So we had a question in the office as to the pros and cons of each of the neuromodulators available in the United States. Botox, sold by Allergan, Dysport sold by Galderma, Xeomin sold by Merz. Dr. Levesque being the rocket ninja plastic surgeon scientist that he is decided on a blinded study with a N of 1 to evaluate the effectiveness of each of the products. We will start with Botox and Dysport, and then later possibly compare Botox to Xeomin and then Xeomin to Dysport.
Study design: Blinded direct comparison
End Points: Time to effect, Duration of effect, side effects, cost.
Day 1: Not much going on as far as noticeable differences. My upper lids are a little heavier from some very slight swelling of the eyelids themselves.
Day 2: There is certainly a sensation in the forehead that has been described to me as heaviness. I would consider it more muscle fatigue or ache. Nothing strong enough to take a tylenol for but certainly an awareness that there was a treatment. No external signs of issues. Can not tell a difference side to side.
Day 3: Fatigue is much better today but still noticeable. Not much external changes.
Day 4: It is getting very difficult to move the forehead now. Maybe some smoothness being seen in the forehead.
Day 5: There are some definite changes mostly centrally in the forehead and softening elsewhere.
Day 6, Noticed that right eyebrow moves higher on animation. Perhaps the left side is slightly quicker to act?
Day 7: Really don't feel any difference now on animating the face but there is certainly global softening in the forehead and crowsfeet area that is more noticeable in person than on these selfie photos.
Day 8: I can raise my right eyebrow slightly more than the left on maximal elevation. Otherwise not feeling or seeing clear differences between the sides.
Day 9: The right side can elevate brow significantly more than the left side. Presumably the effect is less strong on the right side allowing stronger elevation of the brow.
Verdict: In a very slight difference maybe the left side is slightly smoother than the right but this is very subtle. I expect the peaking of the right eyebrow to soften a bit or the next few days but if necessary will add 1 or 2 units above the peaked area. Will update and take some photos month out, 2 months out, 3 months out to monitor the duration.
So which side is BOTOX and which is DYSPORT?
With the resting photos there certainly is a smoothing and softening effect that is much more impressive in person than in these Iphone selfie photos. I'd say I notice the most difference at 8 days and after. What's even more impressive is the rate at which my hair grows. Time to get to the barbershop again!
AT MAXIMAL ELEVATION
What a difference and amazing how quickly when it comes to the forehead elevation or frontalis muscle. Can clearly see signs of working at day 3 and can see that in particular the left side of my face (right side of picture) is more effectively paralyzed. So on my right side we will probably put 1-2 units above the hyperactive frontalis to get better symmetry.
WITH MAXIMAL SMILING
The products appear to start working later than in the forehead area I can see better softening day 8 and definitely day 9. I think my left side is just a bit softer compared to the right side.
WITH MAXIMAL FROWN
So I have pretty strong corrugators and a deep furrow or a "1" but certainly some softening is seen really starting at day 8 and 9 but some weakness seen at Day 3 even with less movement lines. I probably could use a little more in this area. Not seeing a huge difference side to side here honestly.
So now at about 2 weeks after the injection our ladies in the office revealed which side was Botox and which side was Dysport. Botox was used on my left side (right side of picture) and Dysport on the right side of my face (left side of picture).
The units used were as follows:
Botox 15 units glabella (corrugators), 20 units forehead (frontalis), 12 units crowsfeet(orbicularis oculi)
Dysport 25 units glabella (corrugators), 40 units forehead(frontalis), 30 units crowsfeet(orbicularis oculi)
More to come in the coming months.
If you're looking for Botox, Dysport, or Xeomin in Austin Texas or surrounding areas consider coming to Devenir Aesthetics and one of our providers or myself would be happy to make recommendations for a softer and natural appearance.