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Why Does the Concentration of Dysport Differ from Botox?

Do certain areas of the face respond better to Dysport because of differences in the concentration of Dysport compared to Botox?

Doctor Answers (13)

Dysport and Botox concentration

+1

Botox and Dysport are interchangeable and both give excellent results.  The concentration of Botox and Dysport does not decide their effectiveness, since different doctors prefer to use different concentrations.  It is the number of units used that determines the result; however, Botox and Dysport units are not the same.  For these reasons, it is important to have treatment with an experienced injector.


Toronto Dermatologist
5.0 out of 5 stars 16 reviews

Concentrations of Dysport vs Botox

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Thank you for your question. Better result are not due to the differences in the concentration between both neurotoxins. They are simply supplied differently by the different manufacturers. Both products are very similar with very similar results and side effects, but these results can vary person to person. Be certain to be under the supervision of a board certified dermatologist or plastic surgeon with expertise in injectables for an evaluation and for the safest and most effective treatments. I hope this helps.

Sonia Badreshia-Bansal, MD
Bay Area Dermatologist
4.0 out of 5 stars 10 reviews

Differences between Botox and Dysport

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The particular type of neurotoxin made by each company is in the same family but slightly different, kind of like cholesterol lowering medications. For that reason, the dose or units used are different but they are equivalent in effect.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.0 out of 5 stars 6 reviews

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3 to 1 - Dysport VS. Botox

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Both Dysport and Botox are neuromodulators and have very similar results and make-up. However, they are different and they each require their own unique dosage strengths. In our office we use the ratio: 3 units of Dysport to 1 unit of Botox. Talk with your doctor to choose which one would best suit you. Good luck!

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.0 out of 5 stars 37 reviews

Different dosages for Botox and Dysport

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Although, Botox and Dysport have the same mechanism of action, they are not the same product.  Each product is diluted differently and has a different concentration per cc of active protein.  

Missy Clifton, MD
Bentonville Dermatologist
5.0 out of 5 stars 2 reviews

Dysport and Botox concentration difference

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Dysport and Botox are both neuromodulators and have similar chemical structure. However, they are different medications, which require different dosages to achieve similar clinical or cosmetic results. Generally, 3 units of Dysport has the same effect on the face as 1 unit of Botox. Your plastic surgeon or dermatologist will dose each treatment accordingly.

Best of luck.

 

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 48 reviews

Units of Botox Do Not Equal Units of Dysport, But The Clinical Result Is Similar

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You have actually asked two completely different questions.

Your first question>>
Why Does the Concentration of Dysport Differ from Botox Cosmetic?
More correctly, “Why are the number of Units of Botox and Dysport used, different?” This is a relatively straight forward concept, but rather difficult to explain in simple terms. Botox and Dysport are measured in “Units” of biologic activity that correspond to a lethal dose of the product in mice. The actual ‘toxin’ molecule in Botox and Dysport is identical in each product. This toxin molecule is associated with several accessory proteins, but the structure of this protein complex is slightly different between Botox and Dysport. The products themselves undergo different proprietary production processes, and the method of determining biologic ‘activity’ (or potency) varies as well. For these reasons, the “Unit” dosing of Botox and Dysport is different and cannot be interchanged. Each batch (or Lot) of a Botulinum toxin may have a different biologic activity. For that reason it is imperative that each Lot be standardized prior to release so the ‘activity’ of the product remains consistent from vial to vial. Botox and Dysport are supplied based upon these “Units” of activity and not based upon weight. This means that the actual amount (weight) of neurotoxin protein complex placed in a vial may vary slightly between Lots.

Botox Cosmetic (Onabotulinumtoxin) a sterile, vacuum-dried purified botulinum toxin type A, produced by fermentation of the Hall strain of the bacterium Clostridium botulinum type A. Botox is purified from the culture solution by dialysis and a series of acid precipitations. The final product is a complex consisting of the neurotoxin itself, and several accessory proteins. The molecular weight of Botox is 900kDa.  This complex is sterile filtered (0.2 microns) prior to vacuum-drying. The procedure for determining the ‘activity’ of Botox uses a cell-based assay to determine the potency relative to a reference standard. One “Unit” of Botox corresponds to the calculated median intraperitoneal lethal dose (LD50) in mice. In other words, one “Unit” of Botox is the amount that kills 50% of a population of mice when injected into the peritoneal cavity (the abdomen). The assay for determining this biologic ‘activity’ is specific to Allergan's Botox products. Due to specific details of this assay, “Units” of biological activity of Botox cannot be compared to nor converted into “Units” of any other botulinum toxin. The specific activity of Botox Cosmetic is approximately 20 Units/nanogram of neurotoxin protein complex.

Dysport (Abobotulinumtoxin), is a sterile, vacuum-dried purified botulinum toxin type A, produced by fermentation of the Hall Strain of the bacterium Clostridium botulinum type A. Dysport is purified from the culture solution by a series of precipitation, dialysis, and chromatography steps. The final product is a neurotoxin complexed with several accessory proteins. The molecular weight of Dysport varies between 500kDa and 900kDa. Again, the procedure for determining the ‘activity’ of Dysport is specific to Ipsen Pharmaceutical’s Dysport product, and determines the potency relative to a reference standard. One “Unit” of Dysport corresponds to the calculated median lethal intraperitoneal dose (LD50) in mice. And as previous stated, because of the differences in specific details of this assay the “Units” of biological activity of Dysport cannot be compared to nor converted into “Units” of any other botulinum toxin.

Your second question>>
Do Certain Areas of the Face Respond Better to Dysport Than Botox Cosmetic?
As stated above, a “Unit” of Botox is not equivalent to a “Unit” of Dysport. However there is a rough conversion rate that can be used to approximate the ‘activities’ of each. That conversion rate varies between 2 and 3. One “Unit” of Botox is roughly equivalent to 2 – 3 “Units” of Dysport. This conversion rate holds well and produces similar clinical results.  In my practice I use a conversion rate of about 2.5.

Don’t worry about how many units are supplied in a vial, or what the concentration of the product is. The concentration of the product varies based upon the amount of saline used to resuspend the neurotoxin in solution. Different physicians may choose to work with more dilute or more concentrated solutions depending upon their preference or the area being treated. The bottom line is that the use of these products relates only to “Units” of activity. It is the number of “Units” that you receive that determines how much muscle relaxation (paralysis) occurs. Overall, different areas of the face do not respond differently to the two products. An experienced injector will be able to use either product to achieve a good result. When switching between products, patients may experience slightly different results. This is more likely due to differences in dosing, than one product having superior activity to another.

I hope you found this helpful. Best wishes, Ken Dembny

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
5.0 out of 5 stars 17 reviews

Dosing of Botox versus Dysport

+1

The chemical structure of the two products are similar but not completely identical hence the number of units of one product are not completely equivalent on a unit to unit  basis.  This however does not prevent one from adjusting the number of units to achieve identical results.  For the most part one can multiply the number of Botox units by three to determine the equivalent Dysport dose.  There is no difference in effect between the two products once one has made this adjustment.

Ted Brezel, MD
Long Island Dermatologist
5.0 out of 5 stars 3 reviews

Why is Botox Concentration Different than Dysport?

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Hello.  Botox and Dysport have different manufacturing processes and different FDA approvals.  The number of "units" of the products are not defined by the syringe size or other measurement that we would be familiar with.  Rather, what we know is that in each vial of Botox, there are 100 units of the product and in each vial of Dysport there are 300.

Similarly, the FDA approved area between the eyes (glabella) requires us to use approximately 20 units of Botox or 50 units of Dysport.  So, while the amount of product used does not translate easily to everyday measurements, the important part is how much product you are receiving. 

In our practice, we use 3 units of Dysport for every unit of Botox.  Hope this helps.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

The dosing is different but with this the dilution is similar.

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Bottom line, your experienced injector will use a Dysport dose that achieves a clinically similar treatment effect as a BOTOX service.  The manufacturers for competitive reasons have implied that this would be a terribly difficult process.  In reality it has proven to be very straight forward.  As a consumer you should focus less on the precise dose and more on what you are looking to accomplish.  I really do not like the sell by the unit offices because this means that essentially you are practicing on yourself when the reality is that your injector has much more experience in this than you ever will.  

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.