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 botox near me 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 wh

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