• Used to be, when you asked a doctor for Botox, you got Botox.  That’s because Botox was first in the market and had no competition. But soon, that will change.  The FDA has approved Dysport®, a new anti-wrinkle injectible, also made from botulinum toxin.   When it becomes available, should you ask your doctor to make the switch, especially if it’s a little cheaper?That’s an important question, so let’s face the facts.

• Dysport  spreads  after it has been injected. This is both a good and a bad thing. The advantage is that if large areas (like your forehead) need injection, theoretically it requires fewer injections, thereby reducing discomfort. In my experience, however, this migration causes a dilution, so more units need to be injected– so we’re right back where we started.

The disadvantage is that unless your doctor is experienced and has a good understanding of complex musculature (around the eyes, between the eyebrows), Dysport could migrate  and cause blurred vision or sleepy  eyelids.  Those are some pretty devastating consequences–even if they last only 3-4 months, that can seem like a very long time.

Find out what other consumers are saying.  In one blog, only 11 people (out of 21) were pleased with Dysport.  Also read about what other physicians are saying about Dysport, and ask your physician to discuss it with you.

• The price of Botox is high, and competition may bring that price down.  Up until this time, though, Allergan (the manufacturer of Botox) has not felt the pressure.

• Dysport paralyzes the muscle, and becomes effective in about 2-3 days; Botox generally takes longer than that.

• The FDA requires drugs like Botox to carry a warning label, saying that the drug may spread from the injection site to distant parts of the body, and can have serious side effects, like problems with swallowing or breathing.  While anything is possible with botulinum toxin, problems are less likely with Botox Cosmetic. They’re of greater concern when Botox is  used to treat spastic muscles of the eyes, and other systemic usage.

• Once popular, Botox parties are now making a comeback.   The  hostess  usually gets her treatment for free, compliments of the doctor.  And the doctor hopes to meet some new clients. For him, it’s a marketing tool.  But for the patient, is it worth the risk?  Not in my  opinion.  The risk of complications is too high. Sometimes the “doctor” isn’t a doctor at all—it’s only a clinician.  For the patient, alcohol (even if it’s just a glass of wine!) and Botox don’t mix.  Doctors should give Botox injections under the right lighting and conditions, and in the privacy of their own office.

• If you are in a restaurant that serves only Pepsi-Cola®, and you order Coca-Cola®, your waiter is required to advise you of that distinction.  But that’s more of a trademark issue, than a truth-in-dispensing issue.  If you ask for Botox, and your doctor chooses to give you Dysport, should she be required to discuss it with you?

When it comes to Botox or Dysport, be careful and be informed.  Talk to your physician about it.