Dysport vs. BOTOX comment on FaceBook

Personally in my hands, I like BOTOX

Today, I received on FaceBook, a question regarding a comment regarding Dysport vs. Botox.  I was invited to give my personal thoughts and I would like to share them.  For the most part, I disagree with what’s written in the screen capture below:

reasons to make the switch from Botox to Dysport


My response to the question:

I like all of them! Botox, Dysport, and Xeomin

Dysport is excellent.  So is Xeomin.  Dysport, Xeomin, and Botox are neuromodulators.  In my opinion they work very similarly.  I have personally injected all three products and have personally received injections of Botox and Dysport.  I have come to the conclusion when using the products, much of the differences come down to four things:

1. How much was used.

2. Who is the injector.

3. What precise 3-D location was it injected (muscle/fascia all have depth).

4. How was it injected.

How to Compare? pound for pound?

I’m not certain that you can convert one unit of one product to another unit of another product.  For example, how many Hondas equal one Toyota?  Would it be 1.5 Hondas is the equivalent of 1 Toyota because of horse power rating or based on gas mileage – or the other way around.  I have owned both Hondas and Toyotas – and I like both.

So that’s the first problem when comparing neuromodulator.  Do we really know if we have equivalency?  Is 2.5U of Dysport really the same as 1U of Botox?  Or have we now changed it to 2.9U of Dysport to equal 1 U of Botox.  I jumped at the chance to try Dysport in January 2013.  I think the results were great.  But I think that in my own hands, the results of Botox was better.

I agree that Dysport spreads more.  But for me, I see that as a disadvantage.  The way I inject, I like a bit more pin-point accuracy.  But then again, that’s my personal way of injecting.  I like planning my injection sites whenever possible – thus I’m not looking for a wide diffusion pattern of the neuromodulator.

There will be people who say that a Toyota is better than Honda – or the other way around. I think both are good car companies.  But I would say that currently for me, I drive my own Honda a lot better than I would drive a Toyota because that’s what I drive every day.

Botox is my Violin

Schindler’s List Played by Calvin Lee, MD, guest concertmaster Taipei, Taiwan

Yep, that’s me and my violin.

I have been a violinist most of my life.  I frequently say that Botox is my violin.  When I’m using my violin, I can create results more predictably.   My Violin is what I prefer when I concertize.  I would be a bit timid when using a different violin.  But this is not to say that other violins are inferior.  But I have confidence to say that I would make other violins sound quite good!

Thus said in a different way.  I prefer to inject BOTOX because I’m comfortable with it and I can predict the outcome better.  But if I had to use Dysport or Xeomin, I would still get great outcomes, but I would have some uncertainties with it because I don’t use it every day.

Many of my patients and my entire staff prefer their BOTOX results over other products.

Their reasons are multifactorial.  Perhaps in another entry of my BOTOX blog, they can chime in.

I leave you with one more thought:  The injector plays the biggest role in the outcome.

It’s the violinist that makes the sound, not the violin.  Just like it’s the surgeon that makes the surgery, not the scalpel.  Thus we can debate on and on regarding which violin to use or which scalpel to use.  As long as the violin is of high quality and the scalpel is too, then the results lay on the shoulders of the artist.

Here’s a quote from master violinist, Jascha Heifetz:

After a concert, a member of the audience went up to Jascha Heifetz. He said, “Wow, your violin sounds really great.” Heifetz then held the violin up close to his ear and replied, “Funny, I don’t hear anything.”