Understanding Your Neurotoxin Options
When it comes to reducing wrinkles and fine lines, neurotoxin injectables have become the gold standard for minimally invasive facial rejuvenation. With five FDA-approved options now available—Botox, Dysport, Jeuveau, Daxxify, and Letybo—patients have more choices than ever before.
While all five products work on the same principle (temporarily relaxing muscles that cause wrinkles), they have distinct differences in formulation, spread pattern, onset time, and duration. Understanding these differences is essential for making an informed decision about which neurotoxin will best meet your aesthetic goals.
At RIDHA Plastic Surgery & Med Spa in Saratoga Springs, your provider has performed thousands of neurotoxin treatments and can help you determine which product is ideal for your unique facial anatomy, treatment goals, and lifestyle. This comprehensive guide breaks down everything you need to know about all five FDA-approved neurotoxins.
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How Neurotoxin Injectables Work
All five neurotoxins—Botox, Dysport, Jeuveau, Daxxify, and Letybo—are derived from botulinum toxin type A, a purified protein that temporarily blocks nerve signals to muscles. When injected into specific facial muscles, they prevent those muscles from contracting, which smooths out the wrinkles they create.
The Mechanism of Action:
- Neurotoxin is injected with a very fine needle into targeted facial muscles
- The toxin blocks acetylcholine, a neurotransmitter that signals muscle contraction
- Without the signal, the muscle temporarily relaxes and stops contracting
- Wrinkles caused by repeated muscle movement (dynamic wrinkles) smooth out
- Results appear gradually over 1-14 days as the neurotoxin takes effect
- Effects are completely temporary and reversible as the body metabolizes the protein
- Repeat treatments maintain results and can prevent new wrinkles from forming
Because the fundamental mechanism is identical across all five products, they all treat the same types of wrinkles effectively: frown lines (glabellar lines), forehead lines, crow's feet, bunny lines, and other expression-based wrinkles. The differences lie in the formulation, diffusion pattern, and clinical characteristics.
Important: Neurotoxins only work on dynamic wrinkles caused by muscle movement. They do not treat static wrinkles (those visible at rest) or volume loss, which require dermal fillers or other treatments.
Key Differences Between the Five FDA-Approved Neurotoxins
While Botox, Dysport, Jeuveau, Daxxify, and Letybo share the same active ingredient (botulinum toxin type A), their formulations and clinical characteristics differ in ways that can impact your treatment experience and results.
Formulation Differences:
| Botox | Contains accessory proteins along with botulinum toxin type A; most established and widely studied formulation (FDA approved 2002) |
| Dysport | Smaller protein complex with accessory proteins; more dilute formulation spreads over larger areas (FDA approved 2009) |
| Jeuveau | Contains accessory proteins similar to Botox; designed specifically for aesthetic use, also known as 'Newtox' (FDA approved 2019) |
| Daxxify | Uses peptide technology instead of human albumin; no animal or human-derived components, longest-lasting formulation (FDA approved 2022) |
| Letybo | Contains accessory proteins similar to Botox; newest FDA-approved option from Korean manufacturer Hugel (FDA approved 2024) |
Unit Dosing Differences:
One of the most important differences is that these neurotoxins are NOT all interchangeable unit-for-unit. They use different measurement systems:
- Botox: Standard unit measurement (most commonly referenced baseline)
- Dysport: Typically requires 2.5-3 units to equal 1 Botox unit
- Jeuveau: Generally equivalent to Botox on a unit-per-unit basis
- Daxxify: Approximately 40 units equals 20 Botox units (different dosing structure)
- Letybo: Generally equivalent to Botox on a unit-per-unit basis
Important: Unit pricing varies significantly between products. Dysport and Daxxify require different unit counts to achieve the same effect as Botox. All neurotoxins at our practice are priced according to their unit structure—ask your provider to explain the total treatment cost during your consultation.
Diffusion Pattern:
- Botox: More precise, localized spread—ideal for targeted areas like crow's feet
- Dysport: Wider diffusion pattern—better for treating larger areas like the forehead
- Jeuveau: Similar to Botox with controlled, predictable spread
- Daxxify: Moderate spread with precise control at injection sites
- Letybo: Similar to Botox with more predictable, controlled spread
Onset of Results:
| Botox | Initial effects in 3-5 days; full results at 10-14 days |
| Dysport | Faster onset: visible results in 2-3 days; full effect at 7-10 days |
| Jeuveau | Fast onset: visible results in 2-3 days; full effect at 7-10 days |
| Daxxify | Fastest onset: some patients see results in 1-2 days; full effect at 7 days |
| Letybo | Similar to Botox: 3-5 days initial, 10-14 days full results |
Which Neurotoxin Lasts the Longest?
Duration of results is one of the most common questions patients ask when choosing between neurotoxins. This is where Daxxify stands out significantly from the other four options.
Average Duration of Results:
| Botox | 3-4 months on average; some patients maintain results up to 6 months |
| Dysport | 3-4 months typically; may fade slightly faster in some patients |
| Jeuveau | 3-4 months average; comparable longevity to Botox |
| Daxxify | 6-9 months on average; some patients maintain results up to 12 months |
| Letybo | 3-4 months average; comparable longevity to Botox |
Daxxify Breakthrough: Daxxify's peptide technology allows it to last significantly longer than traditional neurotoxins—up to twice as long. This means fewer treatment visits per year and more consistent results for patients who prefer less frequent appointments.
In clinical practice, your provider finds that duration is influenced by both the product and individual patient factors. The same person may experience different longevity with different neurotoxins.
Factors That Influence How Long Results Last:
- Metabolism: Faster metabolism breaks down neurotoxins more quickly
- Muscle mass: Larger, stronger muscles may metabolize product faster
- Dosage: Higher doses generally last longer than minimal doses
- Treatment frequency: Regular treatments may extend duration over time
- Exercise intensity: Very active individuals may experience shorter duration
- Sun exposure: UV damage can accelerate product breakdown
- Age: Older patients with less muscle activity may see longer-lasting results
Maximizing Duration: To extend your neurotoxin results, maintain treatments on a regular schedule, protect your skin from sun damage, and consider Daxxify if longevity is your top priority.
Factors We Consider When Recommending a Neurotoxin
Selecting the best neurotoxin depends on several factors unique to each patient. During your consultation, your provider will discuss which product may work best based on your anatomy, treatment goals, and any previous experience with injectables.
Factors We Consider:
- Your specific facial anatomy and muscle activity
- Treatment areas and goals (frown lines, forehead, crow's feet, etc.)
- Previous experience with neurotoxins and your response
- Desired onset time and duration of results
- Sensitivity to inactive ingredients or protein sources
- Treatment frequency preferences
At RIDHA Plastic Surgery & Med Spa, we carry all FDA-approved neurotoxins so we can customize your treatment to your specific needs rather than being limited by inventory constraints.
Rewards Programs Available:
- Allergan Alle rewards program for Botox
- Aspire Galderma rewards for Dysport
- Evolus rewards for Jeuveau
- Revance RHA rewards for Daxxify
- Ask about our loyalty programs during your consultation
Side Effects and Safety Considerations
All five neurotoxins have excellent safety profiles when administered by qualified injectors like your provider. Side effects are generally mild, temporary, and similar across all products.
Common Side Effects (All Products):
- Mild pain or discomfort at injection sites
- Temporary bruising (occurs in 10-20% of patients)
- Slight swelling or redness that resolves within hours
- Headache in the first 24-48 hours (uncommon)
- Temporary eyelid or eyebrow drooping if product migrates (rare with proper technique)
- Flu-like symptoms in some patients (very rare)
Product-Specific Considerations:
- Botox & Dysport: Contain human albumin; avoid if allergic to egg proteins
- Jeuveau & Letybo: Similar protein composition to Botox
- Daxxify: Contains no human or animal proteins—ideal for patients with protein sensitivities
- All products: Antibody formation is extremely rare (less than 1% of patients)
- If resistance develops: Switching to a different neurotoxin usually restores efficacy
Safety First: All five neurotoxins are FDA-approved and have extensive safety data. When administered by a qualified provider like your provider, serious side effects are exceptionally rare. The key is choosing an experienced injector who understands facial anatomy.
Who Should Avoid Neurotoxin Treatments:
- Pregnant or breastfeeding women
- People with neuromuscular disorders (myasthenia gravis, ALS)
- Active infection or inflammation at injection sites
- Known allergy to any neurotoxin component
- Taking certain antibiotics or muscle relaxants (discuss with your provider)
Which Neurotoxin is Right for You?
With so many options available, how do you decide which neurotoxin is best for your specific needs? your provider considers several factors when recommending a neurotoxin. Here's a guide to help you understand which product might work best for different priorities:
Botox is Ideal For:
- Precise, targeted treatments in small areas like crow's feet
- Patients who prefer the most established, widely-studied product
- Those who want the most predictable, controlled results
- People who have had excellent results with Botox in the past
- Areas requiring very precise placement without diffusion
Dysport is Ideal For:
- Treating larger areas like the entire forehead in one session
- Patients who want faster visible results (2-3 day onset)
- Those seeking a softer, more natural appearance
- People with strong forehead muscles needing wider coverage
- Patients who respond particularly well to this formulation
- Areas benefiting from wider product diffusion
Jeuveau is Ideal For:
- Patients seeking a Botox-like experience at a competitive price point
- Those who want fast onset similar to Dysport (2-3 days)
- People interested in newer aesthetic-focused formulations
- Patients looking for an alternative to their current neurotoxin
- Those who value supporting innovative companies in the aesthetic space
Daxxify is Ideal For:
- Patients who want the longest-lasting results (6-9 months)
- Those who prefer fewer treatment visits per year
- People with protein sensitivities (no human or animal proteins)
- Patients seeking the fastest onset (results in 1-2 days)
- Those willing to invest more upfront for longer-lasting benefits
- Busy professionals who value convenience and consistency
Letybo is Ideal For:
- Patients interested in trying the newest FDA-approved option
- Those seeking Botox-like results with a different formulation
- People looking for alternatives to existing products
- Patients who want predictable, controlled results similar to Botox
- Those curious about Korean aesthetic innovations
your provider's Recommendation: The best neurotoxin is the one that works best for YOUR unique facial anatomy and aesthetic goals. During your consultation, we'll assess your muscle strength, treatment areas, desired onset time, and duration preferences to recommend the optimal product.
Many patients are surprised to learn they can achieve excellent results with all five neurotoxins. The skill and experience of your injector matters far more than the specific product used. your provider has mastered all five neurotoxins and can achieve beautiful, natural-looking results with any of them.
your provider's Expert Perspective
After administering thousands of neurotoxin treatments over 20+ years, your provider has developed deep expertise with all FDA-approved neurotoxins. Here are his insights on how these products compare in real-world clinical practice:
Clinical Observations:
- Results are remarkably similar when products are dosed and placed appropriately
- Patient satisfaction is more about injection technique than product choice
- Some patients develop a preference for one product, which should be honored
- Dysport and Jeuveau's faster onset can be advantageous for event-driven treatments
- Botox's precision makes it ideal for delicate areas around the eyes
- Daxxify is a game-changer for patients who want fewer visits per year
- Letybo provides another excellent option for patients seeking alternatives
- Combination approaches (different products for different areas) can be effective
your provider keeps all five neurotoxins in stock at RIDHA Plastic Surgery & Med Spa because different patients genuinely do better with different products. The key is having the flexibility to customize your treatment based on your individual response, anatomy, and goals.
Frequently Asked Questions About FDA-Approved Neurotoxins
Can you mix different neurotoxins in the same treatment session?
Yes, it's perfectly safe to use different neurotoxins in different areas during the same treatment session. For example, your provider might use Dysport for your forehead (where wider diffusion is beneficial) and Botox for your crow's feet (where precision is important). This customized approach can optimize results in each treatment area.
Why do some providers only offer one or two neurotoxins?
Some practices choose to stock only one or two neurotoxins for simplicity and inventory management. Others may have financial agreements with specific manufacturers. At RIDHA Plastic Surgery & Med Spa, we believe in offering all five FDA-approved options so we can customize treatment to each patient's needs rather than being limited by inventory constraints.
How many units do I need for my treatment?
The number of units needed varies by treatment area, muscle strength, and product choice. Typical amounts for common areas using Botox-equivalent dosing: frown lines (20 units), forehead (10-20 units), and crow's feet (10-12 units per side). Remember that Dysport requires approximately 2.5x more units to achieve the same effect, while Daxxify uses a different dosing structure entirely. your provider will assess your specific needs during consultation.
Can you tell which neurotoxin someone has had by looking at them?
No, when administered properly, all five neurotoxins produce visually identical results. The final appearance is determined by the injector's technique, dosage, and placement—not by the specific product used. If someone looks "overdone" or "frozen," that's a result of excessive dosing or poor technique, not the product itself.
Are generic or discount neurotoxins safe?
Only Botox, Dysport, Jeuveau, Daxxify, and Letybo are FDA-approved neurotoxins in the United States. Any other product claiming to be "like Botox but cheaper" is not legal for cosmetic use in the US and may be dangerous. Never accept treatment with a product your provider can't clearly identify and verify as FDA-approved. The savings aren't worth the risk.
How soon can I get another neurotoxin treatment if I'm not happy with results?
If you didn't achieve the desired effect, you should wait until you can see the full results (7-14 days depending on the product) before considering a touch-up. More product can be added at that point if needed. However, if you want to switch to a different neurotoxin, it's best to wait until the current treatment has worn off to accurately assess how the new product works for you.
Do men respond differently to these neurotoxins than women?
Men typically have stronger facial muscles than women and therefore often require higher doses to achieve the same effect. However, the relative performance of all five neurotoxins is similar for both sexes. Men should expect to need 20-40% more units than women for comparable results, regardless of which product is used.
What happens if I stop getting neurotoxin treatments?
If you discontinue neurotoxin treatments, your muscles will gradually return to normal function over 3-6 months (or longer with Daxxify). Your wrinkles will reappear, but you won't look worse than before you started treatments. In fact, if you've been getting regular treatments, you may have prevented some wrinkles from forming or deepening, so you might actually look better than if you'd never had treatments at all.
Is Daxxify worth the higher cost?
For many patients, yes. While Daxxify typically costs more per treatment, it lasts roughly twice as long as other neurotoxins. This means fewer office visits per year, more consistent results, and often a similar annual cost when you factor in needing only 2 treatments per year instead of 3-4. It's particularly valuable for busy professionals and those who prioritize convenience.