Botox & Fillers


Injection room

Face wrinkles

Botulinum toxin A to treat face wrinkles has been FDA approved since 2002. It is the most prevalent nonsurgical cosmetic procedure done in the U.S. with more than 4.5 Million injections performed in 2016. Xeomin (by Merz) is a Botulinumtoxin Type A similar to Botox (by Allergan). Xeomin is currently FDA approved in the U.S. for skin wrinkle treatment and has been safely and effectively used in Europe since 2008.

Xeomin has been well proven to be equally effective as Botox, with one unit of Xeomin equal to one unit of Botox.[i] Xeomin and Botox have identical side effects (minor swelling, bruising, headache, and soreness). However, Xeomin has a few added benefits:

1. Xeomin is a pure botulinum toxin A without additives.[ii] One benefit of a pure botulinum toxin A is that the human body is less likely to become resistant to it.[iii]Some patients have developed antibodies to Botox.[iv]

2. Xeomin is the only one of the three botulinum toxins that does not need to be refrigerated before use.

3. With its aggressive advertising and market share dominance, Allergan has significantly raised its price for Botox, thus squeezing profits from consumers and healthcare providers.

For these reasons, Xeomin is our preferred botulinum toxin A product.


Ideally, Xeomin is used prior to the formation of face wrinkles—as early as in your mid-20s—to prevent wrinkles from forming in the first place. And beginning at any later age, you effectively halt the further progression of face wrinkles while keeping your skin as wrinkle-free as possible. Xeomin injections last 3-6 months from each procedure, equal to the other botulinum toxin A products. There are no known long-term adverse effects from Xeomin.

Xeomin injections to the face are easily tolerated, and numbing ointment is available upon request, though few patients need this. The injection procedure takes about 10-15 minutes and there is no downtime afterward. Expect two to four days for it to start working, with the full effect typically seen in 1 week.

[i] Dressler D, Tacik P, Adib Saberi F. Botulinum toxin therapy of cervical dystonia: comparing onabotulinumtoxinA (Botox(®)) and incobotulinumtoxinA (Xeomin (®)). J Neural Transm (Vienna). 2014 Jan;121(1):29-31. PubMed PMID: 23913131.
[ii] Frevert J. Xeomin is free from complexing proteins. Toxicon. 2009 Oct;54(5):697-701. PubMed PMID: 19292989.
[iii] Dressler D. Five-year experience with incobotulinumtoxinA (Xeomin(®) ): the first botulinum toxin drug free of complexing proteins. Eur J Neurol. 2012 Mar;19(3):385-9. PubMed PMID: 22035051.

Dermal Fillers


Fillers are a type of minimally invasive aesthetic medicine used to add volume, alter the contours of the face, and fill in wrinkles. Common areas to inject fillers are in the lips, face, neck, and even hands, resulting in a fuller, smoother and more youthful appearance:

  • Lip plumping and defining the vermilion border
  • Frown lines, such as vertical creases between the eyebrows
  • Nasolabial folds, which extending from the bottom sides of the nose to the corners of the mouth
  • Marionette lines which extend downward from the corners of the mouth
  • Thinner lines around the mouth
  • Lines on the chin
  • Hollow jaw line on each side of the chin
  • Nose irregularities

If you know you deserve aesthetic improvements in any of these areas listed above, call for a free consultation.

Filler face locations

Restylane and Restylane Lyft are for mid-to-deep injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds (smile lines). Restylane is also indicated for lip enhancement in patients over the age of 21.[i]

Belotero Balance is a hyaluronic acid (HA) injectable filler similar to Restylane that completely integrates into the skin tissue. Belotero Balance can correct facial wrinkles and folds and give volume to the face and lips exactly as the other leading hyaluronic acid (HA) fillers do. Moreover, its duration is equivalent to Juvéderm (Allergan) and Restylane (Galderma), two other leading HA filler products.[ii] Furthermore, BELOTERO BALANCE treats moderate-to-severe etched-in lines and wrinkles such as vertical lip lines above and around the lips.

Armpit Sweating (hyperhidrosis)

Do you feel you need to change your clothing often due to excessive armpit sweating?

Do you find that you sweat excessively even though you’re not hot, or exerting yourself?

The good news is that hyperhidrosis can effectively be treated with botulinum toxin A. One clinical botulinum toxin A study showed it gives relief longer than 6 months. To learn more, schedule a consultation visit with Dr. Cutler so you can then schedule your procedure.

Reviews From Our Satisfied Clients

Happy clients are our priority!

  • "What a great experience! Relaxing and very professional gem right in the heart of Poway. Highly recommend!!!!!!!!!"
    Vera L., Poway, CA
  • "Great experience! I did a purifying facial with fruit enzymes at SDIM spa and scheduled my appointment for multi acid peel� prices are really reasonable))"
    Olga S., Poway, CA
  • "Amazing service, fabulous products, best facial and lashes in San Diego!"
    Jessie M., Poway, CA
  • ""I like how Dr. Cutler is very calm and gentle with the Botox and Dermal filler procedure. I didn't feel any pain. The place is very beautiful and the receptionist is friendly.""
    Luciana S.
  • "My procedure was a permanent makeup (eyeliner) with Julia. We conversed about my preference and the end result I wanted to achieve. She Accomplished the look I was hoping for!!
    I was delighted with the outcome immediately! Her technique & skills were precise & gentle.
    I've had this procedure done in the past (other spas) & had severe puffiness & swelling and not quite the outcome I wanted. Not so with Julia.
    Slight swelling only. I definitely would recommend Julia to others."
    Teri P.
  • "Love my lashes!!! Julia is the most AMAZING lash artist out in the San Diego area. After struggling to find a lash artist who could provide volume and consistency, I found Julia. My lashes always last 3 weeks or longer and never look to sparse between sets! Quality lashes and quick fills! By far, most highly recommended lash tech"
    Gabrielle O.
  • "Upon entering, I was enchanted with the pristine, non clinical, yet professional look of SDIM. Beautiful, clean, tranquil turquoise and white. Julia was calm, professional and answered my 100 questions. I was afraid of a needle near my eyes for the permanent eyeliner and her demeanor relaxed all of my fears. This is the day after and so far, so good!
    I would recommend Julia for her precision and ability to calm the terrified!"
    Cat V.
  • "I have to say he is one of the best doctors out there. He actually listens to what I have to say. He also does his best to fix all the problems I come to him for. I feel like he knows what he is talking about as apposed to some other doctors I have had who don't know what I'm talking about. He also takes his time and is very thorough. Most doctors I have had don't spend a lot of time in the room. He does. He actually wants to fix the problem and not get through his patients as fast as he can. I'm definitely going back and I'm going to recommend him to all of my friends."
    Kimberly L.
  • "I have had my eyelashes done multiple times by Julia and she is great! She is very fast and every time it turns out great! I have gotten my lashes done many time in the past and this is hands down my favorite place! The spa is super clean and professional and offer many other services! I would highly recommend it!"
    Kaylyn G.
  • "SDIM is a special business. Dr. Cutler has made an inviting space here for San Diegans to feel at home. My experience included Dr. Cutler staying after hours for me and went above and beyond the call of duty in the name of good business while supporting excellent customer satisfaction. For those lucky enough to live in Poway or in the general San Diego area, I highly recommend giving this business a chance to earn your business and I believe you'll be their next five-star review. Their prices seem to be most competitive in town too, I came all the way from downtown after vetting many other practices in San Diego and am glad I took the time to research and make the drive to Poway to visit San Diego Integrative Medicine."
    Dan W.

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