Dr. Jo Herzog, M.D.
Last week, we began discussing Jamie’s experience with three Medicis injectables that we demonstrated at a recent “Lunch & Learn” event. I used Jamie’s experience to show how I evaluate all my patients and discuss their needs and options with them.
Although the products used on Jamie were chosen because I was doing a demo with the Medicis company, I consider some of these my favorites and use them regularly. Still, when consulting with other patients, I will offer them other treatment options along with these.
Today, I will focus on dysport, one of the first drugs used on Jamie during the event. Dysport is one of the “toxins” that can correct wrinkles that occur as a result of facial movement or expression (as opposed to wrinkles that are always present, movement or not). I will discuss dysport alongside its well-known competitor botox.
Dysport and botox are both toxins used for similar purposes. Botox has been around longer, so most people have heard of it, and many have used it. Botox was the first in this category (botulinum toxins) to become popular in the United States. All of the drugs in this category are locally acting “toxins” made from botulinum bacteria. They act by blocking the release of acetylcholine from the neuron, thus preventing the muscle from being stimulated to contract (the contraction, or movement, causes the wrinkling). For many years, these drugs were used for other purposes, such as treatment of strabismus and spasms of large muscles, before ever being used for cosmetic purposes.
Although botox was the first kid on the block, others such as dysport have come along that are equally good for the same purpose. Some physicians use botox and dysport interchangeably, but I think that there are subtle differences that should be weighed based on each individual. However, most people do equally well with either drug if the person injecting them is highly experienced.
There is one good study that I am aware of that has shown dysport to do a better job around the eyes. However, these studies have many variables. A study could come out at any time showing botox to be superior in some way. In my opinion, both drugs are excellent choices.
A new product, xeomin, should be available soon and will be very much like the other options available now. Xeomin was available for a short time but pulled for non-medically related reasons. Produced by the drug company Merz, it will be similar to the other toxins. One difference that that we doctors will be aware of is that xeomin does not require refrigeration in shipping or prior to being used.
Many patients ask about the pricing for botox and dysport, and for the most part, it ends up being very close. But since units of dysport are not equal to units of botox, you can’t compare price unit to unit.
Most doctors use 2.5 to 3 units of dysport to every unit of botox that they would have used. I typically use a ratio of 2.5:1. Prices vary around town and from region to region, but for the most part you will pay a similar price if you go to an experienced injector.
My charges are $5 a unit for dysport (I have seen some offices as low as $4 and some higher) and $12 a unit for botox. (I have seen this as low as $10 and as high as $15). However, be aware that different injectors might use different amounts to do the same job, so you must be an educated consumer. This is not the place to look at saving $50.
Some wonder if there is a downside to these drugs. Other than time and money, the side effects are minimal. Very few patients complain of a headache after injection. Serious complications are quite rare.
One undesirable effect some patients might experience is brow heaviness or lid drooping. Some of this depends on your face and some on injection technique. It can happen to anyone anywhere, but your chances of doing well are best with an experienced injector.
What about a “deal” on botox or dysport? Everyone wants one, but buyer beware. There are deals, but there are also “no deals.” A deal can be found if the drug manufacturer offers a rebate. In this case, you purchase the amount of drug you need and get a rebate of X number of dollars if you follow instructions on the rebate form. This usually requires submitting the form along with reciept from the physician’s office.
On the other hand, if it is a “buy one area for X dollars” deal, you better do your homework. How much will it cost you to finish the job once you are there? How will you feel leaving with one area taken care of and walking out? How many UNITS is an “AREA”????? Do not be afraid to ask, as a $99 bargain can set you back several hundred dollars. Also, do not feel obligated to have anyone talk to you about other treatments when you come in. NOBODY IS GIVING YOU BOTOX FOR $99 FOR NO REASON. Be careful.
All that being said, this is a wonderful, easy fix for wrinkles that lasts an average of three to four months. Most patients agree with Jamie that it involves very little discomfort. Most patients are so pleased with the results that they once they try it, they would never go without it.
Remember, you can always submit questions to me in the Family Savvy comments section. I would love to hear from you.