Botox vs Dysport vs Xeomin: A Comparative Guide
If you place a vial of Botox, Dysport, and Xeomin on a tray, they look interchangeable. In practice, they behave like cousins who share a last name but not the same habits. I have planned thousands of neuromodulator treatments, from first time “baby Botox” to complex facial balancing, and the most common question stays the same: which one should I use? The right answer depends on your anatomy, your goals, and small details like how fast you want to see results or how wide your “motion zone” is when you frown. This guide gives you the differences that change outcomes, not just labels and marketing.
What all three have in common
All three are botulinum toxin type A neuromodulators used in aesthetic and medical treatments. They temporarily relax targeted muscles by blocking acetylcholine release at the neuromuscular junction. That is the core of how botox works. The effect is local, dosage dependent, and reversible. New nerve terminals sprout over weeks to months, which is why results wear off.
Most patients use them for botox for wrinkles created by expression, such as botox for forehead lines, botox for frown lines in the glabella, and botox for crow’s feet. They also help with botox for fine lines when movement drives creasing. In medical contexts, the same mechanism helps with muscle overactivity: botox for migraines, botox for excessive sweating, and masseter botox for teeth grinding or TMJ related pain.
Despite similarities, each product has important differences that influence spread, onset, dosing ratios, and consistency across treatments.
What is Botox, Dysport, and Xeomin, in plain terms
Botox Cosmetic (onabotulinumtoxinA) carries complexing proteins around the active neurotoxin. Dysport (abobotulinumtoxinA) also includes complexing proteins and uses a different formulation that makes its unit not directly comparable to Botox units. Xeomin (incobotulinumtoxinA) is “naked” toxin, free of accessory proteins. All three are FDA approved for glabellar lines. Botox also has approvals for lateral canthal lines, and Dysport has a separate approval set in some regions. Clinically, all three are widely used off label in areas such as a botox brow lift, botox for gummy smile, botox for chin dimpling, or botox for neck bands in platysmal bands.
The presence or absence of complexing proteins does not change the mechanism of action, but it can influence diffusion characteristics in tissue, immune exposure, and possibly how predictable a given vial feels in practice.
Key pharmacologic differences that matter at the chair
Formulation and unit equivalence. Units are not interchangeable. One Botox unit does not equal one Dysport unit. A common clinical conversion is roughly 1 unit of Botox to 2.5 to 3 units of Dysport, though I set conversion ranges by area and patient response. Xeomin is close to a one to one match with Botox in many protocols, but I still titrate by effect, not math alone. If you switch brands mid maintenance schedule, talk through a botox dosage guide with your injector rather than copying the last number on your chart.
Diffusion and spread. Dysport can spread a bit more laterally at typical dilutions, which can move the needle in larger muscles like the frontalis or the masseter, and in broad areas like the forehead. Botox and Xeomin tend to stay tighter if you keep volumes low. That helps for precision botox injections such as a targeted botox for nostril flare or a conservative botox lip flip.
Onset. Dysport often “kicks in” faster. Patients sometimes notice softening within 24 to 48 hours, with fuller effect by day 4 to 5. Botox frequently settles between day 3 and day 7. Xeomin tends to mirror Botox, though I see a subset of patients who feel it slightly local botox treatments earlier. If someone needs results before a shoot on Friday after a Tuesday appointment, Dysport earns the edge.
Duration. Across doses that produce equivalent effect, most patients see similar durations: about 3 to 4 months for high motion areas, up to 5 months in some low motion zones, and 2 to 3 months for micro botox or baby botox patterns. Masseter botox can last longer, commonly 4 to 6 months once the muscle has reduced in bulk. Individual metabolism, exercise frequency, and muscle strength shift these ranges.
Immunogenicity. Xeomin’s “naked” formulation theoretically reduces antibody risk. In practice, true antibody mediated resistance is uncommon. What I see more often is partial tolerance from frequent high dose treatments, especially in patients doing medical botox uses like hyperhidrosis along with facial sites. For patients who suspect waning effect, Xeomin can be a thoughtful trial. The larger lever, however, remains dosing and interval control.
How I match the product to the problem
Glabellar lines and a strong frown. All three perform well here. Dysport can soften a broad “eleven” complex with fewer injection points because of spread. Botox delivers precise control when asymmetry exists or when you want to spare medial frontalis fibers for a lift. Xeomin sits in the middle, predictable and clean.
Forehead lines and brow position. The forehead is thin, mobile, and unforgiving of heavy hands. Botox or Xeomin give me surgical control, especially during a subtle botox eyebrow lift. I map your frontalis pull pattern first. If your brow already sits low, I aim for micro dosing and wider spacing regardless of brand to protect lift. If you animate with a wide “surprise” motion zone, Dysport’s spread can smooth with fewer track marks.
Crow’s feet and smile dynamics. Lateral canthal lines are often driven by orbicularis oculi and cheek elevator interplay. Botox and Xeomin allow me to protect your lateral cheek while softening squint lines. In patients with early hollowing or a gummy smile tendency, I anchor higher and lighter. Dysport works well when the smile is broad and the lines fan out widely.
Masseter botox for jaw slimming or botox for teeth grinding. This is a large muscle. Dysport’s spread, at appropriate dilutions, can cover the belly efficiently. Botox and Xeomin are equally effective when I layer multiple deep injection points and reassess at 8 to 12 weeks. I caution first time patients about chewing fatigue for 1 to 2 weeks and the slower, staged aesthetic change. For TMJ pain, many get relief within 10 to 14 days.
Neck bands and platysmal bands. Platysma is thin but expansive. I lean toward Botox or Xeomin in patients with fine neck skin where micro dosing reduces risk of dysphagia. Dysport can be excellent for robust vertical bands, provided placement stays superficial and lateral to the midline where appropriate.
Lip flip, gummy smile, chin dimpling, nostril flare, and facial symmetry touches. These micro areas reward a product that behaves with precision. I reach for Botox or Xeomin most often and use tiny aliquots. A botox lip flip might be 4 to 8 units of Botox total spread across four points. For gummy smile, think 2 to 4 units per side at the levator labii superioris alaeque nasi sites with careful vector testing while you smile.
The botox consultation process that actually protects results
I start by watching you talk. Natural speech and laugh patterns expose more useful information than a static scowl. Next, I palpate and map movement vectors, then take standardized photos for botox before and after comparisons. I walk through your botox aesthetic goals and whether you want a botox for natural look with light movement or a more polished, line free finish. Together we review a personalized botox plan that sets dose ceilings for delicate areas, identifies asymmetries, and sets a botox maintenance schedule.
First time patients often begin with baby botox. Small doses across key muscles test how you metabolize and how your face responds. We then refine at the two week check. Once stable, we build an advanced botox techniques map with units explained by region so the next session repeats the performance you liked.
Botox results timeline: what to expect day by day
Day 0: You might feel tiny blebs under the skin for 10 to 20 minutes. Makeup can go on gently after the skin is clean and dry.
Day 1 to 2: If you used Dysport, early softening may start. With Botox or Xeomin, you may feel the first hint of “less push” against your fingertips.
Day 3 to 7: Most patients see visible smoothing. Heavy lines that have etched into the skin soften but may not fully disappear on the first round.
Day 10 to 14: Peak effect. This is the best time to assess symmetry and tweak if needed.
Week 8 to 12: You will notice botox wearing off signs such as returning movement at the edges, makeup settling into lines again, or stronger frown recruitment. Booking the next visit before everything returns to baseline extends long term skin benefits.

Safety, side effects, and the judgment calls that prevent them
Botox safety information boils down to dose, depth, and anatomy. The most common side effects include pinprick redness, minor swelling, and a bruise. Headache can occur in the first day or two. Lid or brow ptosis happens when product diffuses into the levator or when too much frontalis is treated low on the forehead in someone with heavy brows. Precise injection mapping and staying above safe brow lines limit this risk. Smile asymmetry can occur when the zygomaticus or risorius pick up product during lower face work. Chin heaviness is possible if mentalis dosing is too high or too deep.
Medical contraindications include pregnancy, breastfeeding, active infection at the injection site, and certain neuromuscular disorders. For patients on anticoagulants, I use extra gentle technique and pressure to reduce bruising, but I do not stop medication without coordination with your prescribing physician.
On long term effects, the best evidence shows no permanent damage when dosing stays within accepted ranges and spacing respects recovery. Muscles adapt, often becoming slightly weaker with repeated treatments, which some patients want for jaw slimming. If a patient exercises intensely and metabolizes fast, we plan smaller intervals rather than overcorrecting with high doses.
Botox vs fillers: different tools, different jobs
Neuromodulators relax muscles. Fillers restore volume or structure. When someone asks for smoother marionette lines or a downturned mouth lift, I may mix approaches. Botox for downturned mouth can soften the depressor anguli oris pull, then a touch of filler supports the corner. For static cheek lines from volume loss, filler does more. For dynamic crow’s feet, botox injections do the heavy lifting. The best outcomes use the right tool for the right cause.
Precision in practice: two patient stories
A television presenter came in three days before filming with etched forehead lines and a heavy right brow. A quick Dysport session targeted her frontalis with low, evenly spaced micro doses. The faster onset mattered. By day two she reported smoother makeup and a balanced lift, with no camera shine off deep creases.
A bruxism patient, mid thirties, came for masseter botox and botox for stress jaw pain. We started with 25 units of Botox per side, placed deep at three points. At six weeks, jaw pain dropped by half and nocturnal grinding sounds reduced, according to her partner. On follow up we maintained function, increased to 30 units per side, and added tiny mentalis doses to relax chin dimpling that appeared when she concentrated at work. Her jawline also narrowed subtly by month four, which matched her aesthetic goals.
Dosing philosophy: less guesswork, more anatomy
I do not chase numbers. I chase effect at rest and in motion. A botox dosage guide helps set expectations, but I still test muscles manually. For a glabellar complex with heavy corrugator pull and a vertical procerus line, I may distribute 18 to 24 Botox units across five points. For the forehead, 6 to 12 units can be plenty in a tall, thin forehead with a low brow set, while 12 to 18 might be needed in a long forehead with strong lateral lift. For crow’s feet, 6 to 12 per side depending on line length and skin quality. For baby botox, I reduce by a third to half and accept shorter duration in exchange for a lighter look.
Preventative botox and micro botox
Preventative botox aims to slow the etching of lines before they become permanent. This works best in the glabella and crow’s feet of patients in their mid to late twenties who already show visible lines when smiling or frowning. Micro botox uses highly diluted product in the superficial dermis to reduce pore appearance and sweat in high shine zones. It is not a substitute for deeper line correction. I use it as a finishing layer in patients who struggle with makeup settling or oil breakthrough, especially in humid seasons.
For first time patients and for men
If it is your first time, bring photos of what bothers you when you smile, frown, or raise your brows. List any events in the next two weeks. We will tailor the botox consultation process to your timeline and tolerances. Most first time patients prefer a botox for natural look. We can always add more at day 10, which is safer than backing out of an overcorrection.
For men, muscle mass is generally greater and hairlines differ. Doses run higher for the same effect, and the brow shape target changes. A masculine brow should not arch sharply. Treatment plans respect that, especially in a botox brow lift.
Recovery time and aftercare that actually helps
Normal daily activities resume right away. You may return to work with small red marks that fade quickly. Skip strenuous workouts for the rest of the day, avoid lying flat for four hours, and hold off on facials, saunas, or tight hats that press on the treated area for 24 hours. Do not rub the sites. If a bruise appears, arnica gel can help, and a cool compress during the first hour limits spread. Makeup is fine after the skin is clean and dry. These simple botox aftercare instructions reduce migration risks and protect symmetry.
Maintenance and the long game
Plan your botox maintenance schedule by watching your return of movement. If you book at the first sign of strong recruitment, you will need fewer units over time, and your skin benefits from fewer fold cycles. Many of my patients land at three to four sessions per year. For medical botox uses such as botox for hyperhidrosis, the schedule can be six to nine months apart once the area is conditioned. For migraines, we often follow structured medical protocols with higher totals and fixed maps.
When botox is wearing off, you will feel it first, even before it shows in photos. That is your cue to call, not when everything has fully returned.
Side by side comparison that stays honest
Onset: Dysport tends to act fastest, often within 24 to 48 hours. Botox and Xeomin usually build over 3 to 7 days. Spread: Dysport can diffuse a touch wider at typical dilutions, good for big muscles and broad wrinkle zones. Botox and Xeomin hold tight for high precision work. Units explained: Botox to Dysport commonly converts near 1 to 2.5 or 3. Xeomin sits close to Botox on a 1 to 1 basis, but clinical judgment beats a calculator. Duration: Most patients see 3 to 4 months across all three, with longer spans in low motion zones or masseter maintenance. Special considerations: Xeomin’s lack of complexing proteins may suit patients worried about antigen exposure or those with inconsistent responses to other brands.
When I switch brands mid course
If someone has mild asymmetry that persists after two sessions, I will often switch from Dysport to Botox or Xeomin to tighten control. If a frequent traveler needs faster onset before events, Dysport fits. If a high dose hyperhidrosis patient shows a shorter interval than expected, I may try Xeomin to test whether consistency improves. These are small levers, but in close cases they matter more than adding an extra unit.
Myths and facts that still circulate
Myth: Botox freezes your face. Fact: Overdosing or poor mapping does. A custom botox treatment with anatomy based placement preserves expression while smoothing lines.
Myth: Once you start, you have to keep going or you will look worse. Fact: botox near me Stopping returns you to your baseline over a few months, not worse. If anything, your skin may look better than before because it had a break from folding.
Myth: Units are the same across products. Fact: They are not. Mixing brand numbers invites errors. Use product specific plans.
Myth: Fillers replace botox for lines. Fact: Fillers address volume. Dynamic lines need muscle relaxation first, then filler if a static crease remains.
Choosing between good options
For a first time patient wanting botox for forehead lines and frown softening with a natural look, I reach for Botox or Xeomin. For a tight deadline, Dysport gets the nod. For masseter botox or broad crow’s feet in thicker skin, Dysport often suits the field. For micro corrections like a lip flip, gummy smile, chin dimpling, or nostril flare, Botox and Xeomin offer precise control. If you have concerns about long term exposure to complexing proteins or a history of inconsistent response, Xeomin is a rational pick.
Any of the three can produce great botox before and after results if the plan is tailored. The craft lies in mapping your unique animation, setting doses that respect brow position and cheek dynamics, and scheduling maintenance before full return of movement.
What to ask during your consultation
Which muscles are driving my lines, and how will you map them? What is your plan to protect my brow position while smoothing my forehead? How many units per area are you planning, and why this product for me? When should I check in for a tweak, and what does that cost? If we need to adjust next time, what will you change first, dose or product?
Anchoring your care around those questions turns a generic visit into a personalized botox plan with clear goals and measurable outcomes.
Final take
Botox, Dysport, and Xeomin are all strong tools. The best one is the one that fits your anatomy, your timeline, and your tolerance for change. With precision botox injections informed by anatomy, a thoughtful botox dosage guide, and honest feedback at the two week mark, you can smooth motion lines, balance facial harmony, and meet specific botox aesthetic goals without trading away expression. Whether you want preventative botox that keeps you camera ready or a focused plan for TMJ relief and jaw slimming, pick an injector who can explain not just what they are doing but why a given product fits your face on that day.