Neuromodulators
Botox, Dysport and Xeomin, chosen for your anatomy.
Why We Stock
All Three
We stock all three FDA-approved botulinum toxin type A products, because no one product is best for every patient or every area.
The active ingredient in all three is the same: botulinum toxin type A, which temporarily interrupts the acetylcholine signal at the neuromuscular junction. They differ in what surrounds it. Botox has the broadest FDA-approved label and the longest safety record. Dysport takes effect faster and spreads more widely, which suits some large treatment areas. Xeomin contains the purified neurotoxin alone, with no accessory proteins, which may matter for patients treated often over many years.
Dr. Schwartz looks at muscle mass, movement, treatment history and goals before choosing a product. Usually that takes five minutes; it takes longer if you have been treated elsewhere.
The products matter less than the injector
Marketing overstates the differences between these products. All three work. What matters more is skill, placement and dose. Choose the injector first; the product follows.
Units are not interchangeable
Botox and Xeomin share a roughly 1:1 unit ratio. It takes about 2.5 Dysport units to match one Botox unit. A price per unit that does not name the product is meaningless, and it often confuses patients.
The Products
Botox (AbbVie), Dysport (Galderma) and Xeomin (Merz). Dr. Schwartz chooses among them based on your anatomy, your treatment history and the areas being treated.
What Neuromodulators
Treat
Neuromodulators treat dynamic lines: wrinkles formed by muscle movement, not by volume loss or sun damage. If a line is visible at rest, a neurotoxin alone will not erase it.
Botox vs. Dysport vs. Xeomin
The differences between the three products that matter clinically.
| 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 of 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; having no accessory proteins does not make it spread more |
| 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, so do not compare prices without knowing which product is being quoted.
Each Product, Explained
Botox is the reference product. It is not chemically better than the others; it has the longest clinical history, the most 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 aesthetic areas: the glabella, the forehead, crow's feet and, alone among cosmetic neurotoxins, the platysmal bands of the neck.
How Botox spreads is well understood, and its dosing is the most thoroughly documented of the three. It behaves predictably in delicate areas like the lower eyelid, the lip border and the brow, where unwanted spread carries the highest aesthetic risk. For patients new to neuromodulators, or those who need very precise placement around the eyes, Botox is the most conservative choice.
The product contains the active 150 kDa neurotoxin along with accessory proteins that form a larger molecular complex. These proteins separate at the body's pH and do nothing therapeutically; they are left over from manufacturing. Neutralizing antibodies can develop but are rare at cosmetic doses.
Dysport works faster and spreads more widely than Botox or Xeomin at equivalent clinical doses. Both differences hold up across multiple independent trials and come from real differences in the molecule.
The faster onset matters if you are scheduling treatment before an event. Clinical data consistently show initial results at 2 to 3 days for Dysport, compared with 4 to 5 days for Botox. If you have a wedding or an important appearance in ten days, that difference counts.
For large treatment areas, such as the whole forehead of a man with a thick, strong frontalis muscle or a broad upper-face treatment, the wider spread can give more even coverage with fewer injection points. In delicate areas near the eyes or in the lower face, where unwanted spread carries higher risk, Dr. Schwartz typically favors Botox or Xeomin. Dysport's unit ratio to Botox is approximately 2.5:1, so comparing per-unit prices without naming the product is meaningless.
Xeomin is the newest of the three and the most purified. It contains only the 150 kDa neurotoxin, the part responsible for the clinical effect, without the accessory proteins in Botox and Dysport. Merz calls this XTRACT Technology; clinicians more often call it "the naked toxin."
Because Xeomin has no accessory proteins, it may be less likely to provoke antibodies. Accessory proteins play no part in the clinical effect, but they do stimulate the immune system to make antibodies. Over time, some patients treated often develop neutralizing antibodies that make the product less effective. Because Xeomin carries less foreign protein per treatment, the theoretical risk of antibodies causing treatment to fail may be lower. The research is less clear-cut than early Xeomin marketing suggested (immunogenicity depends on how often you are treated and the total protein load, not on formulation alone), but if you are treated often over many years, it is worth discussing.
Xeomin has the same unit ratio and spread as Botox. Onset is slightly faster than Botox, at 2 to 3 days. Xeomin can also be stored at room temperature for up to four years; Botox and Dysport must be refrigerated.
What to Expect
Most appointments take 20 to 30 minutes from arrival to departure.
Preparation
Avoid aspirin, ibuprofen, naproxen, fish oil, vitamin E, and alcohol for one week beforehand to minimize bruising. No other special preparation is required. Arrive with a clean face, with no makeup in treatment areas.
The Treatment
Dr. Schwartz watches how your face moves before injecting. Fine needles are used throughout. Discomfort is minimal: a brief pinch at each site. Most patients don't need anesthesia; numbing cream is available on request.
Immediately Post
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.
Onset & Follow-Up
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.
What Patients Ask
The questions we hear most often.
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 practice, all three give comparable results when the right product is chosen and injected well.
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 comes from the dose and placement, not from the products themselves. Dr. Schwartz aims to soften the lines that bother you while keeping your expression. Most patients go back to work the same day.
Discomfort is minimal: a brief, mild pinch at each injection site. The needles are very fine, and the amount injected at each site is small. Treatments are typically complete in under 15 minutes of actual injection time. Most patients don't need anesthesia; numbing cream is available on request.
Edition prices neurotoxin treatments per unit, and you get the price at your consultation. Because units are not interchangeable between products (it takes about 2.5 Dysport units to match one Botox unit), a per-unit price only means something when it names the product. You get an itemized treatment plan before treatment, so the bill at checkout is the one you agreed to.
Yes, and it is common. Neuromodulators treat lines caused by movement; fillers treat volume loss. Many patients have both at one appointment.
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 soon, tell Dr. Schwartz at your consultation so your treatments can be timed around it.
Begin with a Conversation
A neuromodulator consultation at Edition takes 20 to 30 minutes. Dr. Schwartz examines your face, discusses which product and dose suit you, and answers your questions before any treatment. There is no obligation.