Q: Dr. Eppley, do you offer Dysport injections? If so, what is the cost per unit? Do you think Dysport is better than Botox? And if so, why?
A: I do both Botox and Dysport injections for aesthetic facial wrinkle treatments. In my opinion, they are essentially equivalent and Dysport has no significant advantages over Botox. The cost per Dysport unit ($5.00/unit) may be substantially less than Botox but it also takes 2.5 units of Dysport to equal the effects of 1 unit of Botox. Thus one does not choose Dysport because it costs less which is a common misconception. The only real value of Dysport is if one has developed a ‘resistance’ to Botox, Dysport offers a very slight molecular structure variation that may make it more effective. In addition, because Dysport has a greater zone of diffusion it may be more effective in the crow’s feet area This is because the orbicularis oculi muscle is spread out and requires a broader zone of drug spread to get a maximal aesthetic effect.
Perhaps the greatest advantage of Dysport is that it offers competition to Botox which had been the sole provider of this aesthetic treatment for over a decade. (and that only includes the time when it become formally FDA-approved for wrinkles and not the decade before when it was used off-label) Unfortunately, competition for Botox has done little to affect its cost. This is probably because Dysport has just a small fraction of the aesthetic injectable wrinkle market in the U.S.. Dysport at this point can not even claim the analogy that it is Pepsi compared to Coke.
Dr. Barry Eppley