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Dysport and Botox are in the category of cosmetic injectables called “neurotoxins.” While the word “toxin” may technically be the correct word to use, it often frightens patients away from a very safe, effective, elegant and undetectable treatment that ultimately brings much satisfaction. Several new toxins will be introduced and many more will be approved in the near future so it behooves the public to become familiar with the terminology and to recognize this class of injectables as probably the most efficacious, practical and rewarding treatments available.
Dysport and Botox are both composed of botulinum toxin A which inhibits the communication between nerves and muscles, resulting in the relaxation of the muscle and the disappearance of skin lines. Dysport was approved for cosmetic use in 2009 and has provided us with an alternative to Botox. On the average, Dysport is less expensive than Botox.
The results of a treatment with Dysport may be very similar to that of Botox. However, the onset of action of Dysport is often faster than with Botox and in some individuals, Dysport may last longer than Botox. In others however, Botox lasts longer. One cannot predict which substance will last longer; it differs from individual to individual; some even maintain that they see no difference at all.
Another difference between the two toxins is the extent of their diffusion. In some patients, Dysport’s effect trails off more slowly at the edges of the area treated, leaving a very natural appearance, smooth complexion, and no obvious zone of non-treatment. In the hands of an inexperienced injector, Botox may leave an obvious zone of treated area vs. untreated, resulting in a line of demarcation and an unnatural look. Dysport and Botox are not dermal fillers and cannot be compared to other products like Restylane, Radiesse, Sculptra, Juvederm, etc.
Where and When is Dysport Used?
Dysport is most commonly used to treat vertical lines in between the eyebrows that often make people look perpetually angry. Dysport, as Botox, will create a more relaxed look. Dysport, as Botox, is also an appropriate treatment for horizontal forehead lines as well as for crow’s feet.
How is Dysport Different from Botox?
Both are derived from botulinum toxin A. The molecule in each brand is altered slightly and this alteration is responsible for the differences between Dysport and Botox. The differences vary from patient to patient; sometimes pronounced, sometimes ambiguous. One cannot predict what the difference might be in a particular patient. Therefore, the doctor may choose to try Dysport in a patient that has had Botox before to see if it might produce a more elegant look or a look that is longer lasting. Similarly, in a patient that has never had Botox, both substances might be tried at different times in order to see if a difference is notable in that particular patient.
Dysport may disperse over a greater distance which could be beneficial or deleterious. With a tendency to spread, Dysport’s effects might be quite natural: no cut-off point is seen between treated and untreated areas. When Botox is used however, the doctor with experience understands how to account for its lack of dispersion, by fanning the product out toward the edges of the area treated; but by maintaining control by using a product that does not disperse.
With increased diffusion, Dysport may NOT be a good choice. If the patient has heavy eyelids, for example, or uses their forehead to lift their brow in order to see well, or has a tendency toward excess skin on the upper eyelid, Dysport’s diffusion may cause the untoward reaction of droopiness of the eyelid(s) and Botox or another rejuvenative technique might be more beneficial.
Dysport often has a more rapid effect than Botox. For patients that require fast results for an upcoming business meeting, event, or social engagement, Dysport may be chosen for its fast onset. Often, patients see results just two days after treatment instead of 7 days after treatment with Botox.
How Does Dysport Work?
Dysport is a neurotoxin that works by blocking the communication between nerve and muscle. Normally, the nerve “speaks” to the muscle and tells it to contract. This communication is present and critical for movement of all muscles in the body. The upper face is unique in that movement is not vital for function. We can use this principle to weaken the muscles of the upper face in order to decrease wrinkles without affecting function.
The experienced physician injector can weaken these muscles of the upper face without changing the shape of the patient’s brow or completely eradicating their facial expression. After treatment, patients are still able to contract the untreated facial muscles, and even the treated ones, allowing full range of facial expression like smiling, frowning, winking, and raising the brow. THERE IS NO NEED FOR ANYONE TO LOOK FROZEN; THE FROZEN LOOK IS UNACCEPTABLE! It is unfortunate that there are many inexperienced injectors that administer these toxins without true knowledge of facial nerves and muscles. This is what promotes fear of these remarkable tools now available to the cosmetic physician.
I EMPHASIZE THAT THE REASON ONE MIGHT SAY “I NEVER WANT BOTOX/DYSPORT, I NEVER WANT TO LOOK LIKE THAT” IS DUE TO THE FACT THAT ONE ONLY SEES THE ATROCIOUS EFFECTS OF THESE TREATMENTS; ONE DOES NOT REALIZE THAT THE PATIENTS TREATED CORRECTLY GO UNNOTICED. UNFORTUNATELY, THESE DREADFUL RESULTS ARE USUALLY PRODUCED BY THE INEXPERIENCED AND OFTEN NON-PHYSICIAN INJECTOR.
Are Dysport Injections Painful?
If done correctly, there should be minimal to no discomfort from Dysport injections. If your injections are painful, they are not being done correctly.
How Long Does it Take to See Results After Dysport Treatment?
Patients should expect to see results in two to four days as opposed to four to seven days with Botox.
How Long Does Dysport Last?
The duration of action of Dysport is highly variable from patient to patient and cannot be predicted. In some, Dysport dissipates more quickly than Botox which is said to last 3-6 months. However, I have seen many patients on whom Dysport has lasted a year. It is necessary to try it in order to assess how it compares to Botox in all the ways discussed above.
Potential Side Effects of Dysport
When administered by an experienced physician, side effects are rare and patients, in most cases, undergo treatment without incident. Physicians that have been trained extensively in the nerves and muscles of facial expression are Dermatologists and Plastic Surgeons. A patient is certainly in safer hands when in the Dermatologist’s or Plastic Surgeon’s exam chair. Many people try to save money by going to a spa for treatments of this sort or even to a doctor’s office where the doctor is not the injector. As Dermatologists, Drs. Kopelson and Feldman do these treatments every day. The more patients seen, the more experience the injector has, the less untoward effects occur. Often, a patient will come in to see our doctors to correct problems they developed from receiving these treatments elsewhere, attempting to save money. We are more expensive; but we are more well trained.
Not all side effects can be fixed immediately, but our doctors can usually bring back a more normal look to the face. Possible side effects include headache, pain at the injection site, swelling, bruising, droopy eye, and puffy eyes.
Is There a Recovery Period After Dysport Treatment?
As a rule, there is no downtime associated with Dysport treatment and patients can continue with their daily routine immediately. Infrequently, as with any treatment that involves needles, bruising may occur. Usually, we can limit the bruising by using various methods developed over years of experience. If bruising does occur, it can be covered easily with makeup.
How Much Does Dysport Cost?
The cost of Dysport depends on the area of treatment, the sex of the individual, the strength of the muscle and the severity of the problem to be treated. On the average though, Dysport costs less than Botox.