I have found Dysport to indeed work more quickly (2 days for onset as compared to 4), generally last as long, but it doesn't seem to have the same "punch" - which is good for some and not for others.

For people who prefer less movement overall, I have found they prefer Botox.

For people who like more movement, still not enough to continue to create wrinkles, they like Dysport.

People with thinner skin seem to get too much movement with Dysport.

I personally enjoy Dysport more in my own face, but I have had enough patients not like it as much that I haven't offered it in a while.

I have switched over to Dysport completely in my practice due to its favorable cost profile. I find no visible difference when I inject Dysport or Botox in my patient population. Masseter muscle injection to slim the side profile of the face and calf muscle injection to slim the lower legs require a lot of units. These are bread and butter procedures at my practice where the lower cost Dysport makes a huge difference in patient satisfaction and enhancing our profitability.

tony: do you think it might be the conversion/dilution that is giving you less results than botox? I was doing basically a 2:1 conversion by diluting it with 1:5 cc ( i dilute my botox with 1 cc) and not getting great results. Now I'm going to try diluting it with 1.2ml and using a 1:2.5 ratio.

by the way, has anyone every had botox not work?

For some reasons, I am liking Dysport more than Botox. It seems that my clients have a softer " natutral" expression lines. It has reported less fatigue, headaches when using Dysport. The result seems to last longer. But for hyperhidrosis, I insist on Botox as it shows faster result.

RE: Pat Monroe:

The reason why many physician has switched over to Dysport is due to cost saving. Botox injection price is very competitive in many markets. Once you switch over to Dysport. Do not sell by units, go by treatment area such as Glabellar, Frontalix, Crow's feet .etc... Most patients do not know the conversion rate of 3:1 all they know is how much they paid for their previous injection. Patients want result and the cheaper the better. Use Dysport whenever you can and use the saving as a boost in your bottom line. This is a rough economy$350 per vial of 100 U of Botox or $420 for 166 units of Botox alternative. Both are legal, as effective, and as safe as each other. Whether you pass on the saving to your client is up to you. In this time and age, it is becoming very difficult to be lucrative in laser services. Clients are less willing to pay for the latest technology. Price of hair removal, skin rejuvenation, and pigment treatments have declined over the past 3 years due to introduction of cheaper laser equipments from Asia. Filler and Botox injection is the lucrative and growing sector in aesthetic medicine today. Many establishments are now focusing on filler / botox / hair removal services only due to public demand. Derm clinics whom invested heavily on expensive lasers are starting to feel the pinch as multi thousand laser procedures are becoming more difficult to sell in this economy.

My medspas switched over to Dysport for reasons other than it's cost. Dysport works better, lasts longer, and the rep contributed financially to education nights to educate our patients- so it's actually an easier sell.

I still sell it based on units not areas. I don't know why, maybe habit.

We explain the conversion, and you're right their eyes glaze over-they just want it to work.

I disagree with your conclusion of laser treatments, however. Our laser business is still going strong, and represents the over half of the business. But it is steady not exploding. My injectible business is growing, but again, not exploding.

We started using Dysport soon after it was FDA approved for the handful of Botox resistant patients that we have. Those patients love Dysport and have continued to use it. When we opened that first vial of Dysport we offered it to a number of regular botox clients at a discount to try it out. Maybe I didn't dose it well but none of these clients previously happy with Botox wanted to stay with Dysport. In addition, I had one regular Botox client have significant brow and lid pstosis with the dysport (never happened with years of Botox).

I think in order to get a good result you have to use more near 3 to 1 unitst (vs Botox) and then it spreads alot more. We use Botox diluted 1:1 (very concentrate) and I diluted the Dysport per the guidelines. Perhaps I'm just not used to placing large volumes when compared to the Botox and could get better with more time.

I've done one hyperhidrosis with Dysport (my daughter) and thought her results were poor. I used 150 units per axilla.

Anyway, we have very little call for Dysport in our area. I don't think anyone else is even offering it.