Botox, Dysport and Xeomin! Which is best?

Botox Dysport Xeomin by NYC Plastic Surgeon Dr Nicholas Vendemia of MAS | Manhattan Aesthetic SurgeryThere’s a new player in the Botox game… Xeomin!

The list of competitors to the game leader, Botox, is growing, but are any of the new products actually better? Or are all the new choices just making it more confusing?

Continue Reading to learn more about Botox, Dysport, and Xeomin!


  1. What is Botox? Botox is the gold standard for softening frown lines, forehead wrinkles and crow’s feet. It’s a great product as long as it’s being injected by a qualified practitioner who is experienced in all the art of the procedure. It’s a very safe product, and the incidence of side effects and complications is extremely low in the hands of an experienced injector.
  2. How long does Botox last? On average, Botox lasts 4-6 months. Some people can get as long as 8 months, and some only get 2 months, but on average it’s a procedure you’ll need about 2-3 times a year. New research is suggesting that after about 2 years of regular Botox usage, the product may start lasting longer… good news for all the Botox veterans out there!
  3. How long until Botox starts working? Botox reaches it’s full effect after about 7 days, but you’ll notice a difference starting around Day 3. You will not notice any results immediately after the procedure.
  4. How much does Botox cost? Most experienced injectors charge between $12 and $20 per unit. The average dose for a woman is 25-40 units, and for a man it’s 40-60 units. This means that a woman can expect to pay $400-600, and a man can expect $750-1000. Some practitioners charge by “area” rather than by the unit, and in most cases, this winds up being much more expensive. You should be very cautious about prices that are significantly lower that this because there’s a very good chance that you’ll be injected by an inexperienced or unqualified person, or you’ll be getting a counterfeit product! Both of these things happen quite frequently in settings outside of physician’s offices, so be careful about medi-spas and other locations that offer rock bottom Botox prices… you might save money, but you might be sorry you did…
  5. What else should you know about Botox? Botox is the priciest of the group, but in my opinion, you get what you pay for. It’s a very good product that produces consistently outstanding results with a very low incidence of problems. Counterfeit Botox sold over the internet is becoming more and more of a problem though, so you need to be careful about where you have the procedure done. “DIY” Botox kits are turning up now too, and they are leading to more and more complications… don’t DIY!!!


  1. What is Dysport? Dysport is the leading competitor to Botox right now. The company claims that it lasts longer and starts working sooner, but for the most part, those claims are unsubstantiated and “proven” only by research sponsored by the company itself.
  2. How long does Dysport last? Long story short, it lasts about the same amount of time as Botox (4-6 months).
  3. How long until Dysport starts working? Again, long story short, it also takes 3-5 days to start working… just like Botox. One difference that is notable though is that people often describe the sensation that occurs when Dysport kicks in as more “harsh” than Botox. Some patients says that it “feels uncomfortably numb” or that it “feels like I got slapped in the forehead”. Sensations like this aren’t as common with Botox.
  4. How much does Dysport cost? On first glance, cost seems to be the main advantage of Dysport over Botox… but, there’s a catch! You’ll see Dysport advertised at $4-6 per unit which sounds like a winner compared to the $12-20 per unit price of Botox. The problem is that the units are totally difference for Dysport. Instead of a average dose of 25-40 units for a woman getting Botox, a woman getting Dysport can expect to pay for 60-100 units of Dysport. $4-6 per unit sounds too good to be true? Guess what… it is.
  5. What else should you know about Dysport? The main problem with Dysport is that the area of diffusion (how far it spreads after the injection) is too large. Experienced injectors put the product exactly where it needs to be, but if it diffuses too far, it can affect muscles that weren’t meant to be treated, and that can cause problems like “frozen” looks and eyelid droops. Not good! I see a large number of people in my practice who have had “bad Botox” done somewhere else. After I speak with them for a while, 9 times out of 10, the product that they received was Dysport, not Botox. Because of this, I’ve chosen not to use Dysport at all. Yes, it is slightly cheaper, but I think you get what you pay for.


  1. What is Xeomin? Xeomin is the newest FDA-approved product that will likely be available in the US in the spring of 2012. There aren’t many details yet on the main differences of Xeomin versus Botox and Dysport, but so far the only known advantage of this product is that it doesn’t need to be refrigerated before use. If this doesn’t sound too exciting to you, don’t worry… it’s not. This only helps the physician, not the consumer.
  2. How long does Xeomin last? We’re still waiting for more information on this, but chances are that it will be… you guessed it… 4-6 months.
  3. How long until Xeomin starts working? Again, the jury is still out here.
  4. How much does Xeomin cost? Initial reports suggest that Xeomin will be cheaper than Botox, which would be great as long as it’s equally effective and safe.
  5. What else should you know about Xeomin? We’re not sure yet, but if you subscribe to, you’ll be sure to find out as soon as we do!

The Bottom Line

Remember the old adage, “If it’s not broken, don’t fix it.”? I think this is a perfect description of the Botox situation right now. Botox is still the gold standard for treating wrinkles, and as long as you’re getting injected by someone who has mastered the procedure, you’re going to have a consistently great result with very little chance of problems. If Xeomin ends up working just as well as Botox, and ends up being cheaper, than it just might be something to think about. In the meantime, Botox is the way to go.

Botox by Manhattan Plastic Surgeon Dr Nicholas Vendemia of MAS | Manhattan Aesthetic Surgery

New York Plastic Surgeon Dr Nicholas Vendemia MD of MAS | Manhattan Aesthetic Surgery Plastic Surgery New York Plastic Surgeon NYCNicholas Vendemia, M.D.
Plastic Surgeon, New York City
MAS / Manhattan Aesthetic Surgery

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Filed under Botox, Dysport, Xeomin

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