or biostimulator.
- They have an active skin infection in the treatment area.
Why Jeuveau patients in Houston Heights end up at MV
Most of my Jeuveau patients live within a few miles of the practice - Heights, Garden Oaks, Oak Forest, Rice Military, Cottage Grove. The practice is at 24th and Shepherd with free parking under the building. Most patients book the consult, decide on a plan in the room, and treat the same day if it makes sense.
I do every injection personally. The continuity matters with neurotoxin: knowing how a patient responded last cycle is the single biggest predictor of doing well this cycle.
