Dysport: Stories

Suddenly they want us to believe Dysport diffuses like Botox and that it virtually acts in an identical manner. One must ask themselves, why did earlier studies show that it acts quicker? It is a scientific fact that smaller molecules diffuse (Note: spread from the point of injection) further. Diffusion depends on molecular size and Dysport diffuses more than Botox. This is why injecting the frown with Dysport usually will affect most of the forehead area above the frown. I shared over 35 articles with Medicis about this, but they just don't want or care to understand the truth. Their theory, espoused by Monheit for Medicis is that when toxins, including Dysport, reach the pH-neutral environment of the body and leave their acidic environment that the protein envelope surrounding the toxin opens, releasing the pure botulinum molecule. And this is why all type A toxins diffuse equally. However Dr Monheit* obviously does not realize that Dysport is stored at a neutral pH. That means that it is not suddenly exposed to a pH change that causes its surrounding protein to leave. Well, there goes Monheit's* theory; yet they still espouse Monehit’s* theory to this day.

It is important to note that the relative potencies of the various botulinum toxin products differ significantly within the toxin types and brands (Botox,Dysport,Xeomin and Myobloc). The potency of botulinum toxin is measured in functional units that correspond to the calculated median dose that would kill a mouse when injected into the stomach. Clinical doses range widely depending on the size of the muscle to be treated, the degree of muscle weakness required, and the specific botulinum toxin product used (the potency expressed in Units or U is not comparable from one botulinum toxin product to another). Spread of botulinum toxin effects is dose and brand dependant. Large doses rarely ever employed in cosmetic use can cause a Botulism – like effect. Botulism is a serious bacterial toxin-mediated neuroparalytic illness whose onset is typically marked by things such as double vision (diplopia), inability to control or coordinate the muscles used in speaking (dysarthria), and/or difficulty swallowing (dysphagia)), followed by progressive descending muscle Weakness or paralysis that can lead to respiratory failure and death. The clinical use of botulinum toxin products presents the potential for iatrogenic botulism, which may be described as the appearance of one or more clinical manifestations of botulism that has the potential to be clinically serious. This is .can occur with cosmetic use. Local extension of effect of the botulinum toxin into anatomical structures (nerves and muscles) adjacent (contiguous) to the site of injection may occur and is described in product labeling.For example, dysphagia (difficulty swallowing) is described in product labeling as a "commonly reported adverse event following treatment with all botulinum toxins in cervical dystonia. It also has been seen when botulinum toxin products have been injected into the neck at doses as low as 60 units of Botox.also informed . the BLA ( Biologic License Application holders )or drug companies for various toxin products must also have a REMS Approved Risk Evaluation and Mitigation Strategies (REMS) to ensure that the benefits of these products outweigh the potential for serious risks associated with the lack of interchangeability among the various botulinum toxin products.
There is also a lack of uniformity in the terminology used to characterize this adverse events associated with use of botulinum toxin products. Clinical seriousness may be considered with unintended extension of the toxin's neuromuscular blockade effects to anatomical structures beyond the targeted treatment site, whether these structures are close or far from the site of injection. Local weakness of the injected muscle(s) represents the expected pharmacological action of botulinumtoxin. However, weakness of adjacent muscles may also occur due to spread of toxin. On the other hand dysphagia or difficulty swallowing may also be a sign of distant spread of botulinum toxin effects when the agent is administered at a site other than the neck. This has been seen with a Myobloc (a type B toxin) in cosmetic doses and when large doses are used in everything from cerebral palsy to hyperhidrosis or excessive sweating,. The mechanism by which distant spread ofthe toxin effects occurs has not been well established. Patients must be aware of the reports systemic adverse reactions including respiratory compromise and death following the use of botulinum toxins types A and B for both FDA-approved and unapproved uses are suggestive of botulism, which occurs when botulinum toxin spreads in the body beyond the site where it was injected. The most serious cases had outcomes that included hospitalization and death, and occurred mostly in children treated for cerebral palsy-associated limb spasticity. Although current product labeling for Botox, Botox Cosmetic, Dysport and Myobloc contains a section advising physicians that patients with neuromuscular disorders may be at increased risk of clinically significant systemic effects, including severe difficulty swallowing and breathing and respiratory compromise, after local injection of typical doses of botulinum toxin, there is literature suggesting that "similar, potentially life-threatening systemic toxicity from the use of botulinum toxin products can also result after local injection in patients with other underlying conditions such as those with cerebral palsy associated limb spasticity."

I have had Dysport numerous times, and finally, something went wrong. One eyelid drooped. My doctor gave me eyedrops, but they just dilated the pupils and made the eye look even worse. Now the doctor did apologize profusely, and now after four weeks, the eyes are evening out. I just may use Botox next time.

I had Dysport on November 17th. Three days laters my head was tilted. I had neck pain, muscle pain going down my left shoulder to below my elbow. I could not lay down, it ws terrible. I had never experienced naything like this. I had been a user of Botox for several years with minor irritations but never any pain like this. I thought perhaps I had a pinched nerve, had xrays, etc. nothing showed up. I was put on codine, several pain medications and it was horrible. Never Dysport they should call it "DIESPORT."

Since Pharmaceutical companies like Medicis( who represents Dysport) wanted presentations at meetings and these people planned the meetings and controlled the cosmetic journals they really are not concerned about the accuracy of the medical literature only sales. One only needs to look at the recent literature on Dysport and compare it with the literature from Europe 10 years ago. Suddenly they want us to believe Dysport diffuses like Botox and that it virtually acts in an identical manner. One must ask themselves, why did earlier studies show that it acts quicker? It is a scientific fact that smaller molecules diffuse (Note: spread from the point of injection) further. Diffusion depends on molecular size and Dysport diffuses more than Botox. This is why injecting the frown with Dysport usually will affect most of the forehead area above the frown. I shared over 35 articles with Medicis about this, but they just don’t want or care to understand the truth. Your face will return to normal, go to someone who knows what they are doing( no bargain injectors), and no Dysport!

What is the prescription drops? I had Dysport injections 8 days ago for forehead and crow's feet. I have had the forehead done twice before by same person w/ no problems. This time my forehead is too frozen. This was the 1st time for mild crow's feet and today my eyes are numb. I am now worried that they will droop. Can that happen or would it have happened by now? My cheeks lump slightly when I smile now because the muscle won't raise my cheek. My eyes can't squint. Would the drops help?

The problems you are facing may be due to the greater spread of Dysport than Botox. The droopy eyelid should resume it's normal position in about 3-6 weeks.

There are several issues I see with Dysport. While if one reviews the earlier papers by Lowe and Ascher one sees that it does not last as long as Botox. Furthermore all the different type-A toxins perform differently.When I introduced Botox to South America the physicians noted greater spread with Dysport than Botox. In fact with Dypsort the injection pattern they used in the clinical trials was the one I developed for Botox. In reality a 3 point injection pattern with Dysport frequently performs as well as the 5 point pattern they used. Many of the problems patients are describing here may be due to the greater spread of Dysport .than Botox..Arnold William Klein Professor of Dermatology and Medicine, David Geffen School of Medicine at UCLA

Droopy eyelid after Dysport is due to weakness of the Lavator Palpebre muscle Your doctor can prescribe eyedrops that reverse it for few hours. The effect of dysport with droopy lid may last about 3-6 weeks