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Botox vs Dysport

Posted August 29, 2012 in Uncategorized


Botox vs Dysport

I think everyone has heard of Botox, but I frequently get questions about its competitor, Dysport.  The active ingredient is the same in both.  They have the same action on the muscles – to freeze them and give you a nice, smooth forehead!  They are different products, though.

Botox is more consistent

Each product has a slightly different formulation.  Also, the molecular weight, or how big the active particle is, is a standard 900kD for Botox, but varies from 500-900kD.  Makes you wonder why it is so inconsistent and how that effects how it looks on the patients.

Dysport diffuses further from the injection site

It has been speculated that the molecular variability could contribute to Dysport’s tendency to migrate further away from the site of injection than Botox.  Since doctors know that is the case, they adjust their injection patterns and dilution of the product to get the effect that they want.

No “conversion rate”

Since our natural instinct as doctors and consumers is to compare products head-to -head to decide which one we like and for what purposes.  Comparison has been somewhat difficult because there is no set “conversion rate” between Botox and Dysport.   When it was first used in Europe, the  standard conversion ratio was 5:1 or 4:1. Now, many physicians use 3:1,  2.5:1 or even 1.3-1.6:1.  Each office is different in the way that they dilute these products and how that influences how they inject.

The studies are not conclusive

Recently a study was conducted in which Botox was used on the crowsfeet on one side and Dysport was used on the other in 90 patients.  The conversion factor was 3:1.  In the study, both products were effective, but Dysport had a “trend toward greater improvement” on day 2.     However, the glabella, between the eyebrows, is the only FDA approved area to treat.  So a study on another area raises concerns on an ethical level.  Furthermore, the injection pattern has been described as unconventional.  Again, we go back to the lack of a consistent converstion ratio between the two products.  Since very few patients know what dilution their doctor uses, these results may or may not be relevant to you. Just like other pharmaceuticals, some people have a better response with one or the other.

Anecdotally, I have seen more consistent results with Botox, which I attribute to the fact that it does not spread as much and the consistent molecular weight.  I do know other plastic surgeons who use Dysport almost exclusively.  I always advocate “if it ain’t broke, don’t fix it”.  So, whether you are using Botox or Dysport if you are pleased with your results stick with it.  However, my choice to inject and have injected into my own forehead is Botox.

Yu KCNettar KDBapna SBoscardin WJMaas CS.

Split-Face Double-blind study Comparing the Onset Action of Onabotulinum toxin A and Abobotulinum toxin A. Arch Facial Plast Surg. 2012 Apr 30.

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