4.5 months ago, I received 65 units of Dysport; it was my 1st cosmetic injection ever. The effects wore off noticeably within ~6 weeks. Today I received Botox from a different practitioner. I told him about the Dysport injection. He said I needed 12 units of Botox -- far less than the 25 or so I expected based on the Dysport results. He didn't ask me to move my brow when he assessed the dosage, but I did so anyway. Does this dosage seem too low to you based on m my history?
Does This Botox Dosage Seem Low?
Doctor Answers (10)
Different philosophies and budgets
Men and women often require diferent dosages. I agree with most of the comments on this page, however, I find that I can use anywhere from 12 -16 units (up to 20 in men) in the glabella and can achieve adequate correction. The lateral canthal area is variable but again I believe anywhere from 8-12 units is adequate. Most importantly I never use more than 12-16 units in the forehead. To me eliminating all transverse lines in the forehead is not the goal in any patient other than those who have a high brow position to begin with. To me a key is injecting the toxin directly into the muscle and the ability to do this is based on solid experience and observation. I began injecting aesthetic patients in 1993 and have taught my technique to hundreds of doctors over the past 18 years. I have injected thousands of patients using these dose ranges (which are lower than those recommended in much of the medical literature) and continue to have a large group of satisfied patients.
So to answer your question both the method and dosage of the injection are important factors! So the real question is how is your 12 units of Botox working????
Botox/Dysport dosing is individualized
As you are aware, the units are defined differently for Botox and Dysport, but in both cases the dosing is determined on an individual basis. For example, men typically require a larger dose because the muscle mass is larger. Having said that, we usually start with about 20 units Botox/60 units Dysport for one area. It is tempting to use lower doses because of cost but the effect won't last as long.
Dysport and BOTOX are not equivalent in dosage.
There is no simple formula from concerting between BOTOX and Dysport. Practitioners need to develop experience with these agents and the relative dosages between the two products will also be affected by personal technique. Once a practitioner has experience with the two products, then clinically, the longevity and effects seem very similar. What is the right dose for you? Again this will vary with the technique being used. However, it is important to know the overall dose so that you can compare treatments between offices.
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Proper dosing for Botox and Dysport
First of all you didn't mention what area was treated. Lets assume you are talking about the glabella (the frown lines betwee the eyebrows) because that is the area which is most commonly treated. I generally use 20-25 units in this area depending upon my assessment of the strength of the muscles in this area. Men frequently require additional units to receive the same effect as women because of musculature. Under dosing can shorten the time period to relapse of muscle strength. Finally, the general rule of thumb is a 2.5-3 ratio between Botox and Dysport.
Higher doses of Dysport and Botox will be more effective and long lasting.
Personally I like to use 80 units of Dysport for the Glabella, 40 units for the crows's feet, and 100 units for the forehead. For Botox, I like to use 25-30 units of Botox for the glabella, 10 to 15 units for the crow's feet and 25 units for the forehead. This give great long lasting results for my patients.
Dosing with Botox & Dysport
Although Botox andt Dysport are similar in effects and duration, the dosing and calculations are very different from each other. Without knowing your exact treatment plan, it's difficult to comment or answer your question.
Technique, dilution, dosing, and conversion ratio are all factors in your treatment outcomes. We encourage you to report your lack of results with the first practitioner as well as your questions with regards to dosing to the second injector.
Glabellar dysport vs botox
If your effect after Dysport wore off quickly, I doubt that 12 units of Botox in the glabella will last long. Many patients need 20+ units of Botox in the glabella. Easily, this can go up to 25 to 35 units.
Botox and Dysport Dose for the Frown Area
65 units of Dysport for the frown area should give a very nice result, but some patients may need as much as 80 to 90 units in this area. Typically, 25 units of Botox will provide similar results in the frown area. Their effect should last for 4 to 6 months, sometimes longer.
This Dose Does Seem Low
You mentioned about moving your brow, so i will assume this is the frown line. A typical dose fro that area is 20 units of Botox, but some people have really strong muscles and may need more. On occasion, I have seen people very sensitive to Botox, and they need a much lower dose, but this is very rare.
If you are referring to your forehead horizontal lines, the dose depends on how big the forehead is. Again, a typical starting point is 20 Botox units, but for a high and active forehead, especially in men, it is not unusual to use twice that amount. On the other hand, for a smaller forehead, in a woman, one might start out with half the dose. Hope that helps!
Botox and Dysport dosing
You did not mention what regions of your face were treated - but my general philosophy with neurotoxin injections is to base the dosing for maximal effect - under-dosing with Botox/Dysport only leads to patient dissatisfaction, early return visits and more expense in the long run. A typical glabellar dose is 20-25 units of Botox, crow feet around 12-15 units etc... I use a 3:1 unit Dysport to Botox conversion. Make sure your injector is a certified dermatologist or plastic surgeon.