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How Many Units of Dysport Should I Be Given?

The 1st time I had Dysport I had 140 units in total, 50u to my frown, 30u to each eye & 30u to my forehead, she mixed with 2.5mls but this time I saw someone different and had 21 units to my frown, 12u to each eye & 10u to my forehead, she mixed with 2.8mls so have I had enough? & why is it mixed different? Its only been 2 days but after comparing my records between the two I'm now worried I havn't had enough as I am going away for a few weeks so would rather go back now if I do need more?

Doctor Answers (12)

How many units??

+2

For Dysport, 140 units for all three areas as you have described is not unusual. (It is obviously much easier to judge if you can see someone in person and observe the way they animate, so please know that these are just "educated guesses" or assumptions based on what is considered typical.)  On your second visit, judging solely on the amount of units you received, I'm guessing you probably had Botox.  21 units, regardless of dilution is 21 units.  21 units of Dysport is not much for a Glabella (frown area) but 21 units of Botox is well in the range of normal.  You should call the office where you were treated and verify what you had and how much and possibly schedule a follow up if you still have movement that you don't want.   Good luck.

 

 


Los Angeles Plastic Surgeon
4.5 out of 5 stars 67 reviews

Dysport Dosing

+2

The Units for Dysport are quite different than Botox and as the package insert clearly states are not interchangeable.  It sounds like the first time you were injected the product you were injected with was Dysport and your second treatment was with Botox.  Hopefully, you were seen by someone who was familiar with both products and did not interchange the two.  I think it is in your best interest check with the injector to clarify to situation.

Lisa Kates, MD
Annapolis Dermatologist
5.0 out of 5 stars 1 review

Dysport

+1

It is difficult to know exactly what happened here.  I would encourage you to go back to your provider to address your concerns. 

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 140 reviews

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How much dysport

+1

Teeside, Firstly, how the doctor mixes the Dysport does not matter. What matters is the number of units used and the skill of the physician. Two days is not long enough to know what your final effect will be. Do not run back for more yet. Some people are starting to wonder about whether more frequent injections of smaller quantities might encourage antibody formation so I am trying to encourage my patients to have all that they need at one time or wait  until they want a full treatment to do again instead of doing less and expecting a "touch up". 

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 12 reviews

Dysport units that "should" be given vary person to person AND treatment to treatment.

+1

It is very difficult to compare one single treatment with one physician to a single treatment with another. I agree with some of the docs here who wonder if your second treatment was not with Botox rather than Dysport. I think it would be a good idea to get a copy of your records from BOTH doctors, and find out for sure which treatment was used, so you don't torture yourself worrying you had too little when you actually had something totally different. 2.8 cc's for dilution is an unusual dilution, so I wonder about that too.

Be careful and do your research before you ask for more .... your treatment hasn't taken full effect yet and you may end up with TOO much if you aren't cautious.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
5.0 out of 5 stars 40 reviews

Dysport Dosages - It's All About the Units!

+1

What’s the difference between Botox and Dysport?

Well, depending on who you talk to, either a lot or very little.

Botox is, of course, better known. It’s been around for years and is actually one of the most consistently effective non-surgical treatments available. It targets those pesky frown lines and grooves on the forehead, between the eyes (the “11” lines), at the sides of the eyes, and nearly anywhere else on the face. It works by weakening the muscles that, when contracted, cause the lines in the first place. Weaken the muscles, you can’t frown as much, and the lines either disappear completely or, at least, are softened. Treatment typically lasts from about 6-9 months, depending on many factors.

Botox is actually botulinum toxin A (there’s a botulinum toxin B, but we’re not going to talk about that – yet). However, there are TWO versions of botulinum toxin A: onabotulinumtoxinA (which goes by the trade name of Botox, and is manufactured by Allergan) and abobotulinumtoxinaA (which goes by the trade name of Dysport, and is manufactured by Medicis).

So, Botox and Dysport are two versions of essentially the same thing. They are injectable treatments that relax muscles. Each comes in a vial that contains a freeze-dried powder that gets reconstituted (mixed with sterile saline) to form a liquid that can be injected.

Here’s where it starts to get tricky, because there are a lot of variables. When considering an injection, you need to know two things: how many units are being injected, and how old is the solution? Some people have been dissatisfied with the level of correction they’ve achieved, but there may be some simple explanations.

The first issue is how many units will be used. Botox is available in bottles of 50 or 100 units, so there’s a certain degree of flexibility. Most people need about 50 units (or, at least, they could benefit from that amount!) depending on how deep the lines are, how thick the muscles are (larger muscles require more botulinum) and how much correction is desired. Some people share a 50 unit vial if they just want a bit. In general, it takes about 20-40 units to get a nice correction between the eyes, 5-15 units at the sides of the eyes, and 10-40 for the forehead. One person can easily use 50 units; larger people or muscles, or a greater degree of correction, may require up to 100 units.

Dysport is packaged differently – it comes in a vial that contains 300 units. However, you generally need more units of Dysport to provide the same degree of correction as compared with Botox. Most people think it’s about 2 to 2.5 units of Dysport per unit of Botox. That means that 300 units of Dysport is ABOUT equal to 120–150 units of Botox.

But you can reconstitute the product (whether Botox of Dysport) with varying amounts of saline. Putting 4 cc’s into a 100 unit vial makes it 25 units per cc; putting 2 cc’s in makes it 50 units per cc. Putting 3 cc’s into a 300 unit vial of Dysport makes it 100 units per cc, which is then the equivalent of 40-50 units of Botox.

Confused? You don’t really need to be. What you need to know is how many UNITS you’re getting – not how many areas are being “treated” (what does “treatment” mean?), or how many “syringes” are being used (how strong is the solution?) or how many “injections” you’re getting. It’s all about the UNITS.

The next issue is how long the reconstituted product lasts after the saline has been added. Unless it’s being made up fresh for each patient, you have to know how old the product is when you actually get it. Botox, for example, says that any product not used should be discarded after 24 hours; the Dysport, packaging says that any product not used should be discarded 4 hours after reconstitution. Studies have actually shown that Botox can last a lot longer than that (up to several weeks) but it’s one of the factors to take into account if you’re considering these treatments.

For that reason, in my office we ONLY use product within the recommended time periods and, in general, make it up fresh for each patient or treatment.

One more issue is how similar the treatments are, assuming an equivalent number of units is used. There is a some disagreement over this. It has been reported that, when compared with Botox, Dysport works faster and spreads out (diffuses) more evenly. There are many possible factors involved in this, including how much saline is used to reconstitute the product (ie, how dilute it is) but this is a feature that has not yet been fully elucidated.

In summary, Botox and Dysport are excellent and equally effective treatments for facial lines, particularly between the eyes, at the sides of the eyes, and on the forehead. There are some differences, and some people prefer one versus the other, but both work well. If you’re interested in these treatments, ask your doctor the following two questions: (1) How many units am I getting, and (2) When was the product reconstituted?

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 150 reviews

There’s an art to injecting Dysport

+1

There’s an art to injecting Dysport cosmetically in these areas that you’re having done. The same is true with BOTOX. Different doctors will dilute it differently and use slightly different units. Each treatment is not going to be the same as the last because your face changes over time, and the areas you injected before may be different the next time. I wouldn’t worry about comparing the records. The real concern is ultimately in the results. And you don’t want to judge the results within the first 2 weeks because of swelling and bruising that is temporary.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

Dysport questions

+1

Dysport and Botox work the same way to weaken muscles that create wrinkles.  The units of Dysport and Botox are on a different scale.  It seems like the first time you had Dysport injected, and then the second time Botox.  While, Dysport and Botox are not the same drug, and have slightly different drug profiles, there is some equivalency in their respective units.  This "conversion" rate is: 1 unit of Botox  to 2.5-3 Units of dysport.  If you convert the units, you have had roughly about the same amount.  However, injection pattern and depth are also important factors.  That is why is better to have the same injector inject you, so that variables can be kept to a minimum.  I would wait 7 days prior to analyzing your result and the need for a touch up.  All the best, Dr. Vartanian

A. John Vartanian, MD
Glendale Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Dysport is an excellent option

+1
140 units of dysport is on the higher side for dosing. The second injection was most likely Botox since not very many places especially medical spas offer dysport. Either way you should wait the 3-7 days for whichever was injected to work and if you are unhappy either go somewhere else or go back and state your concerns.

Jason D. Meier, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Dysport Dosing

+1

The first injection you describe sounds more typical of Dysport dosing.  The second injection you had sounds more like Botox dosing.  However, without evaluating your medical records, it is impossible to know what you had injected.  If your second injection was actually Dysport, then you were given a very minimal amount of product and I would expect a very minimal result.  If it was Botox, then you should see a nice result.

 

Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 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.