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  • Dr. Jean-Paul Azzi

Botox vs. Xeomin vs. Dysport

Botox vs. Xeomin vs. Dysport

One of the most common procedures Dr. Azzi performs is neuromodulator injections. Dr. Azzi is often asked a variety of questions about three top neuromodulators on the market: Botox, Xeomin and Dysport. Here are some of the most common questions that Dr. Azzi receives from patients.

Patient question: "How do neuromodulators like Botox work?"

Dr. Azzi: “BOTOX®, Xeomin and Dysport are all neuromodulators. They target the underlying causes of frown lines, crow’s feet and other wrinkles by temporarily preventing the movement of facial muscles. This reduction in muscle activity subsequently prevents the creation of lines between and around the eyes and on the forehead. If done properly, a brow lift can also be achieved simultaneously.”

Patient question: What’s the difference between Boxox, Xeomin and Dysport?

Dr. Azzi: “The main difference between Xeomin and Botox or Dysport, is that Xeomin contains just one ingredient: botulinum toxin A. Botox and Dysport contain additives, but Xeomin is a “naked injectable,” meaning that it does not contain any additives. A benefit of a pure-form injectable is that theoretically the human body is less likely to become resistant to it. Because of its lack of additives, it also does not need to be refrigerated whereas neuromodulators with additives require refrigeration. The manufacturing process is slightly different with all 3, which leads to some potential, subtle differences in clinical practice.”

Patient question: “When would you use one product over the other(s)? Does it depend on the individual, their desired result, the facial region, or anything else?”

Dr. Azzi: “Botox, Xemoin and Dysport all work essentially the exact same way. These are neuromodulators what help decrease the signs of lines and wrinkles and prevent the deepening of lines and wrinkles on the face from muscle movement. Many providers are now moving to Xeomin since it has no additives or preservatives. This "organic" Botox should have less chance of reactions.”

Patient question: “I've heard that you can build a tolerance to the protein in Botox or Dysport, but since Xeomin is “naked,” that problem doesn't exist, right? If that's the case, why wouldn't you always just use Xeomin?

Dr. Azzi: “I personally prefer Xeomin, but have never experienced tolerance in a patient. Theoretically, having fewer preservatives and additives should make Xeomin a safer choice compared to Botox and Dysport.”

Patient question: Is there a cost difference between the three?

Dr. Azzi: “The three cost practically the same amount. There are differences in ability to "keep" or store the product. Because Xeomin does not have preservatives, I tend to mix and use the vials immediately, whereas with Botox and Dysport, you can store them for many weeks. This adds to my cost because I occasionally have to discard Xeomin I don't use.”

Patient question: Do you use neuromodulators for anything besides crow’s feet, forehead lines, glabella, and eyebrow lifting?

Dr. Azzi: “There are some other uses for Xeomin and Botox. Many plastic surgeons inject them into the masseter muscle over the jaw to soften the area. It is also injected into the chin to prevent people from "pulling it back." It can also be injected above the upper lip in the orbicularis oris muscle to prevent pursing. That being said, these Botox or Xeomin injection sites can be a little less predictable than the ones mentioned in the question.”

Patient question: Does one product last longer than others? How often do people need to come back for more?

Dr. Azzi: “Typically the products all last the same amount of time. I tell people that the first time it will probably last 3 months, but after several injections, the muscles will atrophy since they are not being used and flexed as much, so it can last longer. Some people I have been injecting for years only come every 5-6 months.”

Patient question: What are the risks of using neuromodulators?

Dr. Azzi: “If done improperly, Botox, Xeomin, and Dysport can cause brow ptosis. This is essentially a droopy brow that makes people pretty unhappy for about 3 months. I often have people come in from a med spa, dentist, OB GYN etc. for me to fix the problem, but there are only a couple little tricks I can do to help the droop. Mostly, they have to wait for it to wear off on its own. Other risks are local reaction such as a little red spot where the needle pokes someone. There have been reports of eyelids actually drooping, but I have never seen this. The product would have to be injected into the eyelid for this to happen. Always trust your face to a specialist and get it done right the first time.”

Patient question: Is there any difference in post-treatment care between the three products?

Dr. Azzi: “I usually tell people to avoid vigorous exercise for about three hours after. Some doctors tell patients to massage their faces, some tell patients to not touch their faces. I don’t think any of that matters if the injection is done in the proper areas (facial muscles) and in the proper doses.”


If you’re thinking about having any treatments to rejuvenate your appearance or to remove any fine lines or wrinkles, we welcome you to make an appointment with Dr. Azzi at one of his offices in Jupiter or Palm City, Florida.

Please call us at (561) 429-5403 or click here to contact us. We serve patients in the following South Florida areas and beyond: Jupiter, Palm Beach Gardens, Palm Beach, West Palm Beach, Tequesta, Hobe Sound, Stuart, Palm City, Jensen Beach and Vero Beach. Live somewhere else? Click here.

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