Choosing Between the Different Botox Alternatives?

What can work for wrinkles, other than botzox?

Doctor Answers 9

Choosing between the different BoTox alternatives?

BoTox, and all forms of Botulinum Toxin A, work by blocking the reuptake of acetylcholine at the neuromuscular junction. By doing so, it inhibits transmission of signals from one neuron to the next at whichever junction it is working on (e.g., neuro junction, sweat gland junction, etc.) The duration of BoTox is typically 3-4 months on average. It can take up to 7 days for it to take effect. Thank you for the question! Hope this helps!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

The "Tox" Mix and Match

Botox is the granddaddy of the neurotoxins and as such has established itself as "the" wrinkle relaxer.  It is a very diverse-use injectable that has a long list of uses.The two newer "tox" products, Dysport and Xeomin, work very similarly but dosing is different, so 1 unit of Botox is not the same as 1 unit of the others.

In many instances I will use more than one of these products to achieve the results my patients are looking for.

There are some differences in some of the action. Dysport seems to spread a little more diffusely so it can easily soften forehead lines and crow's feet. There is no restriction as to combing products. I might use Botox for frown lines and Dysport for the more feathered lines at the corner of the eye.

All three products are effective. Each physician will have preferences and recommendations, but the end choice belongs to the patient.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 19 reviews

Botox alternatives can serve you well

There are alternatives to Botox that will achieve the same or better results for you than botox might, depending upon your needs. Most dermatologists that do a lot of cosmetic work have experience with these products and can help you decide which product would be best for you or in which facial  areas they might choose one over the other. The three main products used are Botox, Dysport and Xeomin. For the most part they are equivalent but some of us have preferences. For example, I prefer Dysport around the eyes and Botox in foreheads of those that have small foreheads. 

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 18 reviews

Botox alternatives for wrinkle reduction

Currently there are two other products available, Xeomin and Dysport. They have similar action to Botox. There are some subtle differences among them. Take the time to discuss with your plastic surgeon about each of them. I typically have my patient try each one of them on different office visits. I will inject to the same area so that the patient can compare and contrast among them. At the end of the day, pick one that works well for you.

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Botox alternatives

Botox, Dysport, and Xeomin are all neurotoxins that work to diminish muscle movement in the forehead, glabella, and crow's feet regions. If you are talking about other wrinkles and folds, like those around the mouth, NLF lines, etc., that would be fillers like Juvederm, Restylane, or Radiesse. If you have questions about which procedure would be best for you, seek a board-certified dermatologist or plastic surgeon for a consultation to discuss your specific situation.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Botox Alternatives

Hi anon.  It's not clear from the question if you are opposed using Botox, are opposed to using all neurotoxins or just had a bad injection where you did not get results.

If you had Botox but did not get good results, consider switching injectors.  There are many reasons why the results may not be great but two are too little product or bad technique.

If you are open to considering other competitors of Botox, try Dysport.  We have found it to be an excellent alternative that works the same as long as the unit dosing is at least 3:1 Dysport:Botox.

Finally, if you are considering alternatives to injection procedures, then laser resurfacing may be an option.  The problem with laser resurfacing for the upper face is that the wrinkles are usually caused by muscle action, which is unaffected by laser resurfacing.  The surface texture may improve, but if you have crow's feet when you smile before laser resurfacing you will also have them after.


Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Botox is a great treatement when performed by an experienced injector

IThere are a number of new neurotoxins hitting the market - personally, I am happy with Botox since I have a lot of experience using it. I've treated a few dozen patients with Dysport, but do not see any distinct advantages.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Botox versus Dysport

Botox and Dysport are similar products that help relax the movements that cause wrinkles.  Each experienced injector has his/her favorite product and it does not really matter which is used.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

One Botox, but different types of wrinkles

Botox is a treatment that relaxes muscles and, in that way reduces wrinkles that form from expression. For instance, crow’s feet that get worse when you smile are treated with Botox, as are the vertical lines between your brows.

For now, there is only one treatment that is legal in the US that does this. That treatment is Botox. Over the next year, it is expected that the FDA will approve other products similar to Botox. Most likely, the first will be Reloxin, which has been available (as Dyport) for years. But for now Botox is it. It remains to be seen how the new products will compare to Botox.

The other type of treatments that help lines are called fillers. Fillers add volume. I feel that the safest fillers are hyaluronic acid fillers like Restylane and Juvederm. They help lines that are always there (like the indentations from the side of your nose to the corners of your mouth and marionette lines). Fillers also replace facial fat which is lost as we age.

Many patients benefit from both Botox (for dynamic lines) and fillers (for lines that are always present). You should discuss this with a cosmetic surgeon to determine what makes sense for you.

Hope this helps.

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 24 reviews

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.