Neuromodulators (Wrinkle Relaxers) in Tampa
Neuromodulators are purified botulinum toxin type A products that temporarily relax the specific muscles that create dynamic expression lines. At Premier Internal Medicine, treatment is performed in the office by Alexandra Zelenka, MD, after a medical history is taken, with dosing planned for your face rather than applied as a fixed formula.
What Are Neuromodulators?
Neuromodulators are prescription injectable medications made from purified botulinum toxin type A. They act at the junction between nerve and muscle, temporarily reducing the signal that tells a specific muscle to contract. When that muscle moves less, the skin folding over it creases less, and the expression line it creates softens. The intended effect is local to the small area treated, and it is temporary by design: muscle activity gradually returns over the months that follow.
The lines that respond are dynamic lines, the ones you can watch appear when you frown, raise your brows, or smile. The three areas most commonly treated are the glabellar lines between the brows, often called frown lines; the horizontal lines across the forehead; and the lateral canthal lines at the outer corners of the eyes, commonly known as crow's feet. Lines etched deeply into the skin at rest, along with concerns that come from sun damage, volume loss, or skin laxity, have different causes and are not what a neuromodulator is designed to address. Part of the consultation is telling you honestly which of your concerns this treatment will and will not help.
Dosing is individualized. Facial anatomy, muscle strength, prior treatment, and the result you are after all change the plan, so there is no single standard dose that suits everyone. Treatment here is performed in the office by Alexandra Zelenka, MD, and it begins with a medical history rather than with a needle: current medications and supplements, allergies, prior injectable treatment, pregnancy or breastfeeding, and any neuromuscular condition are reviewed before anything is scheduled. Aesthetic services at Premier Internal Medicine are self-pay and are not billed to insurance. The aesthetic consultation is $100, applied toward your treatment plan thereafter.
Reasons Patients Ask About Neuromodulators
- Glabellar lines, the vertical frown lines between the brows sometimes called the "11s"
- Horizontal forehead lines that appear when you raise your brows
- Lateral canthal lines, or crow's feet, at the outer corners of the eyes
- Expression lines that are visible with movement and soften when your face is at rest
- A preference for a non-surgical option that does not involve sedation or a general anesthetic
- An interest in starting conservatively and adjusting later, since the effect is temporary
- Concerns you would like assessed before deciding, including whether a different treatment is a better fit
What to Expect
- Treatment is performed in the office by Alexandra Zelenka, MD, after a medical history and a review of your current medications.
- We use prescription neuromodulator products, which are formulations of purified botulinum toxin type A.
- Dosing is individualized to your facial anatomy, muscle strength, and goals rather than applied as a fixed formula.
- The areas most commonly treated are the glabellar frown lines, the horizontal forehead lines, and the crow's feet at the outer corners of the eyes.
- The appointment is brief and done in the office with a fine needle. No general anesthetic or sedation is used.
- The effect comes on gradually over several days and typically lasts a few months, though the duration varies from person to person.
- Possible side effects, and what to call the office about, are reviewed with you before treatment.
- Aesthetics are a self-pay service and are not billed to insurance. The consultation is $100 and is applied toward your treatment plan.
Our Approach to Neuromodulator Treatment
A consultation, a plan built for your face, and a treatment visit that is short and unhurried.
Consultation and Medical History
We start with what is bothering you and with your history: current medications and supplements, allergies, prior injectable treatment, pregnancy or breastfeeding, and any neuromuscular condition. These are the details that decide whether treatment is appropriate at all. The aesthetic consultation is $100 and is applied toward your treatment plan.
Assessment of Your Face at Rest and in Motion
Because the lines that respond to a neuromodulator are the ones created by movement, Dr. Zelenka looks at your face both still and moving. This is where we identify which areas are appropriate to treat, and which of your concerns would be better served by something else entirely.
An Individualized Plan
Injection points and dose are chosen for your anatomy and for the result you want, then explained to you along with what treatment can reasonably be expected to do, and what its possible side effects are. You also hear what it will cost before you agree to it, since dosing, and therefore price, differs from person to person.
Treatment and Aftercare
Treatment is given in the office with a fine needle and takes only a few minutes. Afterward we ask you to stay upright for a few hours, avoid rubbing or massaging the treated area, and skip strenuous exercise for the rest of the day. The effect develops over several days rather than immediately.
What a Treatment Plan Can Look Like
Because dosing is individualized, no two plans are identical. These are the shapes a plan commonly takes, and each is discussed and priced at your consultation.
A Single Area
Many patients begin with one area, most often the glabellar frown lines between the brows. Starting in one place is a reasonable way to see how you respond, and how you feel about the result, before deciding whether to treat anything else.
More Than One Area in a Visit
Where it is appropriate, more than one of the commonly treated areas can be addressed in the same appointment. Whether that suits you comes out of your assessment rather than from a set package.
Maintenance Over Time
The effect is temporary, so patients who want to maintain it return periodically. The right interval differs from person to person, and it is set from what actually happened after your last treatment rather than from a calendar rule.
Concerns a Neuromodulator Will Not Address
Pigmentation, redness, rough texture, and skin laxity are not caused by muscle movement and do not respond to a neuromodulator. Those concerns are approached with different tools, including our Alma Harmony laser platform, an FDA-cleared system whose cleared indications cover a wide range of skin concerns, and they can be discussed at the same consultation.
Benefits
A Physician Takes the History First
Your visit begins with a medical history, not a price sheet. Medications and supplements, allergies, prior injectable treatment, pregnancy or breastfeeding, and any neuromuscular condition are reviewed before treatment is planned, because those are the details that determine whether treatment is appropriate for you.
Dosing Planned for Your Face
Muscle strength and facial anatomy differ from person to person, so the injection points and the amount used are decided individually. If you would prefer a conservative result, we can plan for that and reassess once the effect has settled.
Targeted, and Temporary by Design
The medication is placed into the specific muscles being treated, and its effect wears off over the following months. That is a practical advantage rather than a drawback: nothing is permanent, and the plan can be adjusted at your next visit based on what you thought of the result.
A Short In-Office Visit
Treatment is done in the office with a fine needle and takes only a few minutes once the plan is set. No general anesthetic or sedation is involved, and most patients return to their usual day afterward, apart from strenuous exercise, which we ask you to leave until the next day.
An Honest Answer About Fit
Not every line responds to a neuromodulator, and not every patient is a candidate. If your concern is better addressed another way, or if treatment is not appropriate for you, you will hear that at the consultation rather than afterward.
Care That Sees the Whole Picture
This is an internal medicine practice, so an aesthetic visit sits alongside the rest of your health history. If something in that history matters, such as a medication or an underlying condition, it is in front of the same physician who is planning your treatment.
What to Expect, Step by Step
Your Consultation
We review your goals and your medical history, look at the areas that concern you, and discuss whether a neuromodulator is the right approach. If it is, you get a plan and a price before anything is scheduled. The consultation is $100 and is applied toward your treatment plan.
The Treatment Visit
The medication is placed with a fine needle at the planned points. It takes only a few minutes. No general anesthetic or sedation is used, so there is nothing to wear off before you leave.
The First Few Hours
Stay upright for the next several hours, leave the treated area alone rather than rubbing or massaging it, and skip strenuous exercise for the rest of the day. Most patients otherwise carry on with their usual activities.
The Next Several Days
The effect is not immediate. It develops gradually over several days as the treated muscles relax, which means the way you look on the day of treatment is not the result you are judging.
The Months That Follow
The effect typically lasts a few months, though this varies from person to person. As muscle movement returns, you can decide whether to repeat treatment, adjust the plan, or leave it as it is.
Who Is a Candidate, and Who Is Not
Candidates are evaluated individually. Suitability depends on your health history, the medications and supplements you take, the areas you would like treated, and what you are hoping treatment will do for you.
Neuromodulator treatment is generally not appropriate during pregnancy or while breastfeeding, for people with certain neuromuscular disorders, where there is an active infection or inflamed skin at the intended injection site, or for anyone with a known hypersensitivity to a component of the product. That is not a complete list, and each of these points is discussed at your consultation before any treatment is planned.
Like any injectable medication, a neuromodulator has possible side effects. Temporary tenderness, redness, or bruising where the injections are placed is the most common. Less commonly, the medication can affect a neighboring muscle and cause a temporary droop of an eyelid or brow, and headache is sometimes reported. Effects of botulinum toxin have rarely been reported at sites away from the injection area. We go through these with you before treatment and tell you what to call the office about.
Tell us about everything you take, including over-the-counter medications and supplements, and about any prior injectable treatment, even if it was years ago or somewhere else. Bring anything you are unsure about to the consultation. That is what the visit is for.
Setting Realistic Expectations
Results vary from person to person. A neuromodulator softens the lines created by muscle movement in the area treated. It does not address lines caused by sun damage, volume loss, or skin laxity, and lines that are already etched deeply at rest may soften only partially.
No particular result can be guaranteed. The goal we plan toward is a softer line while your expression still reads as yours. If you are unsure how much change you want, it is entirely reasonable to start conservatively and reassess once the effect has fully settled.
Fees and Insurance
Aesthetic services at Premier Internal Medicine are self-pay. They are not billed to insurance, and no insurance benefit is verified or filed for them.
The aesthetic consultation is $100, and that fee is applied toward your treatment plan thereafter. Because dosing is individualized, the cost of treatment itself is quoted at the consultation once the plan is set, so you know the number before you agree to it.
Our insurance-based primary care panel is currently full, and new primary care patients are accepted only by special request. Our consultative and self-pay services, including aesthetics, hormone care, and functional medicine, remain open to new patients.
Common Questions About Neuromodulators (Wrinkle Relaxers)
What exactly is a neuromodulator?
It is a prescription injectable made from purified botulinum toxin type A. Placed into a specific muscle, it temporarily reduces the nerve signal telling that muscle to contract. With less movement in the muscle, the skin over it creases less and the expression line softens. Treatment is given in the office by Alexandra Zelenka, MD.
Which areas are usually treated?
The three areas most commonly treated are the glabellar lines between the brows, often called frown lines; the horizontal lines across the forehead; and the lateral canthal lines at the outer corners of the eyes, commonly called crow's feet. If you have a concern somewhere else, bring it to the consultation and you will get a straight answer about whether a neuromodulator is the right tool for it.
Does it hurt, and how long does the appointment take?
Treatment uses a fine needle, and most patients describe a brief sting at each injection point rather than pain. The injections themselves take only a few minutes once the plan is set. No general anesthetic or sedation is used, so there is nothing to wear off before you leave.
How soon will I see a change, and how long does it last?
The effect is gradual. It develops over several days rather than immediately, so the day of treatment is not when you judge the result. Once established, the effect typically lasts a few months, but the duration varies from person to person, and yours may be shorter or longer than someone else's.
What are the possible side effects?
Temporary tenderness, redness, or bruising at the injection points is the most common. Less commonly, a neighboring muscle can be affected and cause a temporary droop of an eyelid or brow, and headache is sometimes reported. Effects of botulinum toxin have rarely been reported at sites away from the injection area. We review the possible side effects with you before treatment and tell you what to call the office about.
What should I do after treatment?
Stay upright for a few hours, avoid rubbing or massaging the treated area, and skip strenuous exercise for the rest of the day. Most patients otherwise carry on with their usual activities. We go through aftercare with you at the visit and tell you what to call the office about.
Is there anyone who should not have this treatment?
Yes. Treatment is generally avoided during pregnancy and breastfeeding, in people with certain neuromuscular disorders, where there is an active infection or inflamed skin at the injection site, and in anyone with a known hypersensitivity to a component of the product. Candidates are evaluated individually and all of this is discussed at your consultation, which is why the visit begins with a medical history.
What does it cost, and will insurance cover it?
Aesthetic services are self-pay and are not billed to insurance. The consultation is $100 and is applied toward your treatment plan. Because dosing is individualized, we quote the cost of treatment itself at the consultation, once we know what your plan actually involves.
Related Services
Related
Hormone Optimization & Replacement
Evaluation and treatment of hormone-related symptoms on the same self-pay consultative track. The initial consultation is $200 and follow-ups are $100.
Related
Functional Medicine
A root-cause look at symptoms that cross more than one system. The new-patient consultation is $400, with $200 follow-up or phone visits.
Related
Medical Weight Management
Physician-supervised weight management, with a $200 initial consultation and $100 follow-up visits.
Related
Primary Internal Medicine
Adult primary care with Dr. Zelenka. Our insurance-based panel is currently full, and new primary care patients are accepted only by special request.
Have a Question About Wrinkle Relaxers?
Book a $100 aesthetic consultation at our Westchase office in Tampa. Dr. Zelenka will take your history, look at your face at rest and in motion, and tell you plainly whether a neuromodulator is the right treatment for what is bothering you. The consultation fee is applied toward your treatment plan.
Book an Appointment