If Dysport didn't work, can it be touched up with Botox at the follow up appointment?

Question

I had Dysport injected for my glabella lines and along my brows one week ago. There has been very little effect yet, I still have full movement in my eyebrows. I know that I could possibly see some improvement for another week still, but if I don't, am I able to request a switch to Botox at my follow up appointment? Can the two products be combined? Both Dysport and Botox have the same price per unit here, which confuses me, since I've now read (after my treatment) that Dysport needs more.

Paul S. Nassif, MD · Answer

Hello and thank you for your question. I recommend waiting another week for the full effect of the current dysport treatment to take place. If, after the full recommended window of time has elapsed, I suggest speaking with a board certified dermatologist or plastic surgeon. You may have not received enough units of dysport in your first treatment, in which a touch up treatment is needed. They also will be able to assess your injection history and deduce whether or not neurotoxin resistance is to blame for the lack of results. If such resistance is the case, I suggest speaking with your provider about switching to botox. The molecular differences between the two products can cause different results in many patients. If dysport does not work for you, the chemical compounds in botox may be a better fit for your needs.

Elham Jafari, MD · Answer

Hi and thank you for your question! Assuming that you don't see further improvements after waiting for 2 weeks, the key question is whether you did not get enough Dysport or you did get the right dose, but your body has developed resistance to it. In former case, further touch ups with Dysport would be the recommended course, but if your body is developing resistance to it, then you can consider switching to Botox. Please note that resistance often does not happen overnight and it is commonly seen as a gradual need for more and more units of Botox or Dysport to achieve the same result in the same patient, so just by seeing suboptimal results from one round of injections we cannot conclude that there is resistance. Hence you will most likely be better off with additional touch ups with Dysport at this time. I hope it helps and good luck!

Aldo Guerra, MD · Answer

Since you're only a week out, I will tell you that not enough time has passed to get the full effect of the Dysport. Give it another week and by 2 weeks the effect should be maximized.  At that point, see your injector and discuss the results and next steps....Best wishes, Dr. ALDO

Jason Emer, MD · Answer

Keep in mind, it can take 1-2 weeks for final results with Dysport. If you're unhappy with your final results, you can have a touch-up of Botox. Cost will vary. See an expert. Best, Dr. Emer

M. Bradley Calobrace, MD, FACS · Answer

Dysport typically takes effect in 2-4 days, so if you were injected one week ago the product should be working.  At our practice, we recommend patients wait one week after Dysport injections before following up to ensure the product has had sufficient time to take effect.  I would advise you to follow up with the injector and discuss why the Dysport has not given a good result.  I would first review the dose to determine if an adequate treatment was given.  If for any reason you are unhappy with the Dysport results, it is possible to inject the area with Botox even though Dysport was already administered.  As always, speak with your provider to discuss expectations and outcomes before pursuing treatment.

Jon Kurkjian, MD · Answer

Dysport does not peak in efficacy until about 14 days post injection. I encourage to remain patient and return to your injector for a follow up at 2 weeks. At that point, if you are still not happy with your results you can discuss this with your injector and decide it using more Dysport is a better option than switching to Botox.

David Rosenstein, MD · Answer

It does take 10-14 days to see the full effect of the dysport. If at that point in time you still need a touch-up Botox can be used. Keep in mind there might be a price difference with your practitioner. Best of luck.

John R. Burroughs, MD · Answer

Botox, Dysport, and Xeomin are all serotype A botulinum neuromodulators.  Xeomin and Botox are dosed the same in my experience of 1:1.  Dysport needs 2.5-3 times the number of units, but can work great when dosed and injected properly.  In fact, Dysport give a bit more spread of effect which can be great for crows feet and forehead lines.  If you didn't get much effect at 2-3 weeks then likely you were under-dosed as only a very small number of people are non-responders.  At your follow up you can certainly request one of the other formulations of botulinum toxin.  I mix and match often in my practice depending upon the patient needs and desired effect.  Best regards.

Suneel Chilukuri, MD · Answer

Thank you for your question.  Dysport, Botox, and Xeomin are all neuromodulators with the same effect in the right hands.  The number of "units" is less important than having a cosmetic dermatologist or plastic surgeon who is adept at using any or all three.  If you are having minimal effect, either you were under treated (not enough was placed) or, more commonly, the appropriate muscle was missed.  Please return to your board certified dermatologist or plastic surgeon for further evaluation and treatment.  Make sure he or she is an expert. Best of luck,Suneel Chilukuri, M.D.Houston, Texas

Darab Hormozi, MD · Answer

Yes you can get Botox after Dysport.  The unit equivalency of Dysport is about 3 units per unit of Botox.  The price per unit should reflect that !!

If Dysport didn't work, can it be touched up with Botox at the follow up appointment?

Answers (13)