No two faces move the same way, and neurotoxin brands are not interchangeable like soda flavors. If you have ever left an appointment wondering why your frown lines softened faster one visit and your crow’s feet looked crisper the next, you have already experienced how product choice and technique shape outcomes. Botox, Dysport, and Xeomin are proven tools with overlapping uses, but their subtle differences matter. As a clinician who has injected thousands of units across all three brands, I weigh those differences every day to tailor natural results for real, expressive faces.
What they are, and what they are not
Botox, Dysport, and Xeomin are all botulinum toxin type A. Each brand works by blocking acetylcholine release at the neuromuscular junction, which reduces muscle contraction. That quieting effect softens dynamic wrinkles like forehead lines, glabella lines between the brows, and crow’s feet beside the eyes. In therapeutic contexts, the same mechanism helps with jaw clenching, migraines, and excessive sweating.
They are not fillers, and they do not add volume. Neurotoxins relax; fillers restore structure. If someone wants a fuller lip body or a sharper cheekbone, we reach for hyaluronic acid fillers. If the goal is smoothed frown lines, a subtle brow lift injection, or a lip flip treatment to show less gum when smiling, neurotoxin is the right tool.
Similarities that keep the playing field level
All three are FDA approved for at least the core cosmetic areas and have strong safety records when used appropriately. Typical onset happens within several days, with peak effect around two weeks. Results last in the range of three to four months for most patients, though heavy movement patterns or high-intensity exercise can shorten that window. Side effects are similar across brands and usually mild: fleeting redness, pinpoint bruising, a brief headache, or temporary eyelid heaviness if a dose diffuses into the wrong plane. Dose, dilution, depth, and injector skill drive most outcomes more than the brand name on the vial.
Where they diverge: formulation and performance
The chief difference lies in formulation. Botox (onabotulinumtoxinA) and Dysport (abobotulinumtoxinA) contain complexing accessory proteins alongside the 150 kDa neurotoxin. Xeomin (incobotulinumtoxinA) is purified to remove those accessory proteins, leaving only the active neurotoxin.
Do the added proteins change clinical results? In daily practice, I see three implications.
First, diffusion character. Dysport tends to spread a bit wider per unit based on clinical feel and several head-to-head studies. That can be useful in large, flat muscles like the frontalis of the forehead or the platysma bands in the neck. It can be a liability in tight corridors such as the glabella near the levator palpebrae or in small perioral targets during a botox lip flip. Botox sits in the middle with a predictable spread that most injectors learn on. Xeomin often behaves slightly more focal, which can be an advantage when we want to keep activity in adjacent muscles, like shaping a brow without lowering it.
Second, immunogenicity risk. While clinically rare, some patients who have had very large lifetime doses for therapeutic indications or frequent short-interval cosmetic dosing may develop neutralizing antibodies that reduce response. Because Xeomin lacks accessory proteins, some clinicians select it for patients who worry about antibody formation or who report waning response to other brands. High-quality data suggest antibody-related resistance is uncommon in routine aesthetic dosing, but technique still matters: avoid unnecessary booster visits and keep reasonable intervals.
Third, unit economics and conversion. Units are not 1:1 across brands. In my practice, one Botox unit roughly equals one Xeomin unit in clinical effect, while Dysport often needs a higher number of units to achieve the same result, depending on the area. That does not make Dysport more expensive at the end of the day because pricing per unit is typically lower. What matters is cost per result in a given face. Ask about both unit count and expected price for your goal rather than chasing the cheapest unit.
Choosing for specific goals
Frown line botox in the glabella responds predictably to all three brands. If a patient has a history of heavy frown and sensitive lids, I might favor Botox or Xeomin for a crisp, contained effect. For someone with robust procerus and corrugator strength, Dysport can soften the whole complex efficiently with fewer injection points.
Forehead botox is where spread becomes a friend or foe. The frontalis is a broad, thin elevator with variable patterns. A small-muscled forehead in a petite woman often does well with carefully mapped micro-aliquots of Botox or Xeomin, which allow me to preserve lateral lift and avoid a flat brow. A larger forehead with deep horizontal lines may benefit from Dysport’s wider field. Either way, the art is in balancing relaxation so the brow does not drop.
Crow’s feet botox around the eyes is delicate. Lateral orbicularis oculi fibers sit near the zygomaticus muscles that lift the corners of the mouth. I choose tighter, smaller blebs with Botox or Xeomin when I want to protect an already low cheek. In a robust, high cheek with strong squint lines, Dysport distributes beautifully and sometimes looks more airbrushed in photos at two weeks.
A subtle botox brow lift relies on shaping rather than fully weakening the frontalis. Tiny doses along the lateral brow tail elevate the arch by reducing the pull of the depressors. Precision matters. Xeomin or Botox in small aliquots gives me the control to avoid asymmetry. With Dysport, I adjust my dilution and stay extra superficial.
The botox lip flip is another precision play. For a natural look botox along the vermilion border, where we want just a few units to evert the upper lip without lisp or sip difficulty, I reach for Botox or Xeomin. Dysport is still an option, but I adjust dose and placement. For a gummy smile treatment in a strong elevator of the upper lip, any of the three can work well with correct mapping.
Masseter botox for jawline contouring and for jaw clenching or teeth grinding is its own world. This muscle is thick and layered. Dysport’s wider spread can simplify coverage when the masseter is broad, but Botox and Xeomin are equally effective with proper depth and grid. For patients seeking botox for masseter reduction to slim the lower face, I schedule at least two to three sessions spaced three to four months apart to remodel the muscle gradually. If a patient also has TMJ pain, dose, placement, and medical history guide the choice more than brand.
Neck band botox in the platysma requires thoughtful diffusion. Bands vary in width and strength. Dysport can soften broad bands efficiently. Xeomin or Botox let me confine treatment to the most visible cords and preserve lateral support. For necklace lines, neurotoxin is limited and often pairs with skin boosters rather than serving as a standalone solution.
Hyperhidrosis botox for underarms relies more on total active toxin than on brand identity. I have treated excessive sweating successfully with all three. Dysport can be cost effective for large grids; Botox and Xeomin are excellent as well. Palms and soles are more painful and may require nerve blocks, but the life quality improvement is substantial.
Migraine botox protocols use mapped injection patterns approved specifically for onabotulinumtoxinA. That is a context where brand substitution is not straightforward. Patients who respond to migraine botox should stick with the studied product and dosing schedule unless managed by a specialist.
How brand choice interacts with technique
The best outcomes flow from matching brand behavior to the plan of action and the patient’s anatomy.
Dilution and droplet size influence how far a dose travels. For microbotox or a botox facial, where we aim shallow into the dermis to refine pores, suppress sweat and oil, and slightly reduce fine crinkling, I use higher dilution regardless of brand and keep doses tiny. That protocol improves texture and can make makeup sit better, but it does not lift, so I never promise a replacement for volume loss or laxity.
For baby botox or preventative botox in younger patients with early expression lines, I prioritize conservative dosing and longer follow-ups to see how their musculature settles. Spacing botox sessions at sensible intervals prevents overtreatment and reduces the blunted look that happens when too many areas are frozen at once.
Depth and vector matter. A frown line injection that rides too high risks brow heaviness. A crow’s feet injection that dips too far forward can dampen the zygomatic smile. An underarm botox grid that misses the hair-bearing zone leaves islands of sweating behind. Accuracy trumps brand.
Onset, feel, and duration
Patients often ask how long does botox last and how soon they will see botox results. Across brands, onset starts at about 2 to 5 days, with peak at 10 to 14 days. Dysport sometimes feels faster in the first 48 to 72 hours. Xeomin and Botox feel similar in ramp-up. Duration hinges on muscle size, metabolism, dose, and activity level. For most facial areas, expect 3 to 4 months of meaningful effect. Heavy exercisers and expressive speakers may see 2.5 to 3 months in high-motion areas like the forehead, while masseter botox often lasts 4 to 6 months due to the muscle’s different architecture.
Some patients report that Dysport seems to wear off faster or that Xeomin feels softer. The pattern is not universal. When I track botox timeline data in a patient’s chart, I find that consistent placement and dosing predict longevity more than the label. If results seem to shorten, we discuss lifestyle, stress, and any interval under 12 weeks, then consider a modest dose adjustment.
Safety profile and side effects
Botox safety across all three brands is well established when administered by trained injectors. Common botox side effects include transient redness, small bruises, mild swelling, or a brief ache at injection sites. Headaches are reported by a small fraction of first-time users. Rare events include eyelid ptosis, double vision, or asymmetry, typically from diffusion beyond the target. These issues almost always resolve as the product wears off. Having a plan to manage side effects is part of good care: follow-up checks, tiny touch-ups where appropriate, and realistic expectations about the botox recovery window, which is typically minimal.
Botox risks increase when injections occur in nonmedical settings, with poor hygiene, or from counterfeit product. Verify the setting, credentials, and that your injector reconstitutes from a sealed, branded vial. Cheap botox options can be legitimate promotions, but extreme discounts should raise questions. A higher price does not guarantee better results, yet expertise and medical oversight do cost money.
Planning your appointment and timeline
The botox appointment is brief, usually 15 to 30 minutes for cosmetic botox. A good botox consultation covers your muscle patterns at rest and in motion, medical history, previous botox injections, product options, and the look you want. For botox for men, dosage often scales up slightly due to stronger muscle mass, but the goal remains a natural, rested look. For botox for women, preserving expressiveness around the eyes and mouth is the priority. Everyone gets a tailored map.
Expect tiny needle pricks, pressure rather than pain, and occasional watery eyes near the crow’s feet zones. Post treatment, avoid heavy workouts, saunas, face-down massages, or pressing on treated areas for the first day. Stay upright for several hours and skip hats that squeeze the forehead if that area was treated. Makeup can be applied gently after a few hours.
Most practices schedule a two-week follow-up for first-time botox to assess symmetry and function. Small adjustments doctorlanna.com botox new York fine-tune results, especially around the brow and upper lip. After you build a track record, many patients skip the check unless something feels off.
Cost, value, and how to compare offers
How much is botox depends on geography, injector expertise, and area treated. Many clinics price by unit, while others price by area. In the United States, per-unit pricing for Botox or Xeomin often sits around 10 to 18 dollars. Dysport units are usually cheaper, but you may need more units, so the final botox price can be similar. A glabella area might range from 200 to 400 dollars, forehead from 120 to 300, crow’s feet from 180 to 360. Masseter botox runs higher due to volume. Hyperhidrosis botox for underarms is a larger investment but typically lasts longer.
Botox deals and botox specials are common around holidays or during clinic events. Look beyond the sticker. Ask who injects, what product is used, how many units are included, and whether a follow-up is part of the package. The best botox for you is the one that matches your anatomy and goals, delivered by someone who can say no to overtreatment. Top rated botox clinics earn that status by results and consistency, not by a single low-price day.
Where fillers fit, and when neurotoxin is not enough
Botox vs fillers comes up daily. Softening movement lines with neurotoxin versus restoring volume and structure with filler are complementary moves. A deep, etched line that persists at rest may need both: anti aging botox to calm the muscle and a microthread of filler to lift the groove. Forehead lines that sit in a very low brow can be risky to chase with heavy neurotoxin because too much forehead relaxation drops the brow further. In those cases, a conservative plan that includes brow support, skin quality work, or energy-based tightening makes more sense.
For chin dimpling botox, relaxing the mentalis smooths pebbled texture and can lengthen a short chin slightly. Paired with a touch of filler, it often finishes beautifully. Platysma botox in the neck can soften vertical bands, but horizontal rings need a different strategy. Matching the tool to the problem saves time and avoids that slightly off, overprocessed look.
Designing a natural result
Natural look botox happens when the face keeps its language. We preserve positive expressions and reduce the tension that reads as stress or fatigue. It is common to combine areas in a single session, yet restraint yields better facial balance. Treating the glabella without addressing a heavy lateral brow can make the outer brow look dragged. Doing only forehead lines in someone with strong corrugators can lead to that odd central crease. I often map forehead, frown, and crow’s feet together, then use tiny additional points for a gentle botox brow lift if needed.
Beginner botox patients benefit from smaller starting doses and a follow-up adjustment. People who speak, teach, or perform want to retain certain expressions; we protect those movements deliberately. If you want to look less stern on video calls, glabella botox offers one of the highest returns. If photos catch thin, crinkly smiles, eye wrinkle botox placed carefully provides grace without dulling joy.
What to expect across the first month
In the first 24 hours, you may see little red bumps that settle quickly. Light pressure headaches sometimes appear on day one or two, then pass. By day three to five, the treated area begins to feel steadier. Small tasks like raising brows or squinting may feel different. Around day seven, you see your outcome take shape. At day fourteen, what you see is what you have for the next several weeks. This botox healing time is short, which is why it fits into busy schedules.
If a brow peak feels too sharp or a line still shows, a touch-up at two weeks can adjust the balance. If you plan events, schedule injections two to three weeks before photos so skin has time to settle and any microbruises fade.
Frequency and maintenance
Most people repeat botox treatment every three to four months. Some stretch to five when lifestyle and dosing align. I caution against booking sooner than 10 to 12 weeks unless there is a compelling reason. Muscles need time to cycle; too frequent dosing may invite diminishing returns. Long-term patients often report that lines return more softly after several cycles, which lets us reduce doses or extend intervals. This is particularly true for frown line botox, where habitual scowling eases.
For botox for pores or microbotox, the effect on texture and shine may last eight to twelve weeks. Hyperhidrosis botox for underarms can last six months or longer. Masseter reduction typically requires a series to reshape, then maintenance every six months or more.
Matching brand to patient stories
A distance runner in her thirties with etched forehead lines wanted smoother skin without a heavy brow. We used Xeomin in micro-aliquots across the upper third, Botox for the glabella, and left the lateral frontalis more active. At two weeks she kept her expressive eyes and lost the photo-highlighted creases.
A TV anchor with on-air squint lines and under-eye crinkle preferred a fast onset before a shoot. Dysport around the lateral eyes and a tiny lift at the brow tail cleaned up the frame by day three. We stayed superficial and measured to avoid flattening her cheek smile.
A bruxer with hypertrophic masseters and jaw pain tried onabotulinumtoxinA first, then switched to Xeomin for the third session after reporting slightly shorter duration. With adjusted mapping and dose, his jawline slimmed over six months and morning headaches faded. Product change helped, but the bigger shift was consistent spacing and a proper muscle grid.
When to avoid or delay injections
Neurotoxin is a medical procedure. Postpone if you have an active infection, a cold sore outbreak in the target zone, are pregnant or nursing, or have a neuromuscular disorder without specialist clearance. Discuss medications that affect bleeding or neuromuscular function. If you recently had facial surgery or deep resurfacing, coordinate timing with your surgeon. For first time botox before a major life event, test several months ahead to learn your response and dial in the plan.
The procurement question and why it matters
Supply quality governs safety. Authentic vials have lot numbers and come via official distributors. Reconstituted product should be clear, not cloudy, and mixed with preservative-free sterile saline or, in some practices, bacteriostatic saline. Techniques differ, yet transparency is nonnegotiable. Ask what brand is used for each area, how many botox units are planned, and what outcome the injector expects at two weeks. These are reasonable, informed questions.
A brief, practical comparison
- If you want the most studied brand with a broad track record and reliable, contained spread, choose Botox. It is the default in many practices for glabella, crow’s feet, and precise brow work. If you prefer a slightly faster onset and broader diffusion, especially for large muscles like the frontalis, platysma, or masseter, choose Dysport. Expect a higher unit count with similar overall cost. If you want a purified option without accessory proteins or you value pinpoint placement for delicate shaping, choose Xeomin. Unit for unit, it behaves close to Botox with a clean feel.
Frequently asked, answered real
How many units of botox do I need? It depends. Typical ranges: glabella 15 to 25 units of Botox or Xeomin, crow’s feet 8 to 16 per side, forehead 6 to 20 depending on brow position and muscle pattern. Dysport requires higher numbers to achieve equivalent effect, often about 2.5 to 3 times by unit count, adjusted by anatomy.
Can botox for migraines be combined with cosmetic areas? Yes, but coordinate with the neurologic protocol. We avoid stacking extra doses over the same muscles on the same day if it would exceed safe totals. Communication between providers prevents overlap.
What if I hate the result? Neurotoxin is temporary. As movement returns over weeks, most issues resolve. In the meantime, skillful counterbalancing can help in some cases, but patience is the cure.
Does botox for men differ? The principles are identical. Men usually need higher doses to calm thicker muscles and often want very subtle changes. Mapping and language shift to match goals: less tired or angry, not smoother at all costs.
Can botox be preventative? Yes. Preventative botox makes sense for strong expression patterns that are starting to etch lines at rest. Conservative dosing spaced appropriately is the key to avoiding a frozen look.
The bottom line for real faces
Botox, Dysport, and Xeomin are excellent options for botox for wrinkles, botox for forehead lines, glabella botox, and crow’s feet botox, and for targeted medical uses like botox for sweating or tMJ botox. No brand wins every scenario. Product choice, dose, dilution, depth, and the injector’s eye for balance decide whether you look rested or unnatural. If you are new, start with a thoughtful botox consultation, bring photos of your best expressions and the lines that bug you most, and ask how your provider will keep you expressive. If you are experienced and curious about switching brands, focus on a single area first, log your onset and duration, and adjust based on data, not anecdotes.
Natural results come from restraint, precision, and respect for how your face communicates. Pick the right tool, paired with a plan that fits your anatomy and your life, and you will understand why these small injections remain the most productive minutes many patients spend on their appearance all year.