Botox wars

There is no doubt that the BoNTxAs are here to stay, in the armentarium of the cosmetic provider. For those patients who have been content with Allergan's product, I haven't tried to convert them. 

For those patients who specifically requested Dysport, the onset has been quicker, (averaging 48hours for full blockade) and the "smoothness" more appreciated. From the injector's perspective, Dysport is a little trickier to dose because the manufacturer suggests that a 300Unit bottle is mixed with 2.5cc saline, compared to a 100 unit bottle with 3-4cc.  Hence drawing up minute volumes requires a little more attention. 

The manufacturing standards of both companies is excellent, so Botox fans should celebrate.  Hopefully, we will soon see price wars.  good luck. 

We have observed several differences between Botox and Dysport in the short time we have been using Dysport. We have only been using Dysport for about 4 months so these are subject to change.

• Dysport typically has a bit faster onset, but the difference is measured in hours (24 or so faster for Dysport) so this is not an appreciable factor.
• Dysport seems to work better in the forehead with quicker onset and less units used.  Maybe because the product has a higher propensity for diffusion (spreading).
• We are hearing from other practices but have not confirmed ourselves (as of November 2009) that Dysport has a slightly longer duration when dosed at a 3:1 (3 Dysport units for every 1 Botox unit).
• Price may be slightly lower at some practices for Dysport but at the above dosing, 3:1, our prices for the two products are the same.

We are holding off on recommending Dysport to our patients until we have more data, but some are trying it based on the current rebate being offered by the distributor, Medicis.

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