Question 1

What is Letybo?

Accepted Answer

Letybo (letibotulinumtoxinA-wlbg) is an injectable wrinkle relaxer that temporarily smooths moderate to severe frown lines between the eyebrows.

FDA approved for adults in February 2024, Letybo is the latest addition to the lineup of botulinum toxin type A neuromodulators available in the U.S. But it’s been the #1 neurotoxin in South Korea (where it’s manufactured by Hugel) for years, and the treatment has been growing in popularity in over 70 other countries.

Question 2

How does Letybo work?

Accepted Answer

Letybo works by temporarily blocking the release of acetylcholine, a chemical messenger involved in communication between nerves and muscles. The muscles grow increasingly relaxed, smoothing the overlying skin and softening dynamic wrinkles.

It’s usually injected into the corrugator and procerus muscles, the ones responsible for the vertical glabellar lines (aka “11s”) that pull your eyebrows together when you frown. Experienced providers also frequently use this and other neurotoxins “off-label,” beyond the current FDA approval.

RealSelf Tip: Some people who are new to neurotoxins fear a frozen look, but any competent injector will know how to adjust your dose to treat the wrinkles and preserve a natural-looking range of expression.

Question 3

Letybo pros and cons

Accepted Answer

Pros

Letybo can start working within days. In a Phase III study, the median time to onset was 3 days, and patients reported seeing improvement as early as Day 2.
Clinical trials showed significant improvement in glabellar lines, compared with 0% of placebo-treated patients.
Results can last several months. In the Phase III study, the average time to first retreatment was a little over 4 months.
If you've had Botox or another toxin before, Letybo gives you and your injector another product to consider. This can be especially helpful if you’ve noticed that another product has become less effective over time.

Cons

Its FDA-approved use is currently limited to glabellar lines. Other treatment areas may be discussed or studied, but they're not part of Letybo's current U.S. FDA-approved indication.
As with other neurotoxins, the results aren't permanent. You’ll need follow-ups to maintain your results (though you don’t have to keep doing it, once you’ve started).
Letybo units aren't interchangeable with other botulinum toxin products, so a lower or higher price per “unit” won’t necessarily tell you which is the better value.

RealSelf Tip: While Letybo doesn't yet have the decades of U.S. consumer experience that Botox does, it has years of international use and solid clinical-trial data behind it.

Question 4

How to prepare for a Letybo treatment

Accepted Answer

There's no elaborate pre-treatment ritual for Letybo. But as with all injectables, you can minimize your chance of post-treatment bruising by stopping any nonessential blood thinners a week before your appointment. This includes nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen or naproxen, as well as Omega-3s.

Don't stop a prescription medication on your own to prepare for an injectable treatment. Instead, tell your provider everything you're taking in advance, so they can advise you appropriately.

Question 5

What to expect at your appointment

Accepted Answer

A typical Letybo treatment takes 15 to 20 minutes.

Your injector should start with a brief consultation, especially if it’s your first visit. They’ll review your medical history, medications, allergies, previous botulinum toxin treatments, and any relevant medical conditions.

Because facial anatomy varies from person to person, injection technique matters. Your provider should assess your facial anatomy and the strength of your muscle movement by asking you to frown, raise your eyebrows, and make other expressions.

This is the perfect time for you to be clear with them about the kind of result you want. For the FDA-approved treatment of glabellar lines, the recommended dose is 20 units (one in the procerus muscle and two in each corrugator muscle), but a competent injector can adjust this up or down to achieve your desired effect.

After cleansing the skin to prevent infection, your provider will use a small needle to administer the injections directly into the muscle. You’ll feel a sharp pinch, but the pain won’t last long.

RealSelf Tip: If you're particularly needle-phobic, ask your provider in advance whether they recommend a topical numbing product. You’ll need to give it some time to take effect, so they may ask you to arrive early.

Question 6

What should you avoid after Letybo?

Accepted Answer

Your injector should give you their specific aftercare instructions. These are the most common recommendations:

Because botulinum toxin can affect muscles beyond the intended injection area, follow your provider's instructions about touching, rubbing, or applying pressure to the treated area. Learn more about what not to do.
Most people can return to normal activities quickly, but you may have some temporary bruising, redness, tenderness, or swelling at the injection sites.

Question 7

How long does Letybo take to work?

Accepted Answer

Don't expect to walk out of your appointment wrinkle-free.

In the Phase III study, the median onset of effect of Letybo was 3 days, with some patients noticing an improvement earlier. Hugel, the manufacturer, describes visible results beginning within 1 to 3 days, and clinical-trial data show that results continue to develop for up to a month post-treatment.

If you're planning to get Letybo before a wedding, vacation, or big event, book your appointment for at least a week (and ideally 1 month) in advance, just to be safe.

Question 8

How long does Letybo last?

Accepted Answer

Letybo lasts 3 to 4 months, although individual results vary.

In the Phase III study, the typcial time until retreatment was 127 days.
Hugel describes Letybo as lasting up to 4 months.
The FDA recommends that you don’t get Letybo more frequently than every 3 months.

Your individual longevity can vary based on factors including muscle activity, treatment dose, anatomy, and how your body responds to the product.

Question 9

Letybo vs. Botox: which is better?

Accepted Answer

You'll sometimes hear Letybo called “Korean Botox.” It's an easy shorthand, but the products shouldn't be treated as interchangeable: Letybo, Botox, and their competitors are different botulinum toxin products with their own formulations, labeling, clinical-development history, and dosing.

Letybo vs. Botox

Letybo and Botox both temporarily reduce muscle activity to soften dynamic wrinkles, and both have FDA-approved cosmetic indications for glabellar lines.

The biggest practical difference right now is that Botox has a longer U.S. track record and broader FDA approvals, while Letybo is newer to the U.S. market.

Clinical research has also directly compared letibotulinumtoxinA (Letybo) with onabotulinumtoxinA (Botox) and found comparable efficacy for glabellar lines.

The best option for you depends on your anatomy, muscle activity, treatment goals, previous experience with neuromodulators, provider expertise, availability near you, and price.

And honestly, your injector's training and expertise matters more than the logo on the vial. A skilled injector should be able to explain why they're recommending a particular product and how they'll tailor the treatment to your face.

Question 10

Is Letybo safe?

Accepted Answer

Letybo was evaluated in three Phase III clinical trials involving 1,271 patients, and it’s FDA-approved as being safe and effective.

In the FDA-reviewed trials, the most common adverse reaction was a headache, reported in 2% of Letybo-treated patients.

Other potential adverse reactions include injection-site reactions and effects related to unintended effects on nearby muscles.

Rarely, any botulinum toxin product can spread beyond the injection site and cause symptoms such as generalized weakness, difficulty swallowing, or difficulty breathing. These symptoms may occur hours to weeks after injection and can be serious. Follow your provider’s aftercare instructions to help mitigate this potential risk, and seek immediate medical attention if you have symptoms that concern you.

Letybo may not be appropriate for you if you have:

a known hypersensitivity to Letybo or another botulinum toxin product
an infection at the planned injection site
certain neuromuscular disorders
certain conditions affecting swallowing or breathing

Letybo is not recommended for use in children, pregnant women, or women who are breastfeeding according to the current U.S. prescribing information.

Your injector should determine whether you're a good candidate based on your health history, anatomy, medications, and treatment goals.

RealSelf Tip: The safest way to get a neuromodulator isn't to chase the lowest price or newest product. Choose a qualified medical provider with substantial experience, and make sure you know exactly what product you're receiving.

Question 11

Sources & studies

Accepted Answer

Mueller DS, Prinz V, Adelglass J, Cox SE, Gold MH, Kaufman-Janette J, Nestor MS, Taylor S, Frank K. Efficacy and Safety of Letibotulinumtoxin A in the Treatment of Glabellar Lines: A Randomized, Double-Blind, Multicenter, Placebo-Controlled Phase 3 Study. Aesthet Surg J. 2022 May 18;42(6):677-688. doi: 10.1093/asj/sjac019. PMID: 35092418; PMCID: PMC13267890.
U.S. Food and Drug Administration & FDA Access Data
Letybo.com
Letybo Prescribing Information

LETYBO

Mari Malcolm

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