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Dysport and Botox in New York; better, worse or the same?

Friday, October 16th, 2009

Dysport has been around in Europe almost as long as Botox. Recently it was FDA approved for cosmetic use in the U.S. for glabellar lines. These are the “angry 11’s” or frown lines between the eyebrows. Intentionally, this is the same area that Botox Cosmetic is approved for. Any other cosmetic uses, such as horizontal brow lines, crows’ feet, eyebrow lifts, raise down-turned corners of the mouth, plus loads of other uses, are called “off label.” What this means is that treatments for anything other than frown lines, is up to the doctor to explain to patients that the use is off label, but given the doctor’s professional experience and knowledge they are using the drug in a non-approved yet acceptable way. Off label issues was recently addressed in the NY Times by Natasha Singer.

So, what are the differences? Botox is now formally called anabotulinum toxinA and Dysport is abobotulinum toxinA. I won’t bore you with the technical stuff; these are very similar molecules and most importantly both are Botulinum Toxin Type A. Other Botulinum toxins are currently being investigated, but none have been found to be as effective and have as low a side effect rate as Botulinum Toxin Type A. Clinically, the new kid on the block is always touted as being better. Every new filler company says their filler lasts longer and in the long run, most didn’t. I polled my neurotoxin “guru” at the recent AAFPRS meeting, plus attended the new technology session. Their take is that the effects of Dysport may come on earlier and may last longer than Botox. However, Dysport may also have more diffusion. What that means is that there is slightly more spread from the point of injection. This occurs with Botox as well, but for both I use a very low dilution so spread with either should be minimal.

Will I switch? I had my official training from the Medicis Company for Dysport yesterday. I treated four loyal, astute patients. I will follow them and see for myself how fast it worked and how long it lasts on them, also if they note any differences. What my guru said was that it’s like Restylane and Juvederm, we first had only Restylane and once Juvederm came on the market I found that each has specific advantages and learned which one to use for each individual patient and area of the face to get the best results.  I will keep you posted.

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