Botox vs. Dysport vs. Xeomin

27 Jan

I spend a lot of time reading (I think I’ve mentioned this).  I was looking for some good things to talk about on my blog, when I came across an article on Medscape entitled “Diluted Abobotulinum Toxin A Reduces Wrinkles Over Larger Area,” with a picture of Botox Cosmetic.  I am irate at this misleading article.  Just from a title and a picture.

1. Botox Cosmetic is Onobotulinum Toxin A.  Dysport is Abobotulinum Toxin A.  The product picture is wrong.  And this is on Medscape, a search engine for MEDICAL JOURNALS.

2.  Sounds great right?  Reducing wrinkles over a larger area?  Marketing ploy.  Many woman have found they do not like Dysport because of the increased chances of ptosis (drooping of the eyelid).  Fact, the product spreads further.  The results might not be what you wanted.  Don’t you love the way the company spun it to make it sound like a good thing?

Of course, I can’t read the actual article because I’m not a member… but I have a feeling if I could read this article… I’d be yelling at my computer.  I know the average person doesn’t know very much about injectables, and we use the internet to find answers.

This article is a small example of the necessity of judging the reliability and validity of what you read.  Even when you are reading a Medical Journal.  (And I thought the Nursing Research class I took was a giant waste of time!  Boy was I wrong).

Botox, Dysport and Xeomin have a lot in common, but they also have some important differences.  None of these products can be used interchangeably with each other.

So What IS the Differences Between These Products?!?!

Storage

Botox and Dysport need to be refrigerated prior to reconstitution.  Xeomin does not need to be refrigerated. This may be an advantage when it comes to distribution (it makes it easier for people like me to be mobile between offices).

Reconstitution

These products are live organisms.  They cannot be injected straight from the bottle.  The practitioner must dilute the product with normal saline (which is the same concentration of salt water as your body).  There is no standard amount of NS for reconstitution, although Dysport typically requires more saline.  The saline acts as a carrier of product through the muscle.  The more saline, the further it carriers.  Like I said, this seems like it would be a good thing… but it actually can have undesirable results.  Especially when practitioners are so used to the effects of Botox.

*note:  the process of reconstitution can over dilute these products so they are not as effective.  If you need to keep revisiting your practitioner, they’re watering down their products and overcharging you.  You should be paying by the UNIT.  Not the vial, not the syringe, not the millilitre – these are not valid units of measurements when it comes to these products. 

Effects

The time of onset of these products are similar.  My patients (and I) have found Xeomin to begin working slightly faster (by a day).  Typical it takes 2 days to see a difference, and 2 weeks to see the full effect from all of these products.  They all last about 3-6 months, depending on how much (i.e. how many UNITS) were injected.

Cost

There is very little difference between the prices of these products.  Dysport was supposedly going to be cheaper… but like I said, due to the reconstitution properties, this is necessarily worth it.

Botulinum Toxin Type A

The different products all have different prefixes (ono/abo/inco) but they are all have the same stem word Botulinum Toxin Type A (Type A is actually a suffix).

Botulinum Toxin is a protein that is derived from the organism Clostridium botulinum.  There are several different types of Botulinum Toxin.  All used medicinally for different things.  I’m not a chemist or a biologist, and for all intensive purposes, all you need to know is, Botulinum Toxin Type A is for being young.  I think Type B is for cervical dystonia… anyways…

For all intensive purposes, the difference in the prefixes are the company who makes the product.  Allergan makes Botox (and Juvederm and Breast Implants and Vivite).  They had a patent on the product (patents last 20 years) which recently expired.  Allowing for competition.  Xeomin is made by Merz (who makes Radiesse) and Dysport is made by Medicis (as far as I know… their only aesthetic product).

 So What Product Is Right For YOU?!?!

In all fairness, they are very similar products.  The major differences in results are more from the injector than the products themselves.  Even someone with years of experience with Botox (Onobotulinum Toxin Type A) will need to adjust to using Dysport (Abobotulinum Toxin Type A), and this seems to be the biggest problem Dysport must overcome.  Good luck to the product education team at Medicis.  As for Xeomin, it’s reconstitution properties make it more similar to Botox, and I foresee this as being a more competitive product.  I personally have made the switch, and so have a lot of my co-workers.

**Just to give some validity to this article.  I have never injected Dysport.  My Medical Director (Dr. Russo) trialed it, and found his clients didn’t like it.  We are in the process of trialing Xeomin.  So, No I have never used Dysport in any way (on myself or on others).  However.  As an advanced Aesthetic practitioner and a woman who has clearly had some work done… I’m a pretty reliable source.  My link between woman’s dislike for Dysport (it’s increase in possible lid ptosis) and the process by which it’s reconstituted is pretty well supported. 

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One Response to “Botox vs. Dysport vs. Xeomin”

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