When seeking the most effective non-surgical solutions for facial rejuvenation in San Francisco, BOTOX® and Dysport® represent the gold standard in neuromodulator treatments. At Dr. Karen Horton’s San Francisco Plastic Surgery practice, injectable wrinkle relaxer treatments are performed by Board-Certified Nurse Practitioners Emily Sespaniak, MSN, NP-C, and Agnes Wong, MSN, NP-BC, who bring advanced training, precision, and artistry to every treatment. Their approach focuses on achieving natural-looking results that enhance your unique facial features while preserving expression.

Located in the vibrant San Francisco Bay Area, the practice is a trusted destination for patients seeking sophisticated, non-surgical facial rejuvenation. Our Nurse Practitioners combine a deep understanding of facial anatomy with meticulous injection technique to tailor each BOTOX and Dysport treatment to a patient’s individual goals. Both providers are known for their thoughtful, conservative approach and commitment to patient education, comfort, and safety.

Key Differences Between BOTOX and Dysport

While both treatments utilize botulinum toxin type A, they differ in their molecular structure and diffusion patterns:

• BOTOX: More concentrated formulation with precise targeting capabilities
• Dysport: Broader diffusion pattern, ideal for treating larger areas like the forehead
• Onset: Dysport may show results 2-3 days earlier than BOTOX
• Duration: Both typically last 3-4 months, though individual results may vary

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The Treatment Experience

Consultation and Customized Treatment Plan

Every patient begins with a comprehensive consultation, during which facial anatomy and aesthetic goals are discussed, followed by the development of a customized treatment plan. This personalized approach ensures optimal results while maintaining your natural expressions. Patients should inform their provider about any previous BOTOX injections and relevant health conditions.

Treatment Process

The actual injection process typically takes 15-30 minutes, depending on the number of areas being treated. Using ultra-fine needles, your Nurse Practitioner precisely places the neuromodulator into targeted facial muscles. Most patients describe the sensation as brief, minor pinpricks with minimal discomfort. Cooling packs before the treatment add additional comfort to the experience.

Safety Protocols:

• Sterile technique and single-use needles
• Pre-treatment medical history review
• Comprehensive informed consent process
• Emergency protocols in place
• Post-treatment monitoring and follow-up

Post-Treatment Care and Recovery

One of the significant advantages of neuromodulator treatments is the minimal downtime required. Most patients can return to normal activities immediately following treatment.

Immediate Post-Treatment Guidelines:

• Avoid lying flat for 4 hours
• Refrain from vigorous exercise for 24 hours
• Avoid rubbing or massaging treated areas

Results and Longevity

Results typically become visible within 3-7 days, with full effects apparent within two weeks. The duration of results varies by individual but generally lasts 3-4 months. Patient satisfaction rates fall between 87% and 99% for BOTOX and Dysport treatments.^6,7

Factors influencing longevity of neuromodulator effects include:

• Individual metabolism
• Muscle strength and activity
• Treatment area
• Dosage and injection technique
• Lifestyle factors

Safety Profile and Side Effects

Both BOTOX and Dysport have extensive safety profiles backed by decades of clinical use. Serious adverse events are extremely rare when treatments are performed by qualified practitioners.⁷

Common, temporary side effects may include:

• Mild swelling or redness at injection sites (occurs in <5% of patients)
• Temporary bruising (occurs in <10% of patients)
• Headache (rare, <2% of patients)
• Temporary asymmetry (typically resolves within days, <1% of patients)

Serious complications are extremely rare but may include:

• Allergic reactions (<0.1% of patients)
• Unintended muscle weakness
• Difficulty swallowing or breathing (extremely rare)

Our practice maintains comprehensive emergency protocols and is trained in managing any potential complications that may arise.

¹ American Society of Plastic Surgeons. 2024 Plastic Surgery Statistics Report. https://www.plasticsurgery.org/documents/news/statistics/2024/plastic-surgery-statistics-report-2024.pdf. Accessed September 5, 2025.
² American Academy of Ophthalmology. How Does Botulinum Toxin (BOTOX) Work? https://www.aao.org/eye-health/treatments/how-does-botulinum-toxin-BOTOX-work. Accessed September 5, 2025.
³ Dermatologic Surgery. Lifting With Neuromodulators. https://pubmed.ncbi.nlm.nih.gov/39196835/. Accessed September 5, 2025.
⁴ Cureus. Evaluation of the Efficacy of Low-Dose Botulinum Toxin Injection Into the Masseter Muscle for the Treatment of Nocturnal Bruxism: A Randomized Controlled Clinical Trial. https://pmc.ncbi.nlm.nih.gov/articles/PMC9719743/. Accessed September 5, 2025.
⁵ Aesthetic Surgery Journal. Improving Neck and Jawline Aesthetics With OnabotulinumtoxinA by Minimizing Platysma Muscle Contraction Effects: Efficacy and Safety Results in a Phase 3 Randomized, Placebo-Controlled Study. https://pubmed.ncbi.nlm.nih.gov/39475141/. Accessed September 5, 2025.
⁶ Journal of Cosmetic Dermatology. Evaluation of people’s satisfaction with botulinum toxin injection for facial rejuvenation based on age. https://pubmed.ncbi.nlm.nih.gov/38500014/. Accessed September 5, 2025.
⁷ The Journal Of Clinical And Aesthetic Dermatology. Patient Satisfaction with AbobotulinumtoxinA for Aesthetic Use in the Upper Face: A Systematic Literature Review and Post-hoc Analysis of the APPEAL Study. https://pmc.ncbi.nlm.nih.gov/articles/PMC8211347/. Accessed September 5, 2025.
⁸ American Academy of Dermatology. Botulinum toxin therapy: FAQs. https://www.aad.org/public/cosmetic/wrinkles/botulinum-toxin-faqs. Accessed September 5, 2025.