What is Botox and How Does It Work?
Doctor administered neurotoxin injections for results that refresh your face without changing it.
You want to look like yourself. Just a little more rested. A little smoother. Not frozen, not overdone, and definitely not like you had something done. That is exactly what Botox at Highland Aesthetics is designed to deliver.
Dr. Dawn Nuckolls, DO administers every injection personally. She trained in medical aesthetics, holds injectable certification, and has treated patients from Johnson City to Kingsport to Elizabethton. She still draws the placement points on your skin before ever picking up a needle, because precision matters more than speed.
You Have Real Concerns. Let's Address Them Directly.
The most common thing Dr. Nuckolls hears before a first appointment is some version of: "Please don't drop my eyebrow." It is a legitimate concern. Neurotoxin injected in the wrong place, in the wrong amount, by someone who is not paying close enough attention, can cause exactly that.
Dr. Nuckolls is a physician trained in internal medicine. She is meticulous about injection placement. She has heard the horror stories, she knows where the risk zones are, and she draws on every patient before injecting so that by the time the needle is in her hand, she is only focused on the injection itself, not figuring out where to go.
Her approach is simple: if a result is not going to look natural, she will say so. She has turned patients away from treatments that would not suit them. That is not something a clinic that just wants to sell units will do.
What Is Botox (and What Are the Other Neurotoxins)?
Botox is a name brand, not a category. Think of it like how people say "Kleenex" when they mean tissue. The underlying substance is botulinum toxin, and several pharmaceutical companies produce their own formulas. At Highland Aesthetics, Dr. Nuckolls offers four options:
Botox is the original and most recognized brand from Allergan. It has the longest track record and is what most patients picture when they imagine neurotoxin treatment.
Xeomin (manufactured by Merz) is a "naked" neurotoxin, meaning it has fewer protein additives than Botox. Some patients who have metabolized Botox unusually quickly respond better to Xeomin.
Dysport (also from Merz) is slightly more diluted and can spread a bit further, which some injectors prefer for larger treatment areas like the forehead.
Daxxify is the newest option and stands apart in one key way: it can last up to six months. Most neurotoxins last three to four months. For patients who want fewer appointments, Daxxify is worth discussing.
All four relax the muscles that create expression lines. None of them change your features or add volume. The right choice depends on your anatomy, your metabolism, and what result you are looking for. Dr. Nuckolls will help you decide at your free consultation.
Treatment Areas at Highland Aesthetics
Dr. Nuckolls currently treats the following areas with neurotoxins:
Forehead lines — horizontal lines that appear when you raise your eyebrows, softened without flattening your natural expression.
The elevens (glabellar lines) — the vertical lines between your brows that can make you look frustrated or angry even when you are not.
Crow's feet — the lines that fan out from the corners of the eyes when you smile or squint.
Chin dimpling — the "orange peel" texture that some people get on the chin, which responds well to small doses of neurotoxin.
Neck bands (platysmal bands) — the vertical cords that appear in some people's necks with age, treatable when the underlying cause is muscular.
If you are looking for treatment in an area not listed here, ask at your consultation. If it is something she treats, she will tell you. If it is not in her scope or she does not think it will give you a natural result, she will tell you that too.
What to Expect at Your Appointment
Step one: The consultation
Step two: Mapping the treatment
Step three: The injection
Step four: Results and follow-up
Why Patients Choose Highland Aesthetics for Their Neurotoxin Treatments
In the Johnson City market, most injectable services are delivered by nurse practitioners, registered nurses, or aestheticians. That is not necessarily wrong, but it is different from what you get at Highland Aesthetics.
Dr. Dawn Nuckolls is a medical doctor. She trained in internal medicine, which means she understands anatomy at a clinical level, not just an aesthetic one. She knows what happens when things go right, and she knows how to manage things when they do not. She also holds injectable certification from formal cosmetic training.
She is also a former personal trainer, a marathon runner, an Ironman triathlete, and someone who thinks about health and wellness in a genuine, integrated way. She is not selling you treatments. She is helping you feel better in your own skin.
Free consultations. No pressure. A doctor who will tell you the truth.
Frequently Asked Questions
Eyebrow drooping is a real risk with neurotoxin treatment when injection placement is imprecise. Dr. Nuckolls is trained in safe injection anatomy, draws placement points before every treatment, and takes a careful, conservative approach with new patients. While no injection is completely risk-free, her meticulous method significantly reduces this risk.
Botox, Xeomin, and Dysport typically last three to four months. Daxxify can last up to six months. Individual metabolism plays a role. Some patients process neurotoxins faster than average, in which case Dr. Nuckolls may recommend trying a different formula at your next appointment.
Neurotoxin is temporary. If a result is not what you hoped for, it will fade on its own within a few months. Dr. Nuckolls can do a small correction if something looks uneven, so reach out before assuming you have to wait it out.
Yes, neurotoxins are often combined with dermal fillers for a more complete result. Dr. Nuckolls will discuss your full aesthetic picture at your consultation if you want to explore options. She will only recommend combining treatments if she genuinely thinks it is the right approach for you.
