Aesthetics at Edition
Neuromodulators
Botox, Dysport, and Xeomin — selected for your anatomy, not by habit.
Botox, Dysport, and Xeomin — selected for your anatomy, not by habit.
Most practices default to a single neurotoxin — the one with the most familiar name or the best rep-to-office relationship. At Edition, we stock all three FDA-approved botulinum toxin type A products because no single formula is optimal for every patient, every area, or every treatment goal.
The active ingredient across all three is identical: botulinum toxin type A, which temporarily interrupts the acetylcholine signal at the neuromuscular junction. The difference lies in the surrounding formulation. Botox carries the broadest FDA-approved label and the deepest safety record. Dysport has a faster onset profile and a diffusion characteristic that suits certain large-field treatments. Xeomin contains the purified neurotoxin alone — no accessory proteins — which may matter for patients receiving frequent, long-term treatments.
At your consultation, Dr. Schwartz evaluates muscle mass, movement patterns, treatment history, and goals before selecting a product. For most patients, that conversation takes five minutes. For patients with prior treatment elsewhere, it can be considerably more nuanced — and considerably more consequential.
The marketing around neuromodulators significantly overstates the differences between products. All three work. The variables that actually matter — injector skill, precise placement, correct dosing — are rarely the ones being advertised. Choose your injector first. The product selection follows from there.
Botox and Xeomin share a roughly 1:1 unit ratio. Dysport units are approximately 2.5 times the Botox unit for equivalent effect. Prices quoted per unit without specifying the product are meaningless — and a common source of patient confusion.
Edition stocks all three FDA-approved botulinum toxin type A products — Botox (AbbVie), Dysport (Galderma), and Xeomin (Merz). Each has a distinct formulation, onset profile, diffusion characteristic, and unit conversion. No single product is optimal for every patient, every area, or every treatment goal.
Dr. Schwartz selects the appropriate product based on your anatomy, treatment history, and the specific areas being addressed. The decision is clinical — not driven by brand preference or inventory convenience.
Neuromodulators address dynamic lines — wrinkles formed by muscle movement, not by volume loss or sun damage. Understanding the distinction matters: if a line is visible at rest, a neurotoxin alone will not erase it.
The table below summarizes the clinically meaningful differences between the three products. This is a starting point, not a decision guide — the right product for you depends on factors a table cannot capture.
| Botox | Dysport | Xeomin | |
|---|---|---|---|
| Manufacturer | AbbVie (Allergan) | Galderma (Ipsen) | Merz Pharmaceuticals |
| Generic name | OnabotulinumtoxinA | AbobotulinumtoxinA | IncobotulinumtoxinA |
| FDA-approved areas | Forehead, glabella, crow's feet, platysmal bands — broadest label | Glabella (primary FDA cosmetic indication) | Glabella, crow's feet |
| Onset | 4–5 days initial; full effect 10–14 days | 2–3 days — fastest onset among the three | 2–3 days initial; full effect 10–14 days |
| Duration | 3–4 months typical | 3–5 months; may outlast Botox in some patients | 3–4 months; comparable to Botox |
| Diffusion | Precise, controlled spread — preferred for delicate areas | Broader field effect — useful for large muscle groups | Comparable to Botox; no accessory proteins do not increase diffusion |
| Formulation | Neurotoxin + accessory proteins | Neurotoxin + accessory proteins (larger complex) | Pure 150 kDa neurotoxin only — no complexing proteins |
| Immunogenicity | Low; stable long-term safety record | Low; comparable to Botox | Potentially lowest; theoretical benefit for long-term repeat patients |
| Unit ratio to Botox | 1:1 reference | ~2.5:1 (Dysport units are lower potency per unit) | 1:1 — directly comparable to Botox dosing |
* Duration and onset are population-level averages. Individual results vary based on muscle mass, metabolism, treatment area, and dosing. Units are not interchangeable across products — do not compare pricing without specifying which product is being quoted.
The comparison table tells you what differs. These sections tell you why it matters — and who each product is most likely to suit.
Botox is the reference standard in cosmetic neurotoxins — not because it is chemically superior to the alternatives, but because it has the longest clinical history, the deepest body of published safety data, and the broadest FDA-approved label of any neurotoxin in the United States. As of 2024, Botox Cosmetic holds FDA approval for four distinct aesthetic areas: the glabella, forehead, crow's feet, and — uniquely among cosmetic neurotoxins — the platysmal bands of the neck.
Botox tends to be the precision instrument of the three. Its diffusion pattern is well-characterized, its dosing protocols are the most extensively documented, and it behaves predictably in delicate treatment areas like the lower eyelid, the lip border, and the brow where inadvertent spread carries the highest aesthetic risk. For patients new to neuromodulators, or those requiring very precise placement around the eyes, Botox remains the most conservative choice.
The product contains the active 150 kDa neurotoxin along with accessory proteins that form a larger molecular complex. These proteins dissociate at physiologic pH and play no therapeutic role — they are an artifact of the manufacturing process rather than a design feature. Neutralizing antibody development is possible but rare in cosmetic dosing ranges.
Dysport occupies a distinct clinical niche among the three neurotoxins. Its defining characteristics — faster visible onset and a broader diffusion pattern at equivalent clinical doses — are not marketing claims. They are reproducible across multiple independent trials and reflect genuine differences in the molecular architecture of the product relative to Botox and Xeomin.
The onset advantage is meaningful for patients scheduling treatment before an event. Clinical data consistently show initial results at 2 to 3 days for Dysport, compared to 4 to 5 days for Botox. For the patient with a wedding or a significant appearance in ten days, the difference between products is not trivial.
The broader field effect is a feature in the right hands and a liability in the wrong area. For large treatment zones — a full forehead in a male patient with thick, strong frontalis muscle, or a broad upper-face balancing treatment — the wider distribution can provide more even coverage with fewer injection points. In delicate areas near the eyes or lower face where inadvertent spread carries higher risk, Dr. Schwartz typically favors Botox or Xeomin. Dysport's unit ratio to Botox is approximately 2.5:1 — meaning that a per-unit price comparison without specifying the product is meaningless.
Xeomin is the newest of the three and the most biochemically pure. It contains only the 150 kDa neurotoxin — the active portion responsible for the clinical effect — without the accessory proteins present in Botox and Dysport. Merz refers to this as XTRACT Technology; clinicians more often describe it simply as "the naked toxin."
The absence of accessory proteins is the defining feature of Xeomin and the source of its most discussed potential advantage: reduced immunogenicity. Accessory proteins are inert therapeutically — they play no role in the clinical effect — but they do stimulate the immune system to produce antibodies. Over time, some patients who receive frequent neurotoxin treatments develop neutralizing antibodies that diminish the product's effectiveness. Because Xeomin delivers a lower burden of foreign protein per treatment, the theoretical risk of antibody-mediated treatment failure may be lower. The clinical literature is more nuanced than early Xeomin marketing suggested — immunogenicity is influenced by dose frequency and total protein load, not formulation alone — but for patients receiving frequent treatments over many years, the distinction is worth discussing.
In terms of clinical performance, Xeomin shares Botox's unit ratio and diffusion characteristics. Onset is slightly faster than Botox at 2 to 3 days. Xeomin also has an unusual shelf-life advantage: it is stable at room temperature for up to four years, compared to the refrigerated storage required for Botox and Dysport.
Neuromodulator treatments at Edition are designed to be efficient, comfortable, and entirely unhurried. Most appointments take 20 to 30 minutes from arrival to departure.
Avoid aspirin, ibuprofen, fish oil, and vitamin E for one week prior to minimize bruising. No other special preparation is required. Arrive with a clean face — no makeup in treatment areas.
Dr. Schwartz assesses your facial movement patterns before injecting. Fine-gauge needles are used throughout. Most patients describe minimal discomfort — a brief pinch at each site. No anesthesia is needed or typically offered.
Small bumps at injection sites resolve within 20 to 30 minutes. Avoid lying flat, exercise, and alcohol for four hours. Minor bruising is possible and resolves within 3 to 7 days. No downtime is required.
Dysport and Xeomin: initial effect at 2 to 3 days. Botox: 4 to 5 days. All products reach full effect at 10 to 14 days. A complimentary two-week check is offered for all first-time Edition patients.
The questions we hear most often — answered directly.
All three are FDA-approved botulinum toxin type A products that work by temporarily relaxing facial muscles. They differ in formulation, onset speed, diffusion pattern, and unit potency. Botox has the broadest FDA-approved label and the most established safety record. Dysport tends to show results faster and diffuses slightly more broadly, making it well-suited for larger treatment areas. Xeomin contains only the pure neurotoxin without accessory proteins, which may offer advantages for patients receiving frequent long-term treatments. In clinical practice, all three deliver comparable results when appropriately selected and expertly injected.
Results typically last 3 to 5 months, with Dysport occasionally lasting slightly longer in some patients. Duration varies based on the product, the number of units administered, the treatment area, individual metabolism, and muscle mass. Men generally experience shorter duration due to larger muscle mass. Consistent, appropriate-interval treatments over time tend to produce more stable results than sporadic, high-dose treatments.
Only if over-treated. The frozen look is a dosing and placement problem, not an inherent property of neurotoxins. Dr. Schwartz's approach prioritizes natural movement preservation — the goal is to soften the lines that concern you, not eliminate every trace of facial expression. Most Edition patients return to work the same day with results that colleagues cannot identify as a procedure, only as looking well-rested.
Discomfort is minimal. Most patients describe a brief, mild pinch at each injection site. The needles used are extremely fine-gauge, and the volume injected at each site is small. Treatments are typically complete in under 15 minutes of actual injection time. Topical anesthetic is available on request but is rarely asked for.
Edition prices neurotoxin treatments per unit, with transparent pricing provided at consultation. Because units are not interchangeable between products — Dysport units are approximately 2.5 times the Botox unit for equivalent effect — per-unit pricing is only meaningful when accompanied by the product name. We provide an itemized treatment plan before proceeding, with no surprises at checkout.
Yes, and it is common. Neuromodulators and fillers address different problems — dynamic lines versus volume loss — and often work synergistically. Many Edition patients receive both in a single appointment. Dr. Schwartz assesses the full facial picture at consultation and recommends a treatment sequence that produces the most natural, balanced result.
Before: avoid aspirin, ibuprofen, naproxen, fish oil, vitamin E, and alcohol for one week to minimize bruising. After: avoid lying flat, strenuous exercise, facial massage, and alcohol for four hours. Do not rub or apply pressure to treated areas for 24 hours. Arnica gel or bromelain can help resolve any bruising faster if needed.
Neuromodulator treatments are not performed during pregnancy or while breastfeeding. There is no established safety data for botulinum toxin use in pregnancy, and Edition does not make exceptions. If you are planning a pregnancy in the near future, this is worth discussing at your consultation so we can time your treatments accordingly.
A neuromodulator consultation at Edition takes 20 to 30 minutes. Dr. Schwartz assesses your facial anatomy, discusses which product and dosing approach is right for you, and answers every question before proceeding. There is no obligation.