Botox vs. Dysport vs. Xeomin: Establishing the Cosmetic Injections

Mar 3, 2014 | Facial Procedures | 0 comments

The word “Botox” has become a well-established part of American lexicon. And why not? There are an average of 3 million Botox injections performed in the United States every year. To many, the words botulinum toxin and Botox are utterly synonymous.

But how much longer will that be the case? In 2009, a new player called Dysport was approved by the FDA and entered the field of cosmetic procedures. Shortly thereafter, another botulinum toxin injection was developed called Xeomin. But the real question is, are these new injections comparable to the long standing safety and efficacy of Botox?

Dysport, Xeomin, and Botox are all botulinum toxin injections with very similar chemical make ups and mechanisms of action (neuromuscular blocking toxin). This means that the injection will relax the muscles that control the wrinkling effect of your skin, smoothing the skin and reducing wrinkles. So what’s the difference between them?

Botox is still regarded by most professionals as the highest standard of elective cosmetic injections.

Dysport vs Botox:

Dysport was designed to have less of a protein load than Botox. Proteins within the injections can cause the body to have an adverse reaction to the injection, as antibodies are created to detect and destroy the ‘invading’ proteins. The assumption in creating Dysport was that fewer proteins lessens the chance of antibodies beginning to attack the injection and thus the clinical effects of Dysport should last longer than those of Botox. However, Dysport is created with some proteins from cows, and therefore people with a true milk allergy should not be treated with Dysport.

Despite this intention in the creation of Dysport, there has been no clinical evidence thus far that Dysport has longer results than Botox. Both injections last 3-6 months, and some clinical trials have maintained that Botox lasts slightly longer than Dysport. However, further clinical trials will have to be completed in double-blind studies to form a concrete analysis of the comparative qualities of the drugs.

There is, however, a consensus among cosmetic surgeons that the effects of Dysport seem to implement slightly more quickly than with Botox, beating it out by approximately 1-2 days.

Injection Spread

Dysport’s second ‘claim to fame’ was the increased spreading action during injection. This can be both positive and negative. In large areas that would normally require multiple injections (forehead, armpits, etc) less injections are necessary, meaning there is less swelling and discomfort for the patient. If, however, the injection is being used in small areas, such as around the eyes, unwanted spreading can create drooping eyes or blurry vision. Dysport has stated that this complication would be more reflective of the skill of the cosmetic surgeon rather than the actual product.


Finally, Dysport is more dilute than Botox, a technical fact which results in the need for three times more units for one-third the cost per unit with approximately the same outcomes. The end result is usually a similar price for the same treatment with Botox.

In summation, Dysport currently has no ‘red flag’ concerns for safety or for efficacy. Allergies and infections as well are on par with Botox. Your cosmetic surgeon may have preferences regarding which injection to use (still the majority of the following backs Botox) and you and he can discuss the best option to suit your goals.

Xeomin vs Botox:

Xeomin has put a lot of cash into marketing this new product. The top selling point is that it doesn’t need to be refrigerated (making it more widely available for distribution) and there is less risk of allergies developing.

Purity and Protein Load

Xeomin was designed as a more purified form of the active component of the botulinum toxin and the proteins found in Botox and Dysport have been removed altogether. This was done based on an assumption similar to that of the creators of Dysport, that fewer proteins will incite fewer antibodies to respond to the foreign substance. And again, similar to Dysport, there hasn’t been any evidence showing that Xeomin has any fewer allergic responses than Botox. Thus far, this has been marketing based upon a theory.


Some plastic surgeons will claim that Xeomin may not last as long as Botox, but this argument has been undocumented. Some surgeons have suggested that the reason Botox lasts so long is because of the greater number of proteins in the injection, which are purported to make the medication work better.

The results of a Xeomin injection take effect within the same timeframe as Botox, 5-7 days, and appear to last the same duration, 3-6 months, though there have been some plastic surgeons claiming that Xeomin lasts several weeks less than Botox, but this argument has been undocumented.

Here at my office, I prefer to continue to use Botox injections over the others. Botox has been in use for over 15 years, and has proved predictable, safe and effective again and again. If you have further questions regarding these injections, come into my office for a free consultation and we can determine which type of cosmetic procedure will be most effective for you.

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