Choosing Between BOTOX, Dysport, and Xeomin
Botox (onabotulinumtoxinA) was a quantum leap forward in plastic surgery. It provides a nonsurgical reproducible and safe therapy for facial wrinkles, hyperhydrosis (excessive sweating in armpit), and blepharospasm. It has enjoyed complete market dominance since its inception nearly 10 years ago. In 2006, Dysport, sold by the Valeant Pharmaceuticals, was introduced as a competitor to BOTOX®. Dysport® showed a great deal of promise for relieving wrinkles around the eyes and forehead but, at a lower price point than BOTOX®. However, it unfortunately has quite not lived up to its promise to replace Allergan’s product as the lower cost alternative because of problems associated with diffusion, inaccurate results, and patient dissatisfaction. Therefore, it maintains a distant second place in the neuromodulator market and it is unlikely that this will ever improve.
Recently, Merz Pharmaceuticals has introduced a new exciting product called Xeomin. Xeomin® has a very similar performance profile to BOTOX®. As well, unlike BOTOX®, Xeomin® does not require an artificial compounding protein. Because of this, Xeomin® appears to have a faster onset of action and our patients report that it may have a longer lasting effect.
So practically speaking, what dos this mean? When you get BOTOX® injected, the compounding protein has to fall off the BOTOX® molecule inside the muscle, bind to the muscle receptor and then, it has to stop the muscle from contracting. Subsequent to muscle loss, wrinkles loosen up and fade away. Therefore, depending on a multitude of factors, BOTOX® can take 3-14 days before you will see a full muscle relaxing effect.
On the other hand, with Xeomin®, when the product is injected, it immediately binds to the muscle because there is no compounding protein that has to “fall off” first. Predictably, we have found that Xeomin® will begin to work within about 48 hours. Our patients tell us that they feel that Xeomin® works faster and lasts longer than BOTOX®.
BOTOX and Xeomin Availability
At Ocean Drive Plastic Surgery, we do not partner with any single injectable company and therefore, we are proud to offer our patients with a choice in injectable products. Our patients who are most comfortable “sticking” with BOTOX® may continue to receive BOTOX® injections while our other patients may choose to try Xeomin® to see if they too get a quicker and longer lasting effect.