If Botox didn't work, why is injectionist recommending Dysport?

Thanks for your question. We utilize both Botox and Dysport. Some patients respond better to Botox, whereas others respond better with Dysport. Both are safe and effective.

Creases between the eyes are classified as either “dynamic” (those that are created by frowning and other facial expressions) or “static” (those that are etched in and remain even when the face is at rest and expressionless). Neuromodulators such as Botox and Dysport are great at relaxing the dynamic lines but are not as effective at immediately relieving the static ones. They are equivalent and one will not work any better than the other. There are three ways to potentially address the remaining creases between your eyes. First, a higher dose of neuromodulator may be required if you still have unwanted motion there. Second, repeated treatments evert 4-6 months over a longer period of time can help to alleviate even etched in lines. Third, a touch of filler in that area can also lead to improvement. However, injection of filler in that area is an advanced technique and should only be performed by a Board Certified Dermatologist with specialty training in cosmetic procedures.

We do a fair amount of both in our practice. There are some patients who may be very resistant to one versus another. However, most commonly if you found that it didn't work, then it may be worth going to a more advanced injector to ensure that the placement of the product and the technique is not the problem.   I train a number of injectors on both Botox and Dysport. I find that the most common reason why it doesn't work is technique rather than the product.  I also find, that if the result is the same with both in the technique is adequate, then the addition of a dermal filler may help to soften the crease that is visible without any facial expression.