Even though I obviously didn't get enough Dysport the first time, should I still see at least a slight difference?

Question

This is a follow up question and update. I had 35 units of Dysport in my glabella and forehead and it's now 9 days later and no change at all. My question now is since there is no change can that mean it doesn't work for me and should I try botox instead? Can you mix Dysport and Botox? What should I be concerned about if anything?

Aldo Guerra, MD · Answer

Thanks for your question. I believe you should return to your injector for a full evaluation including a review of your before and after photos. You may simply need a higher dose for the best outcome. You can also use Botox or Xeonim.Best wishes, Dr. Aldo

Jeffrey R. Raval, MD, FACS, MBA · Answer

Hello,
Good question! I would go back to your injector and request an evaluation! 35 units is typically not enough to make a difference when injecting with Dysport.

Landon Pryor, MD, FACS · Answer

Thank you for your question, Ggdianne!  Generally, you should see your Dysport kick in within 7 days after the procedure.  The amounts of units needed vary with each patient.  It is dependent upon the amount of lines and wrinkles that are present, the correction that you are looking to achieve and your individual muscle strength in the facial area.  It is possible that you need additional product.  Botox and Dysport cannot be mixed together.  I recommend scheduling a follow up appointment with your office to determine the best route from here.

Summit Kundaria, MD · Answer

Thank you for the question.   I think you should go with more Dysport.  Sometimes there is a threshold effect, and you need to get a critical number of units into the muscle before it "gives" and relaxes.  I don't think you are quite "there" yet.  I don't think you had enough neurotoxin to label you a "non responder" yet, and would stick with whichever is the most economical for now. Good luck!

Benjamin J. Cousins, MD · Answer

Thank you for your post. It may be best to stick with an experienced Board Certified injector who you are comfortable with and can have follow-up and repeat evaluations with so you are on the same page. Dysport/Botox will typically begin to "kick in" after 4-7 days, but some may see results earlier. The full effect is usually seen after 7-10 days so then  would be  a great time for a follow-up with your injector if you are not getting the results you desire. Additional injections may be given then as a "touch up" if more correction is desired/needed. 
Dr. Benjamin J. Cousins MD Board Certified Plastic Surgeon Miami/Miami Beach

Kathleen F. Archer, MD · Answer

Dear GG Dianne:
35 units of Dysport to treat both the glabellar area and forehead is insufficient.  There is not a direct correlation between Botox and Dysport, it varies slightly from patient to patient.  Typically, it takes between 3 and 5 units of Dysport to get the same effect of 1 unit of Botox, so you received the equivalent of 7-12 units of Botox which is simply inadequate to treat either of these areas.  I evaluate the amount of muscle contraction of the area I am treating and base the dosage on the size of the area and the muscle action.  Typically, I use between 20-25 units of Botox initially to the glabella and 30+ units to the forehead.  I have found that Asian patients can require & respond to lesser amounts.  
I have been injecting Botox for over 30 years and am one of Allergan's trainers and member of their National Education Foundation.  I find Botox more comfortable to inject for my patients than Dysport, but you should get the same result with either one with the proper dosage.  It is recommended to wait about 3 months between treatments.  The doses are not additive, which means that if you go back in, your doctor will not be able to count the 35 units they initially injected, you start from ground zero.  Too frequent injections pose the possibility of developing an immune response to the neurotoxin and losing the effect of the agent.  It is also normal to gradually require increasing doses as we get older.

T.G. Khan, DO, FACS · Answer

35 Units of Dysport is nothing really - thats equivalent to about 10 units of botox - depending on your wrinkling, you need at least 50 - 100 units to treatment a forehead and sometimes more.

Richard E. Moore, MD · Answer

Thank you for your follow-up question. Since the number of units you received is 1/3 the standard dose, I would not expect to see any significant results. In order to diminish the movement of the muscle you must blockade the majority of the nerve's ability to stimulate the muscles. Once you hit a critical threshold the muscle contractions will weaken or cease. You obviously did not hit that threshold. Botox would not work any better if injected at sub-therapeutic  dosages. I would not mix Botox and Dysport at this time to get a therapeutic dosage but you could certainly switch to Botox with your next set of injections.  I hope this was helpful - Dr. Moore.

Steven F. Weiner, MD · Answer

I would get more of the Dysport. Botox and Dysport should work similarly if the dosing and injection technique is appropriate. I typically inject 50-70 Dysport units in the glabella and 20-25u in the forehead. Having no results is because too few units were used.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question.  Although I have (very rarely) seen a few patients who have developed resistance to a particular neuromodulator product after years of consistent use, I have never seen a first-time patient not respond to Botox or Dysport.  I still strongly suspect that you received an insufficient dose with your prior treatment - to give you an idea, 50 units is the suggested, on-label dose in the glabella alone.  Treating the forehead would likely require an additional 15-35 units, depending on your anatomy, muscle strength, and desired result. 
While there is no contraindication to using Botox and Dysport at the same time, I think you likely just need more Dysport.  I would recommend following-up with your injector to discuss your concerns.  If you would prefer a second opinion, I would recommend seeing a cosmetic dermatologist or plastic surgeon.  Best of luck.

Even though I obviously didn't get enough Dysport the first time, should I still see at least a slight difference?

Answers (11)

More Dysport Questions

is it best to wait for Dysport to wear off or go back and try to fix the issue? (photos)

Should I be seeing results from Dysport yet? (Photos)

Will 50 units of Botox be equivalent to 150 units of Dysport?

Droopy eyelid after Dysport?

How many units of Dysport or Botox for gummy smile?

Dysport in crows feet and bunny lines, facial droop. Is there any solution?

WE SEND PRETTY
EMAILS