Dysport Work for a Botox-resistant Patient?

My grandmother has built up a strong resistance to Botox through years of injections for treatment of cervical dystonia. She no longer sees a response to the injections, and she has been advised to give her body two years to degrade the immunity. Is Dysport different enough that she might respond?

Doctor Answers 12

Dysport for Botox Resistant Patient

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The short answer is yes, Dysport may work in a Botox resistant patient. Occasionally when Botox doesn't seem to work as well after years of injection, switching to Dysport seems to help in many patients.  Dysport and Botox are both preparations of botulinum toxin A, a derived protein that works at the nerve-muscle interface to relax targeted muscles. The Dysport protein is slighlty smaller and seems to work slightly faster. Dysport has been around in Europe more recently introduced in the USA. At this point it as slightly cheaper even with the more units required to inject, that is the dosage is not the same between the two drugs though both work well in my experience. Dysport is made by Medicis (owned by Valeant) the makers of Restylane and Perlane.  The end result is the similar from the patient' standpoint.

Dysport vs Botox

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Dysport and Botox while both a botulinum toxin, they are different and therefore Dysport may work for your grandmother.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Dysport and Botox Can Be Different

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I have seen patients who respond to Dysport but not Botox. I would also suggest looking into Xeomin which was recently approved to treat cervical dystonia in the US. It is also a botulinum toxin type A product.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Dysport Work for a Botox-resistant Patient?

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Botox resistance is rare in my 15 year experience, and it may be worthwhile to try Dysport.  Make sure you consult with an experienced injector of Botox or Dysport.

Ramtin Kassir, MD NY/NJ facial plastic surgeon

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 179 reviews

I have patients that respond well to Dysport that Botox did not work well

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I personally have had patients who responded well to an equivalent dose of dysport when botox did not work well after a while for essential blepharospasm.  The compounds are similar but not exactly the same. It is hard to determine why the dysport at the same corresponding dosage would work when botox would not but I have a multiple of patients who have had that response. 

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon

Make sure adequate Botox or Dysport get injected for man or older woman

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Most of the time when a man or an older woman does not respond well to Botox, it's typically a matter of not enough Botox units got injected to the desirable areas. True resistance to Botox is exceedingly rare. I do have patients for whom Dysport may work a little better than Botox and vice versa. Myobloc may work better but not yet FDA approved for cosmetic usage.

William Ting, MD
Bay Area Dermatologic Surgeon
4.5 out of 5 stars 14 reviews

Using Dysport in patients who have previously used Botox

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Dysport is a close relative of Botox that is now available in the United States through Medicis. We have seen great results in patients who have previously used Botox or have developed a resistance, or in patients new to these muscle relaxers. If you have use Botox but have not been satisfied with the results, you may consider using Dysport and you may consider a stronger concentration of Dysport as you may have stronger muscles in this area. The amount of Dysport used is slightly different than the amount of Botox per area. For great results, work with a board-certified plastic surgeon who has a great deal of experience with fillers, Botox and the new Dysport. The price of Dysport will vary by the practice. In our practice, Dysport is somewhat cheaper than Botox. Keep in mind when buying either filler to make sure that you are paying by the unit instead of by the volume (per area, per cc, per ml, etc)

Dysport may work when Botox doesn't

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Dysport and Botox are both Botulinum Toxin type A products. They are, however, subtly different. It is this small difference that may account for Dysport working where Botox does not. In my practice I have treated a couple of patients that don't respond to Botox injections. They seem to be doing well with Dysport so far. Traditionally we have used Myoblock for these patients, but Dysport presents another options. I would recommend trying Dysport if you find that Botox is not effective.

I hope this info helps!

Adam Rubinstein, MD
Miami Plastic Surgeon
4.9 out of 5 stars 21 reviews

Resistance to Botox

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There are many patients who present to a plastic surgeon's office complaining that they need more and more Botox with continued use. It is completely feasible and theoretically possible that these patients should benefit from Dysport or Myobloc. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Try Myobloc

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Some patients who are resistant to Botox A (Botox) seem to respond to Botox B (Myobloc). Myobloc is FDA approved and I have found it safe and effective in my practice over the last three years.

John P. Di Saia, MD
Orange Plastic Surgeon

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.