Indiana Plastic Surgery Blog

More than 100,000 patients have reportedly taken the “Dysport Challenge” since Medicis started the offer in March 2010, and with only one month before the program expires, consumers are starting to wonder on which side of the Botox vs. Dysport debate both public and expert opinion will fall.

The Dysport Challenge is a promotional offer designed by Medicis, the manufacturer of the wrinkle-relaxing injectable Dysport, to pit their new botulinum type A product against the long-standing wrinkle reduction king Botox, which is manufactured by Allergan.

After patients have received Dysport injections to reduce forehead creases, frown lines or crow’s feet, the Dysport Challenge asks them to indicate whether they are satisfied with the outcome of their injections by selecting a positive “Love It” response, or if they are dissatisfied and wish to trade Dysport for its competitor Botox by selecting a negative “Leave It” response.

Patients enrolled in the program would receive a total of $150 in rebates on two Dysport treatments if they choose the “Love It” selection, whereas patients who choose the “Leave It” selection and opt for Botox injections during their next wrinkle treatment session would still receive a $75 rebate.

Medicis has previously reported that of all the patients who have registered for the Dysport Challenge thus far, only 2.6% have made a selection to “Leave It” since the program was launched.

Although the majority of Dysport patients have responded positively to the treatment according to Dysport Challenge results, this does not necessarily indicate that most patients preferred Dysport over Botox, only that they are happy with Dysport results.

Similarly, the Dermatology Times reports that expert opinion has not clearly swayed in favor of either Dysport or Botox, largely because physicians are still learning the nuances of administering the new product.

“Most of your problems and disappointments will occur in your first 100 cases because you’re still learning,” says Ontario dermatologist Dr. Kevin Smith.

The newness of Dysport is still a factor for experts in assessing its performance as compared to Botox, and other than obvious differences in the chemistry and ratio of unit measurements between the two products, the only other purported difference is that Dysport may have a tendency to spread or migrate more than Botox after injection.

Some physicians find it likely that injector preference for Botox or Dysport will be determined not by differences in the two products, but differences in the doctors’ loyalties to the product manufacturers and comfort level using one product over another.

Regarding the Botox vs. Dysport debate, Nashville dermatologist Dr. Michael Gold commented that Dysport data shows no difference in migration tendencies as compared to Botox “depending upon whose study you read,” and added, “If you’re experienced enough with Dysport, the spread factor is a nonissue.”

“There’s a major tug-of-war going on between physicians who utilize those toxins,” Dr. Gold said.  “Depending on whose team you’re on, your statements will generally favor that toxin over another.”

First quarter earnings for Allergan, maker of Botox, are way up. Second quarter forecasts, according to the Wall Street Journal, are way ahead of expectations.

Given the statistics just released by the ASPS, their success shouldn’t be all that surprising. According to the society, minimally invasive procedures have increased an incredible 99 percent since 2000.  Topping the list are wrinkle fillers and botulinum toxin injections, two treatments in which plastic surgeons will likely reach for an Allergan product.

Image courtesy of the ASPS

For Allergan, being on the cutting-edge of aesthetic medicine also doesn’t hurt. New products like Juvederm Ultra XC and Latisse are getting plenty of attention right now, which should only increase consumer demand for these cosmetic procedures.

The FDA just expanded clearance for Botox, approving the drug to be used as a treatment for spasticity in muscles of the elbow, wrist and fingers. Such conditions occur frequently after a stroke, injury or debilitating disease.

They specified that Botox treatment should not be considered a substitute for physical therapy or the “usual standard of care rehabilitation regimens.”

It seems that treatment applications for Botox are continually expanding. While Botox is best known for cosmetic usage — typically the treatment of forehead wrinkles or “frown lines” –there are several therapeutic treatments now being offered by physicians today. Excessive sweating, cervical dystonia and muscle spasm are just a few of those alternative treatments.

• Botox in Munster, Indiana
• More information from the FDA

By now, doctors have established that Botox can help smooth out facial wrinkles and folds, but is that all?  Experts once believed that off-label use of the drug – one originally developed for treating muscles spasms – would be fairly limited. If you do a little research at the present time however, you’ll hear of physicians using Botox many interesting purposes.

Doctors use Botox to treat headaches, and their basic procedures are very similar to wrinkle treatment. It hasn’t been explained just how the Botulinum toxin provides relief; it may work to inhibit certain pain-transmitting nerves. Nonetheless, many people suffer from fewer headaches after being treated with Botox.

Last March, the New York Times published a story on the off-label use of Botox to help those who have suffered a stroke and have trouble relaxing certain muscles. According to the experts, “only about 5 percent of the stroke patients who could benefit from its use ever get it.”

As reported in the Journal of the American Academy of Dermatology, researchers from Allergan Inc. conducted surveys about sweating, revealing that almost 3 percent of the U.S. population (7.8 million people) believe their sweating to be excessive. At the time of the survey (in 2004), less than half of the respondents had sought medical help for the problem. Botox blocks the localized release of a specific chemical that stimulates sweating, and so the FDA approved it for this use years ago.

Aside from these therapies, surgeons and dermatologists are finding even more cosmetic uses for Botox. Dr. Lawrence Reed recently told an ABC news affiliate that “we’re at the tip of the iceberg where Botox is going to be used.” Reed has apparently been pioneering some interesting new cosmetic applications.

For acne, Dr. Reed injects Botox just below the skin: “It decreases the muscle pump and blocks the production of oils, so we use it for acne,” he claims. Other patients of Dr. Reed found success using Botox to relax certain muscles and actually make their eyes appear larger, and to supplement laser skin resurfacing.

Just a few words of caution: If you’re considering Botox for any off-label use, make sure you choose a qualified physician. Despite the optimism surrounding Botox as a ‘wonder drug’, there have been complications and side effects associated with off-label use and inexperienced providers.

A survey conducted by researchers from the American Society for Aesthetic Plastic Surgery (ASAPS) has given us some insight about patients who choose wrinkle treatments. Researchers sent questionnaires last March to 687 patients who had received Botox and/or dermal filler treatment. 

The following statistics illustrate the opinions of the ‘typical’ patient. Who is the ‘typical’ patient?  According to surveyors, she’s “a married, working mother between 41-55 years of age with a household income of under $100,000.”

70 percent of the respondents claimed that Botox and dermal fillers play an important role in their cosmetic routine and about the same number of patients said they had combined the two.

When asked what their motivation was for pursuing Botox treatment, 34 percent said their appearance looked “stressed” or “angry”. Others said that a friend, family member, or their physician had recommended it, or they were preparing for a social event. 66 percent said they received Botox treatment 2-3 times per year. 72 percent of the respondents chose Botox to treat glabellar lines – the vertical lines that appear between your eyebrows.  

When asked about their motivation to use hyaluronic acid fillers, the majority (63 percent) of patients reported a desire to remove facial wrinkles and folds – mostly the nasolabial folds that travel from the nose to each side of the mouth.

A full summary of the results is available (in MS Word) here.

Archives of Facial Plastic Surgery recently published a study featuring a medical performance and safety evaluation of Dysport, the new wrinkle-reducing, Botox alternative, marketed by Medicis Pharmaceutical.  The study focuses on use of Dysport for treatment of moderate to severe glabeller lines (forehead wrinkles), and the results appear mostly optimistic.

The FDA has given clearance for the drug, and it should become available very soon.  Dysport is being introduced by Medicis with the hope that it will be a direct competitor to Botox – a product that allowed Allergan Inc. to net $1.3 billion in revenue last year.

A dermatologist out of California who participated in the study commented to Bloomberg news, saying “the side effects are the same as Botox” and “many of our patients liked it even better.”

The active ingredients in Botox and Dysport are very similar; they each contain a particular ‘botulinum toxin’ that has been proven to relax the muscles that cause wrinkles in the face.

Few people may realize that Dysport has been sold overseas for years.  Nonetheless, Botox has claimed over 80 percent of the worldwide market.  One market analyst speculates that “[Dysport] may be priced 15 percent lower than Botox” which could allow it to take a significant share of that market.

Indiana Plastic Surgery is pleased to announce a Botox Cosmetic and Juvederm facial filler seminar on June 19th from 6:00 – 8:00 pm at our Munster office. Bring a friend and receive a discount on Botox or Juvederm injection treatments. Click here to register for this event now, you don’t want to miss it!

BOTOX® Cosmetic treatments in Valparaiso, IN are performed at Indiana Plastic Surgery. BOTOX® Cosmetic is the most popular physician-administered aesthetic procedure in North America. BOTOX® Cosmetic treatments are approved by the FDA for temporarily removing the affects of moderate to severe frown lines between the brows in people ages 18–65. The results of a single 10 minute treatment can last up to four months. Results may vary from patient to patient.

When consulting with Dr. David Robinson, he can help you decide on a practical approach to using BOTOX® Cosmetic for your aesthetic appearance.

Below are photos of examples of the before and after results of using Botox Cosmetic. Dr. Robinson serves the Valaparaiso, Schererville, Merrillville and Chesterton, Indiana areas. Please call for your FREE consultation today. (866) 613-2100