Botox® has become the standard treatment for moderate to severe crow’s feet as well as a wrinkle treatment for the forehead and between the eyebrows. More recently, alternatives such as Dysport® have been approved. Both have been in medical use for over 30 years. More than simple skin care, these non-surgical injections should be performed by a certified plastic surgeon. Patients benefit from a temporary reduction of frown lines and laugh lines for a fresher and younger look.
What is Botox®?
Botox® itself is a purified protein from Clostridium Botulinum, approved for cosmetic use by the FDA in 2002. There were some 3 million procedures in 2005 alone. It works by relaxing muscles, reducing the appearance of moderate to severe wrinkles made more visible by collagen depletion and other cellular changes that happen as we age. These injections may also used to treat a gummy smile (raised upper lip).
Each procedure is brief, lasting 15 to 20 minutes, with no recovery down-time. Depending on where Botox® is injected in to you’ll see noticeable improvement in frown lines between the eyebrows, forehead wrinkles, and/or crow’s feet within a few days to a week. Full results occur in about 2 weeks with no additional treatments. Results last some 3 to 5 months, typically around 4 months.
What is Dysport®?
Very much like Botox®, Dysport® was more recently cleared by the FDA in 2009 for cosmetic purposes such as reducing crows feet and forehead lines. Some people may think that there is only a difference in brand names, but they are indeed different compounds. Both injections are derived from the same source, but Botox® uses the protein onabotulinumtoxinA whereas Dysport® uses abobotulinumtoxinA. The volumes injected are quite different, so proper medical training and experience is even more important when switching over.
Which is Better?
Most medical practitioners offer both types, as treatments and results are quite similar and the choice is often a matter of patient preference. Results with Botox® are seen in 3-7 days while those for Dysport® are seen in as little as 1 day, but more typically 2-5 days. So Dysport® takes effect a bit sooner. Some people claim that it also lasts longer, but clinical studies haven’t supported a significant difference. There are also differences in spreading, with each Dysport® injection affecting a larger area. That can mean fewer injections, but it may not be the best choice for patients who are treating smaller regions.
Several studies suggest that Botox® may achieve better results for lines between the eyebrows, Dysport® for crows feet, and both equally well for forehead lines (http://www.livescience.com/35743-Dysport-Botox-anti-wrinkle-treatment-crows-feet.html). There are other studies, however, that do not indicate significant differences. But it is clear that skill in assessment and procedures is more important than the compound used. Treatments should only be administered by a board certified plastic surgeon or dermatologist to avoid problems such as a frozen facial expression or eyelid droop. A conservative carefully-judged approach is best for natural-looking results.
Doctor Ha and the Dallas Plastic Surgery Institute
A graduate of the prestigious U.T. Southwestern Medical Center, Dr. Ha also received a fellowship in craniofacial and pediatric plastic surgery. A board certified plastic surgeon, he has extensive experience in cosmetic, reconstructive, and pediatric reconstructive surgery. He is particularly talented in combining technical expertise with aesthetic judgment for natural looking results. His practice in Dallas, Texas provides a relaxing and supportive atmosphere.