Injectables · Neuromodulators
Botox® & Xeomin®. In Pittsburgh's North Hills.
Conservative neurotoxin dosing, planned with one provider you'll see every visit.
The Approach
Softer lines.
Same expressions.
Neurotoxins are a clinical decision, not a menu item. We use Xeomin® as our primary neuromodulator and Botox® when it's the better fit. Either way, we underdose first. You can always add. You can't subtract.
Clinical Summary
Botox and Xeomin are prescription neuromodulators used to soften expression lines (the vertical elevens between the brows, horizontal forehead lines, and crow's feet) by relaxing the small muscles that crease the skin. At Aetheria Aesthetics & Wellness in Pittsburgh's North Hills, every neurotoxin visit is performed personally by Melissa Kolowitz, PA-C, after a 45-minute consultation that maps your anatomy, history, and goals. First-time patients are dosed conservatively on purpose, with a complimentary two-week follow-up to review the result and add units only if needed. Onset typically begins within three to seven days, peaks around two weeks, and lasts three to four months. Most patients return to normal activity immediately. Candidacy, the choice between Botox and Xeomin, and dosing are clinical decisions made together at consultation. Individual results vary.
The Molecules
Why we lead with Xeomin.
Botox and Xeomin both block the nerve signal that creates dynamic wrinkles. The difference is what comes with the active molecule.
Xeomin® · The naked molecule
Xeomin is incobotulinumtoxinA. Pure active molecule. No accessory complexing proteins. No human albumin. Manufactured by Merz, FDA-approved for glabellar lines since 2010.
The clean formulation matters most for two patients: long-term users who want to reduce the chance of antibody resistance, and patients who haven't responded as expected to Botox. For patients trying a neurotoxin for the first time who plan to continue for years, starting with Xeomin sets up a cleaner long-term relationship with the medication.
Botox® · The original
Botox is onabotulinumtoxinA. The first FDA-approved neuromodulator for cosmetic use, approved for glabellar lines in 2002. Decades of clinical evidence. Allergan's product, recently rebranded as Botox Cosmetic.
Botox stays in the rotation because some patients respond better to it for specific areas, particularly the masseter and platysmal bands. Some patients have established Botox histories and prefer to stay on it. Both are valid clinical decisions made together at consultation.
Choosing between them · Together, at consult
Most consultations end with Xeomin as the recommendation. Some don't. The decision depends on what you've used before, how your body has responded, what you're treating, and what you're looking for over the next several years, not just this visit.
If you've never had a neurotoxin, we'll typically start with Xeomin and a conservative dose. The result typically shows by two weeks. We'll add at follow-up if you want more. We don't believe in hitting your full dose on the first visit and hoping it lands right.
A note from Melissa
Neurotoxins are not a chain experience. Or shouldn't be.
The biggest mistake I see in this space is rotating injectors. Six providers across two years. None of them remember your face from last time. None of them can see what's different.
I see one patient at a time. The same patient at every visit. Over years, that's how you stay ahead of how a face actually ages, instead of always catching up.
If you want a quick treatment between meetings, Aetheria isn't the right place. If you want someone who knows your face and dosed it last time, it might be.
The Visit
What it actually looks like.
Consultation.
Forty-five minutes. Face assessment, medical history, what you've done before, and what you'd like over the next several years.
Treatment, if appropriate.
Many patients treat the same day. Some don't. We'll have made a plan together and underdosed it on purpose.
Onset begins.
The first softening typically becomes apparent. Some movement still present.
Peak result, typically.
What most patients see for the next three to four months.
Follow-up.
Quick visit, no charge. We see the peak result together. Add a few units if you want more. Most patients don't need to.
Maintenance.
The plan we made at consult tells us when to come back. For most patients, three to four times per year keeps you steady without overshooting.
Long-term
A relationship, not a transaction.
Faces age in patterns. We evolve the plan as yours does, instead of treating every visit as if it were the first.
Treatment Areas
Where neurotoxins work.
Upper face
Glabella (the vertical "11s" between the brows). Forehead horizontal lines. Crow's feet. Brow lift. The most established cosmetic uses, with the longest evidence base.
Lower face
Lip flip for subtle eversion of the upper lip. Gummy smile correction. Chin dimpling (mentalis). Perioral lines. Often paired with filler for layered results when appropriate.
Jawline & neck
Masseter for jawline slimming and TMJ relief. Platysmal bands for neck definition. These areas use higher unit counts and benefit most from a provider who understands the anatomy in detail.
Other clinical uses
Hyperhidrosis (excessive sweating) of the underarms, palms, soles. Migraine prevention in select cases. These are medical applications. Consultation determines candidacy and dosing approach.
"If neurotoxins aren't the right tool for what you're after, I'll say so."
What patients say
In their words.
Melissa did a wonderful job listening to my goals and helping me determine what services were right for me. She could have easily convinced me to do more, but she was honest and only suggested what I truly needed.
Had a wonderful consultation with the owner, Melissa. She took her time and walked me through all her services and answered my questions without trying to oversell me.
I love that Melissa is the only injector. There's no rotating chair of providers. She remembered exactly what we did last time and adjusted from there.
Questions we actually get
Straight answers.
What patients ask before booking.
Why doesn't your website list prices per unit?
Two reasons. First, dosing is a clinical decision: how many units you actually need depends on your muscles, your goals, and your treatment history. A "per-unit" price implies a known quantity before we've met. Second, pricing belongs where it stays current and complete: the Aetheria app, our store, carries the full menu, packages, and membership plans, and your exact plan is priced at consultation.
Why do you lead with Xeomin instead of Botox?
Xeomin is a cleaner formulation: just the active molecule, no complexing proteins. For patients planning to use neurotoxins for years, that matters because it reduces the chance of building antibody resistance over time. Botox stays in our rotation for specific indications and patient histories where it's the better fit. The choice is made together at consultation.
How long do results last?
Three to four months for most patients. Some metabolize faster, some slower. The first treatment often wears off slightly faster than later ones. The muscle is still learning the pattern. We track your duration over visits and tune the maintenance interval to fit yours.
When will I see results?
Onset typically begins around day 4 to 7, with peak result around day 14. We schedule a no-cost follow-up at the two-week mark to see the peak result together and add small refinements if you want more.
Will I look frozen?
Not unless you ask for that, and we'd discuss whether it's the right look for your face anyway. Conservative dosing on the first visit means you keep movement and warmth in your face. If you want a smoother result at the next visit, we add. Going the other direction takes months.
Is there downtime?
Minimal. Small injection points fade within an hour or two. Avoid lying flat, hard exercise, and rubbing the area for four hours. Most patients return to work and a normal evening the same day.
Can Botox stop working over time?
It can, in a small percentage of patients. The clinical term is "neutralizing antibodies": the immune system recognizes the complexing proteins in Botox and starts neutralizing the active molecule. This is one reason many practices are moving toward Xeomin, which has fewer extraneous proteins. If your Botox stopped working as well as it used to, switching to Xeomin is often the right conversation.
Can I switch from Botox to Xeomin?
Yes, and many patients do. We typically schedule the switch at your next maintenance visit, using a comparable dose of Xeomin. Onset is similar. Most patients report the result feels equivalent or slightly cleaner.
What's the consultation experience like?
Forty-five minutes. Just you and Melissa. Face assessment, medical history, what you've used before, what you're looking for. We'll talk through the plan and decide whether to treat the same day or schedule. There's no pressure to do either.
Do you serve patients outside North Hills?
Most patients come from the North Hills, the city, and the northern suburbs. We're a single-location practice in Sola Salon at Ross Park Mall, with easy parking and easy in-and-out. Patients also drive in from Cranberry, Wexford, and the South Hills.
Want the deep dive? Read the complete Botox guide →
When you're ready.
Consultations are private, plans are conservative, and relationships are long.