Daxxify: A New Toxin Challenging Consent in Aethetics


Daxxify, a new long-acting form of Botulinum toxin for facial muscle relaxation, is on the horizon. While it promises longer-lasting wrinkle reduction, its extended duration raises concerns about potential side effects and longevity.

The Extended Downside of Daxxify

The primary concern lies in Daxxify’s prolonged duration of action. Unlike its shorter-acting counterparts like Botox, where side effects like brow droop typically fade within a few months, Daxxify’s effects could linger for much longer. This extended timeframe makes even common side effects a more significant issue.

The Importance of Informed Consent

Given the extended duration of potential side effects, informed consent becomes even more critical with Daxxify.  A simple consent form with fine print won’t suffice.  Practitioners need to clearly explain the material risks associated with the treatment, including:

  • Emotional distress and dissatisfaction with results
  • Difficulty speaking
  • Blurred vision
  • Facial muscle paralysis
  • Temporary facial disfigurement, potentially leading to psychological distress.
  • Loss of income due to impaired driving or speech.

Mitigating Risks Through a Comprehensive Approach

Here are some key steps practitioners can take to minimise risks and ensure truly informed consent for Daxxify:

  • Information and Education: Provide patients with clear and understandable information that is free of medical jargon.
  • Cooling-Off Period: Allow patients ample time to reflect on the treatment and potential side effects before deciding.
  • Valid Consent: Obtain well-documented, valid consent that explicitly addresses the material risks and the extended duration of potential side effects. Focus on the possible impact on the patient’s life and mental health in case of a poor outcome.
  • Alternatives: Offer each patient a reasonable alternative, including not undergoing treatment.
  • Comprehensive Assessment: Perform a thorough facial muscle assessment, considering factors like age and brow position that could increase the risk of brow ptosis (drooping).
  • Trial Injection: Consider an initial trial injection with a shorter-acting Botulinum toxin to ensure desired results are achieved without unwanted side effects.
  • Meticulous Technique: Maintain thorough records of injection patterns, angles, depths, and photographic evidence for future reference.
  • Ultrasound Guidance: Consider using ultrasound-guided injections in high-risk zones for added precision.
daxxify bottle on a ceramic surface 1


Daxxify introduces a new wrinkle-reduction solution; however, its long-lasting effects require careful deliberation by healthcare providers and patients. A comprehensive approach involving informed consent and open communication can assist in this process.


Vince Bertucci, Jean D Carruthers, Deborah D Sherman, Conor J Gallagher, Jessica Brown, Integrative Assessment for Optimizing Aesthetic Outcomes When Treating Glabellar Lines With Botulinum Toxin Type A: An Appreciation of the Role of the Frontalis, Aesthetic Surgery Journal, Volume 43, Issue Supplement_1, December 2023, Pages S19–S31, https://doi.org/10.1093/asj/sjac267


  1. What makes Daxxify different from other Botulinum toxin treatments? Daxxify’s primary distinction lies in its long-acting nature, offering a more extended period of wrinkle reduction than traditional treatments like Botox.
  2. What are the potential side effects of Daxxify? Side effects may include emotional distress, difficulty speaking, blurred vision, facial muscle paralysis, and temporary facial disfigurement.
  3. How can practitioners ensure patient safety when using Daxxify? Practitioners can enhance patient safety by providing thorough information, ensuring valid consent, offering alternatives, conducting comprehensive assessments, and employing meticulous techniques.
  4. Is there a way to test how Daxxify will affect me before committing to the full treatment? Yes, practitioners may offer a trial injection with a shorter-acting Botulinum toxin to assess the potential outcomes without the extended commitment.
  5. Can the effects of Daxxify be reversed if I’m not satisfied with the results? Due to its long-acting nature, Daxxify’s effects cannot be reversed immediately. This underscores the importance of informed consent and considering trial injections before proceeding.
Andy Taylor

I am a Consultant working in the NHS specialising in non-surgical aesthetic treatments.