When Botox arrived on the scene 15-20 years ago, there was very little doubt as to it’s purpose–to reduce expression movement that created wrinkles. However, with the emergence of Dysport, and later Xeomin, confusion arose as to which might be the best choice for a particular patient. Time has now allowed us to sort out some of this confusion.
In actuality, almost all of these products work strikingly similar to each other. However there are very minor differences between the three, and certainly some patients might respond better to one than the other, but this is the exception rather than the rule. The only easily demonstrable difference between the three is that Dysport seems to “kick in” quicker than the others, usually within 24-48 hours as opposed to 3-5 days. Xeomin is considered the mildest of the three, and because of that characteristic, we rarely use it in our office. After years of observation, I have come to the conclusion that Dysport is the “strongest” of the group, meaning that it has the most consistent response without having to supplement extra doses as often. My opinion is that it also is likely to last slightly longer.
In our office we use the most concentrated form of either Botox or Dysport, a feature that requires extreme accuracy in placement. However this allows much greater benefit of a predictable response with an extremely low incidence of the product drifting into an unwanted area, which could lead to an unintended relaxation of the wrong muscle. Less experienced injectors will often use a more dilute solution, requiring more volume to get the desired response, thus leading to more unintended side effects.
So even though Botox has by far the highest name recognition and is the “Kleenex” of neuromodulators, we use dramatically more Dysport as our preference. By purchasing Dysport in higher volumes, we also are able to achieve a less expensive overhead, and these savings are also passed along to you as the patient.
Michael L. Maris, M.D.