XEOmin.
The "naked" neurotoxin — purified down to the active molecule, with no complexing proteins. A smart choice for long-term toxin users and formulation minimalists alike. Trained injectors, conservative dosing, complimentary 2-week touch-up.
The active molecule, and nothing else.
Xeomin (incobotulinumtoxinA) is a botulinum toxin type A made by Merz Aesthetics. Like Botox, it temporarily relaxes the small facial muscles responsible for dynamic wrinkles — the lines that show when you smile, frown, or raise your eyebrows.
What makes Xeomin different is what it leaves out. A proprietary double-filtration process strips away the complexing and accessory proteins that surround the active molecule in other botulinum products. What remains — and what gets injected — is the purified neurotoxin alone. That's why it's often called the "naked" toxin.
Xeomin has been FDA-approved for aesthetic use since 2011, holds several additional therapeutic FDA approvals, and is used in more than 70 countries. Results typically appear within 3–7 days and last 3–4 months.
Less protein, less to react to.
For most first-time patients, Xeomin and Botox perform comparably — similar onset, similar duration, similar natural result when dosed conservatively. The formulation difference matters most in two situations:
Long-term toxin users. A small subset of patients who have used botulinum products for years develop neutralizing antibodies — the immune system learns to recognize the accessory proteins, and results start fading faster or needing higher doses. Because Xeomin carries no complexing proteins, it presents less for the immune system to target. If your usual product feels like it has "stopped working," this is the conversation to have.
Formulation minimalists. Some patients simply prefer the cleanest available option — active ingredient and nothing else. Xeomin is that product.
We carry all four major neurotoxin brands — Botox, Dysport, Xeomin, and Jeuveau — so the recommendation you get at consultation is based on your face, your history, and your goals, not on what happens to be in the refrigerator.
Six areas, one toolkit.
Xeomin's FDA-approved aesthetic indication is glabellar (frown) lines; experienced injectors commonly treat the other areas below as well-established off-label uses. In your consultation we'll identify which areas would benefit most for your goals.
Glabellar lines
The "11s" between the eyebrows — Xeomin's FDA-approved aesthetic indication.
Forehead lines
Horizontal lines that appear when you raise your brows.
Crow's feet
Lines around the outer eyes that show with smiling.
Bunny lines
Diagonal creases across the nose bridge when you scrunch.
Chin dimpling
Pebbled or "orange-peel" texture on the chin.
Masseter
Jawline slimming and TMJ / clenching relief.
Forehead Crow's feet Bunny lines Masseter Chin Naked toxin Merz Aesthetics Glabellar Forehead Crow's feet Bunny lines Masseter Chin Naked toxin Merz Aesthetics Glabellar Forehead Crow's feet Bunny lines Masseter Chin Naked toxin Merz Aesthetics What to know, in four lines.
- 01
All four toxin brands we carry are botulinum toxin type A. The meaningful difference between them is the protein packaging around the active molecule — and Xeomin has none.
- 02
"Naked" means no complexing proteins. That matters most to long-term toxin users — the accessory proteins in other formulations are what the immune system can learn to recognize.
- 03
Xeomin dosing is generally considered comparable to Botox unit-for-unit, so switching brands doesn't mean re-learning your treatment.
- 04
Pricing is per unit and quoted in writing at consultation. No surprise charges, no day-of upsells.
From day zero, to day fourteen.
Treatment day. 10–15 min of micro-injections. No anesthesia, no downtime — drive yourself back to work.
Tiny pinprick bumps fade within an hour. Avoid lying flat, vigorous exercise, and saunas for 24 hours.
First effects appear. Lines begin to soften as the muscle starts to relax.
Full effect. Complimentary touch-up assessment — we fine-tune dosing if anything looks asymmetric or under-treated.
What it actually costs.
Xeomin pricing at Reviv is per unit, with dosing generally comparable to Botox unit-for-unit. Most first-treatments use 20–40 units across the upper face. Final cost depends on the areas treated and the dosing your face requires — quoted in writing at consultation, before any treatment begins.
Who it's for — and who it isn't.
- Long-term toxin users who feel their usual product has become less effective over time
- Patients who prefer the most minimalist formulation available — active neurotoxin and nothing else
- First-time patients with dynamic expression lines — Xeomin is a complete first-treatment option, not just a switch
- Patients with masseter hypertrophy, jaw clenching, or TMJ discomfort
- Pregnant or breastfeeding patients
- Patients with myasthenia gravis or other neuromuscular disorders
- Patients with a known allergy to any of the formulation's ingredients
- Patients seeking volume restoration — that's a filler conversation
Your Xeomin team.
Dr. Gayle Misle, MD
Founder of Reviv Med Spa & Laser Treatment. Leads our injectable program with extensive training in neurotoxin technique and a conservative-first dosing philosophy.
Megan Sosnick, RN
Aesthetic Nurse and Practice Manager. Runs your initial consultation, places injections alongside Dr. Misle, and manages your 2-week touch-up assessment.
Trained hands. Same studio.
Xeomin at Reviv is administered by our Medical Director Dr. Gayle Misle and our Aesthetic Nurse Megan Sosnick — both onsite at our Millbrae studio, both with extensive neurotoxin training. Same hands, same protocols, every visit.
What people say about Reviv.
It was only my second time getting a toxin treatment and Reviv Med Spa came highly recommended. Nurse injector Megan took the time to go over the different toxins they offer and recommended Xeomin for me, as I wanted natural results without looking “done.” I’m so glad she did - my lines are totally gone and my skin is GLOWING!…
Reviv is the best place on the Peninsula to get Xeomin/Botox. I’ve been going to Dr Misle for several years and she’s very talented at having her clients look natural. She isn’t pushy about other services and the staff are professional and friendly.…
Have been coming here for 3+ years. Very skilled injectors, professional, friendly, and beautiful office. Dr. M. has an instinctual understanding of how and where to apply what for desired affects. Have used Botox, Dysport, and xeomin with great results.…
Frequently asked.
What is the difference between Xeomin and Botox?
Both are botulinum toxin type A and relax the same muscles the same way. The difference is formulation: Botox carries accessory (complexing) proteins around the active molecule, while Xeomin is purified down to the active neurotoxin alone — which is why it's often called the "naked" toxin. Results, onset, and duration are broadly comparable for most patients.
What does "naked toxin" actually mean?
Xeomin is manufactured with a purification process that removes the complexing proteins other botulinum products contain. What's injected is the active neurotoxin without additional bacterial proteins. For most patients this makes no visible difference — the relevance is for long-term users, because accessory proteins are what the immune system can learn to recognize.
Does Xeomin help if Botox stopped working for me?
Possibly. A small subset of long-term toxin users develop neutralizing antibodies — often signaled by results that fade faster or need higher doses. Because Xeomin carries no complexing proteins, it presents less for the immune system to react to. If you feel your usual product has become less effective, bring your treatment history to a consultation and we'll assess honestly — sometimes the answer is dosing or placement, not the brand.
How long does Xeomin last?
Typically 3–4 months, comparable to Botox. First effects appear within 3–7 days, with full effect around day 14. We schedule a complimentary 2-week touch-up assessment to fine-tune if needed.
Is Xeomin FDA approved?
Yes. Xeomin (incobotulinumtoxinA, by Merz Aesthetics) is FDA-approved for moderate to severe glabellar (frown) lines, and it also holds several therapeutic FDA approvals. It has been used in the U.S. since 2011.
How much does Xeomin cost?
Pricing is per unit; dosing is generally comparable to Botox unit-for-unit, with most first-treatments using 20–40 units across the upper face. Request a consultation for an exact written quote — we do not surprise patients with unexpected charges.
Can I switch between Xeomin and Botox?
Yes. Many patients alternate or switch brands without issue — the products work the same way. We track what you received, at what dose, and how it performed, so every visit builds on the last regardless of brand.
Is there downtime?
No. You can drive home or back to work. Avoid lying flat, facial massage, vigorous exercise, and saunas for 24 hours. Small bumps at the injection sites fade within an hour.
Who should not get Xeomin?
Patients who are pregnant or breastfeeding, who have certain neuromuscular disorders (e.g., myasthenia gravis), or who are allergic to any of the ingredients. We screen at consultation. If you have questions about whether Xeomin is right for you, ask us.
Patients come to us from across the peninsula.
Reviv Med Spa is at 31 S El Camino Real in Millbrae, California — easy to reach from across the Bay Area peninsula. Patients come to us from Burlingame, San Mateo, Hillsborough, San Bruno, Foster City, and the broader peninsula including Atherton, Belmont, Brisbane, Daly City, Half Moon Bay, Menlo Park, Pacifica, Palo Alto, Portola Valley, Redwood City, San Carlos, and South San Francisco. Off the 101, just south of SFO. Free parking on site.