What Is MotoX and How Did We Get Here?
Let's start at the foundation: standard Botox. You take a concentrated amount of botulinum toxin and inject it deep into the muscle. The idea is simple—tell that muscle not to contract. When the muscle doesn't contract, the skin doesn't fold, and the lines that are there iron themselves out. That's essentially what standard Botox treatments are meant for.
Now, ask anyone who's had regular Botox over the years if it has helped their skin. Every single one will tell you a big, absolute yes. The reason? There are additional benefits beyond just smoothing wrinkles. Botox helps shrink pore size. People have large pores for multiple reasons—genetics, clogged pores, excess sebum production, acne scarring, active acne. Botox reduces the amount of sebum being produced. If you suffer from active acne, that's going to take care of it. It also hits the acetylcholine receptors at your sweat glands, reducing your sweat. You still get a nice glow, but you don't look as oily. Your skin looks better overall. And for many clients, there's also a reduction in rosacea and melasma.
This brings us to MotoX—a specific use of neuromodulators in mesotherapy for the face, neck, and décolletage. The core idea is to get all those skin quality benefits from neuromodulators without involving any muscle activity whatsoever.
How MotoX Works: Placing Product Only in the Dermis
The way to achieve this is by placing all the product into the dermis only. "Meso" is Greek for middle—so you're injecting into the middle layer, between the epidermis and the subcutaneous tissue. The only way it can stay there without migrating or hitting other muscles is by hyper-diluting the dose. You place a very minute amount, just enough to give the skin the adequate dosing required, without affecting any other tissues.
This is an advanced skill. Every time you use this injection technique, you must see a raised bleb—a small raised bump on the skin. That tells you you're in the dermis. If you don't see a bleb, you've gone too deep, and the product likely reached the muscle. That means the patient will have asymmetry in their face. So you definitely want to go to a skilled provider, or you need to be a skilled provider before offering this technique.
Treating the Face: When and Where to Apply MotoX
If someone has never had neuromodulators before, you can do the entire face. But I would recommend not doing anywhere around the eye or around the mouth. If you do, it can mess up the way they open their eyes and potentially interfere with their speech—they will not like that.
If someone has already had neuromodulators, say for the upper face—glabella wrinkles, forehead, crow's feet—they are already getting the full benefit of the microtox from their standard stronger dose. So you don't need to repeat that area. Instead, focus on the lower aspect of the face. I concentrate on the cheek and the lower aspect of the jawline. That entire area gets coated with this mesotherapy.
I do 30 to 50 pokes per side, each one in the dermis. I use a 4:1 dilution—four units of saline with one unit of toxin. Each injection point takes about 2.5 to 3 units of that mixed dilution. You have to be careful not to go too deep, or you'll cause issues.
The Neck: Two Approaches
For the neck, you can approach it in one of two ways. The first is to strictly treat the bands—those horizontal necklace lines that cause the "tech neck" effect. You can place small blebs superficially along the lines. This softens them, but it doesn't do a great job—maybe a 20% improvement.
The second approach focuses on overall texture, pore size reduction, and giving the skin a nice glistening appearance. You do little superficial blebs all throughout the neck, similar to the face. You're looking at another 30 to 50 injection points per side because it's a big surface area. Use the same 4:1 dilution to prevent any swallowing issues.
The Décolletage: A Combination Approach
The décolletage is treated almost as a combination of your MotoX and your standard Botox dosing. You'll have an impact on the skin, but you also need to address those vertical lines that form between the chest and the décolletage. These lines usually come from breast size, sleeping on your side, exercise, or sun damage. A neuromodulator can help improve them, but you need a higher dose to get the full response.
I take my standard 1:1 dilution—the same one I use for contracting muscles up top—but I place it intradermally, just like I would my MotoX. I do 50 units here, which means 50 injections, using a triangle pattern going all the way down in between. The product works wonders—it helps with sweat decrease, overactive sebum production, makes the skin look better, and definitely softens those lines.
How Long Does MotoX Last?
You might wonder: if you're using the product in a hyper-diluted state, how long does it last? You can't compare it to regular Botox. Regular Botox is all about how long the muscle relaxes. With MotoX, you're not hitting the muscle at all—you're focusing entirely on skin improvements.
The best way to answer this is that initially, when it's your first time, you'll notice an improvement after about two weeks. It will probably last 6 to 8 weeks. But the more you do it, the more longevity you get. Because the treatment has a bigger impact on the skin and the molecular matrix of the skin, it continues to work even after the medication is gone. Your skin will look much better in the long term with repeated use compared to never using it at all.
There are studies that support that MotoX can alleviate or diminish the appearance of rosacea and melasma. In my personal opinion, I haven't noticed that yet, but I haven't continued long-term with these clients. I have a feeling that the people who get the benefits are those who do this in a long-term fashion. It's very similar to doing mesotherapy: the first time, you might see a couple months of improvement, but with repeated uses, you'll definitely notice months of improvement afterwards.
So whether you're a provider or someone considering this treatment, know that MotoX is not just about the immediate results—it's about the cumulative transformation of your skin over time.