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As stated by the American Society of Plastic Surgeons, Botulinum Toxin Type A injections are the leading cosmetic minimally-invasive procedures in America, nowadays1. Botulinum Toxin Type A is a neurotoxin, also called neuromodulator, which is used in the cosmetics industry to prevent the movement of facial muscles by blocking nerve impulses. Since 2002, neurotoxins are successfully used to temporarily remove wrinkles in the brow, forehead, and around the eyes. The first neurotoxin available in the market was Botox, followed 7 years later by Dysport and, ultimately, Xeomin made his appearance in America in 2011. Officially, these three neurotoxins are the only US Food and Drugs Administration approved for the treatment of glabellar lines.

Although Botox, Dysport and Xeomin are all neuromodulators formulated to fulfill the same functions, there are some particularities in their nature and composition that distinguish them from each other. In my quest for always offering my patients the best quality medical service and cost-effective products, I will share the conclusions of my research on those differences. For starts, it is a well-known fact that Botox is the most popular among the neurotoxins and the one with the longest trajectory in the US marketplace. However, the next neuromodulator to entry the aesthetic treatments’ arena, Dysport, presented a remarkably advantage over Botox. Dysport has a smaller protein carrier than Botox, which translates in a higher spread of toxin after injection. Consequently, Dysport offers a faster onset of action than Botox (1-2 days versus 3-5 days), and it requires less injection sites for larges areas such as the forehead or under the arms for hyperhidrosis. Accordingly, less injection sites turns on gains on patient’s comfort. However, Dysport injections are much less convenient to apply in small zones. Owing to its higher diffusion characteristic, instilling it in small muscles, as in the brow or around the eyes, would increase the risk of side effects like drooping of the eyelid, for instance.

But better advantage than having a smaller protein carrier is no having a protein at all. That’s the case of Xeomin, the newest and more affordable Botox competitor. Xeomin is derived from the same parent molecule as Botox, but unlike Botox, it does not have a preservative protein. When Botox and Dysport are injected, the Botulinum molecule must free itself from its protein carrier before bonding with the facial muscles and, as a result, eliminate the wrinkles. On the contrary, Xeomin has no preservative protein, therefore it is immediately available to the muscle receptors2. Cost-effectiveness is another benefit of Xeomin, popularly known as the “Naked Botox”. Xeomin does not required refrigeration, making its transportation more convenient than any other neuromodulator. For its part, Botox and Dysport are both transported in dry ice, which represents an additional expense for distributors, injectors and, ultimately, for patients.


1Plastic Surgery Statistics Report 2016. American Society of Plastic Surgeons. www.plasticsurgery.org

2Gart, Michael. “Aesthetic Uses of Neuromodulators: Current Uses and Future Directions”. Journal of the American Society of Plastic Surgeons. www.journalslww.com

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