Editorials

Botulinum Toxin A and Different Types/Manufactures

Many patients have recently been asking which type of Botulinum Toxin Type A is right for me. Some patients believe that “Dysport” is a new type of Botulinum Toxin Type A (produced by Medicis Corporation), however it is just a different formulation/mixture that has been available overseas for many years. “Botox Cosmetic” produced by Allergan Corporation is the most widely recognized and researched formulation in the United States and demonstrates wonderful efficacy and reproducibility.

Basically all botulinum toxins are not equally manufactured or formulated and are not interchangeable. For example “Botox Cosmetic” has a more uniform protein complex size and does not contain lactose.

Each formulation/mixture possesses different biologic properties. One study (J Am Acad Dermatol 2006; 55:975-80.) looked at dose and duration in a double-blind, randomized, parallel-group study and discovered that “Botox Cosmetic” achieved greater improvement of glabellar line severity (between the eyes) at maximal muscular contraction at both 12 and 16 weeks than “Dysport”.

So in conclusion “Botox Cosmetic” offered more prolonged efficacy (relaxation) of glabellar (frown) lines at the dose ratio of 1 “Botox” as compared to 2.5 of “Dysport” in this particular study.  This landmark research paper involved researchers from London, UK and Santa Monica, CA and looked at 62 patients with moderate or severe frown lines.

Due to the different formulation one cannot compare “potency unit for unit” between “Botox Cosmetic” and “Dysport”  as this is not possible as different manufacturing/formulations of each product exist, therefore, researchers looked and ratios instead.

“Botox Cosmetic” offers a more prolonged effect and higher levels of patient satisfaction than “Dysport” in the treatment of glabellar (frown) lines according to the above cited research paper/study.

For additional information on my unique extensive training including the completion of an Accredited Aesthetic Surgery Fellowship by the Aesthetic Surgery Foundation please visit: www.davidfellowsmd.com

David Fellows, M.D., M.F.A.
Plastic & Reconstructive surgery
Master of Fine Arts Figurative Sculpturing