If Botox didn't work for me, what are the chances Dysport will?

Question

I had masseter botox with 30 units in each side 5 weeks ago. Still I'm constantly clenching and had no slimming at all. I went in today and was told some people who were vaccination against COVID became immune to botox and this is supposedly what's happening in my case so they tried dysport. I am nervous I won't see any results and end up just have wasted my money again. Is it likely to see results this time? If not are there no other alternatives?

Anil R. Shah, MD · Answer

Hi Ochiexx,

I am Sarah, a medical assistant at Aesthetic Skin MD with Dr. Anil Shah in Chicago, and I am so sorry to hear that your masseter injections have not been successful thus far. Trying Dysport instead of Botox can be more successful for some due to Dysport having less proteins that are the targets for the immune system that inactivate Botox. Therefore, you should be optimistic about receiving Dysport and give it a chance. If you ever have any more questions or want to book an appointment with us, please visit our website at the link below.

Nima Shemirani, MD · Answer

Hi @ochiexx! I would recommend increasing the amount of units since you continue to experience clenching.

Jason Emer, MD · Answer

If Botox is not an option for you, Dysport or Xeomin are the next options. I suggest dermarolling at home to give the skin Botox-like effects with at-home treatment. See an expert. Best, Dr. Emer

Marc Polacco, MD · Answer

Thank you for your question. There are a few things to consider. One is that you may need a higher dose of botox in the masseter. Also, for patients with TMJ issues, I typically will also treat the temporalis muscle in addition to the masseter. Assuming that the issue is your immune system recognizing the botox, yes, there are alternatives such as Dysport, Xeomin, Juveau, and Daxxify. I'll typically try Xeomin in patients who have developed tolerance, as it may be less immunogenic. I hope this is helpful information, and all the best to you.
-Dr. P

Nelson Lee Novick, MD · Answer

I have been injecting Botox for aesthetic reasons for over three decades and have seldom encountered cases of allergy to Botox or immunologic resistance to it. To my knowledge there are no documented cases of cross-immunity between Botox and the Covid vaccines. In general, treating masseter hypertrophy and over-clenching and grinding issues requires considerably higher doses of Botox than those used for the treatment of dynamic wrinkling. What is more likely in this case is that an insufficient dose of Botox was used on each side with 50 or more units per side more likely to have been effective. You would be wise to make certain you are consulting with a board certified dermatologist injector before throwing out the baby with the bathwater and switching to another neurotoxin. And if a switch is warranted, Xeomin would be my first choice, since in its manufacture the active neurotoxin has been stripped of some of the proteins that could at least theoretically be immunologic. Hope this helps and best of luck.

Camille Cash, MD · Answer

Each neurotoxin is designed a bit differently.  If a patient does not respond to Botox there is a chance that Dysport or Xeomin may work.  A new FDA neuromodulator on the market is Daxxify.  This product is different from the others and its effects can last several months longer than the others.

Onir Spiegel, DDS, PhD · Answer

If you are no longer seeing the results you are used to seeing from your Botox it may be time to up the dosage or switch the product. This is not an uncommon phenomena and thankfully there are four products on the market to get you the results you desire.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hello! Great questions. Dysport works differently than Botox. The effect tends to be more diffuse and onset faster. It can provide a nice relief of masseter tension. If patients don't respond to Botox, Dysport (or Xeomin) are the next in line. I would seek consultation with your injector to see what dosage may be best as it would be worth a try. Hope this helps!

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Both products are the Botulinum Toxin Type A so perhaps not.  However there is no guarantee that either will help with clenching.  There are two sets of muscles and its not a guarantee that the muscles underneath the masseter can be reached.  
Hope this helps

If Botox didn't work for me, what are the chances Dysport will?

Answers (9)

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