People rarely ask for neurotoxin by brand name on their first visit. They point to the mirror and trace the lines that bother them: the etched elevens between the brows, the fan of crow’s feet that makeup settles into, the horizontal tracks across the forehead. Then they ask what will actually soften those lines without flattening their expression. That is where choosing among Botox, Dysport, and Xeomin matters.
All three are FDA approved for glabellar lines, the frown lines between the eyebrows. They are also routinely used off label in the forehead, crow’s feet, bunny lines over the nose, lip flips, DAO muscles for a downturned mouth, chin dimpling, masseter reduction for facial contouring, and neck bands. They share a common mechanism, yet they differ in formulation, unit potency, spread, onset, and some practical realities like pricing and availability. I have injected thousands of faces over the years, and the decision often comes down to anatomy, timing, budget, and how a person wants to look at the two to four week mark, not just day three.
What all three have in common
Botox, Dysport, and Xeomin are neuromodulators based on botulinum toxin type A. They bind to the neuromuscular junction and temporarily block acetylcholine release, which relaxes the targeted muscle. When properly dosed and placed, that relaxation leads to smoother skin overlying the muscle, so the crease softens or, in younger skin, disappears. The effect is local, dose dependent, and temporary.
Onset usually begins within a few days, with maximal effect by two weeks. Duration ranges around three to four months in the upper face for most people, although I have patients who stretch past five months in the glabella and others who need touch ups after ten weeks, especially endurance athletes or people with fast metabolisms. All three agents have strong safety records when used by trained injectors and sourced from legitimate suppliers.
What changes between brands are the accessory proteins, the unit calibration, and the way the product diffuses in tissue. Those differences sound like technical trivia, but they show up in the mirror.
The quick gist, translated into how results feel
- Botox: The classic reference point. Predictable, steady onset, moderate spread. If you want a known quantity and a long track record, this is the baseline. Dysport: Tends to kick in faster in my practice, with a slightly wider field of effect per unit. Useful for broader foreheads or strong frown lines, and for people who say, “I have an event this weekend.” Xeomin: A “naked” form of botulinum toxin A without accessory complexing proteins. Clean feel, precise placement, especially good where too much diffusion would blur expression. Some people who feel heavy or frozen on other products like the lightness of Xeomin.
Those are trends, not absolutes. I use each brand across the full range of aesthetic areas. The art lies in matching the product to the person and adjusting technique.
What “units” actually mean and why it confuses pricing
Patients often compare quotes by the unit and wonder why a Dysport treatment seems cheaper per unit but the total is similar. Units are not interchangeable across brands. Botox and Xeomin units are dosed similarly in many areas. Dysport’s unit is calibrated differently, so a typical conversion is roughly 2.5 to 3 Dysport units for 1 Botox or Xeomin unit for a comparable effect. Your injector may price by area or by tailored dosing rather than by the unit to make this simpler.
I prefer to write the plan in terms of effect. If the goal is softening the glabella while maintaining forehead lift, the dosing strategy matters more than unit math. Experienced injectors translate unit equivalence automatically.
Onset and duration in real terms
Botox usually shows early smoothing around day 3 to 5, with a steady build to day 10 to 14. Dysport often starts showing changes as early as day 2, sometimes even by the next day in very reactive muscles, and often peaks a bit sooner. Xeomin’s onset sits between Botox and Dysport for many patients, with a clean, progressive build.
Duration best Burlington botox services differences are often subtle. In head to head patient experiences, Botox and Dysport feel similar over three to four months. Xeomin can look crisp in months one and two and then fade a touch sooner for heavy animators, though I have a subset that holds perfectly to four months. Hydration, metabolism, injection depth, and the muscle’s workload matter. The corrugators that pull your brows inward are active every time you squint or concentrate, so they tend to burn through neurotoxin faster than, say, the procerus.
If you are aiming for spacing treatments at four-month intervals, any of the three can be planned that way. If you need a visible change after two days for a photo shoot, I reach for Dysport more often. For precision shaping in small areas, such as a micro dose along the lip line or the jelly roll under the eyes, I will often pick Xeomin or a diluted preparation of Botox to control spread.
Formulation details that matter when the needle touches skin
Botox and Dysport come with complexing proteins around the active toxin, which originally served to stabilize the molecule. Xeomin removes those accessory proteins, yielding the core neurotoxin only. On paper, this may influence immunogenicity, meaning the theoretical chance your body recognizes the complex as foreign and forms neutralizing antibodies over time. In practice, true clinical resistance is rare across all three, though I have seen reduced responsiveness in a handful of patients who had very frequent, high-dose treatments over many years, especially for medical indications like cervical dystonia. For typical aesthetic dosing, the risk is low. When someone reports shorter benefit session after session, I evaluate technique, muscle recruitment patterns, and product storage before deciding to trial a different brand.
Spread and diffusion feel different. Dysport, in equal effect dosing, seems to cover a slightly broader area, which can be helpful in large frontalis muscles where smooth blending matters, and trickier near thin muscles where a millimeter too far risks brow ptosis. Xeomin often holds tight where placed, which is useful near the lateral brow and around the mouth where precision is the difference between refreshed and odd. Botox sits in the middle in my hands.
What a typical appointment actually looks like
A thorough visit starts with movement mapping. I ask you to frown hard, lift your brows, smile, squint, and talk so I can see the interplay between frontalis, corrugator, procerus, and orbicularis oculi. I watch for asymmetries, prior brow lifts, scar patterns, and eyebrow position at rest. People often fixate on lines, but muscle pull and skin elasticity determine what the right plan looks like.
We discuss what bothers you and what you never want. Some people hate any hint of forehead lines and will accept a flatter brow. Others rely on the lift from frontalis to keep their eyes open and would rather have a few soft lines than a heavy lid. If you have hooded lids or a naturally low brow, the forehead doses must be conservative and carefully spaced.
After cleansing, I mark injection points based on how your muscles fire. For a classic glabella treatment, that may be four to five points around the corrugators and one in the procerus. Forehead points sit higher than most expect, because the lower forehead controls brow position. Crow’s feet injections are placed in the outer canthal area, with care to avoid weakening the zygomaticus major that lifts your smile. The needle is tiny, the product volume is low, and the whole process takes minutes. Expect a few small bee-sting bumps that settle within half an hour.
I always schedule a follow up at two weeks for new patients or when switching products. That is the moment to fine tune. If you need another unit or two to balance a strong left corrugator or to lift a tail of the brow by reducing downward pull, we can add it then. It is the most efficient way to get a dialed-in plan for future visits.
Where each product shines, with practical examples
A corporate executive in her forties with etched glabellar lines and an upcoming keynote usually appreciates Dysport for the fast onset, paired with a conservative forehead plan to preserve expressive lift. A young actor with early crow’s feet and a camera test prefers Xeomin around the eyes for its precise edge control, so his smile reads warm rather than pinched. A software engineer who wants fewer frown lines but hates the idea of looking “done” often starts with Botox in classic doses because it sets a predictable baseline that we can adjust.
In the lower face, where muscles are small and movements are fine, I find Xeomin or a micro dose of Botox most forgiving. A lip flip uses tiny amounts in the orbicularis oris, and a touch too much can distort a smile. For masseter slimming, where the muscle is large and strong, all three products work well, but Dysport’s broader effect can be helpful in bulky masseters without resorting to very high concentrations.
Safety, side effects, and what to expect
Common, self-limited effects include mild redness at injection sites, pinpoint bruising, and transient headaches in a small percentage of people, especially after glabella injections. Bruises are rarer with careful technique, but if you take fish oil, aspirin, or other blood thinners, tell your injector. Injections placed too low in the forehead or too close to the levator palpebrae can cause brow or lid ptosis. It is uncommon, usually mild, and resolves as the effect fades, but it is much more likely in rushed or cookie-cutter treatments. This is why mapping and staying within safe zones matters more than the brand.
If you are pregnant, trying to conceive, or breastfeeding, we wait. None of the products are approved in those settings. If you have a neuromuscular disorder, a history of keloids, or a known sensitivity to any component in the product, talk through risks with your clinician. Real Botox cosmetic injections and related treatments should be sourced through medical channels, delivered in a medical setting, and documented in your chart. Avoid pop-up events promising suspiciously cheap botox skin treatments. Authenticity of the vial and sterile technique are nonnegotiable.
Cost, value, and how to avoid paying twice
Price varies by market and injector experience. Some clinics price per unit, others by area. A fair approach accounts for an individual’s muscle strength, animation patterns, and goals. Beware of chasing the lowest per-unit price without understanding unit equivalence and dilution. A highly diluted product might look like a bargain but wear off quickly. A seasoned injector’s plan is often more cost effective over a year because it wastes fewer units and avoids corrections.
If you are comparing options, ask for a clear dosing estimate for your areas, whether a two-week touch up is included, and how they handle asymmetries. Also ask how many injectable sessions the practitioner does weekly. Technique is learned through repetition and careful follow up. Your botox aesthetic injections should feel like professional medical care, not a retail upsell.
Managing expectations so you like your face at day 14
Neurotoxin works in gradients. A tiny bit too much in a key muscle can flatten expression, especially in someone who relies on brow lift for communication. I always ask people to bring a photo of themselves at an age where they liked their expression. We are chasing familiarity, not a new face. If your partner only notices that you look rested, we succeeded.
New patients sometimes expect the etched line to vanish completely on the first pass. A static crease that has been present for a decade will soften, not disappear, until collagen remodeling catches up and the skin rests from constant folding. This is where consistent botox wrinkle management changes the skin. Over two or three cycles, the line often looks less deep even at rest because the skin is not being hammered by the same mechanical stress. Pairing botox face injections with a sensible skincare plan, sunscreen, and if appropriate, fractional laser or microneedling to stimulate dermal collagen makes a real difference.
Special scenarios and edge cases I watch for
People with heavy lateral brows and hooded lids can look tired if the frontalis is overtreated. I underdose the central forehead, place lateral support points higher, and rely on treating the glabella to reduce downward pull on the brows. Sometimes a small laterally placed point in the orbicularis oculi can lift the tail of the brow by reducing downward tension, but that takes finesse and conservative dosing.
For thin-skinned runners and swimmers with strong squinting habits, crow’s feet need careful layering. Too much in the outer canthus flattens the smile, too little does not smooth the radiating lines. I often divide treatment into two sessions two weeks apart for precise control.
For chin dimpling from an overactive mentalis, any of the three agents works well with small doses. A light hand preserves lower lip function. For platysmal bands, dosing is higher, and I let people know that swallowing can feel different for a few days if the product migrates. In that area, a consistent grid and conservative first pass are essential.
For masseter hypertrophy used for facial contouring, plan on a series of sessions every four to six months for the first year to change the muscle’s bulk. People often pair this with botox facial contouring goals in the jawline and chin. Bruxism relief is a common and welcome side benefit.
The role of skin care and lifestyle
Neurotoxin is not a substitute for skin health. You will get better results, and keep them longer, with daily sunscreen, a retinoid as tolerated, and a moisturizer that suits your skin type. If your baseline is dehydration, alcohol-heavy weekends, and sporadic sleep, expect lines to rebound faster. I see this often in people who travel for work and squint on planes, then dehydrate at altitude. Planning your botox preventative treatment around travel and seasons helps.
For those exploring complementary treatments, light radiofrequency microneedling, gentle chemical peels, or fractional lasers can accelerate softening of etched lines while the neurotoxin prevents mechanical creasing. Sequence matters. I prefer to place botox cosmetic injections first, let the muscle activity calm, then treat the skin so healing occurs without repetitive folding. For fillers near lines that are primarily dynamic, I am conservative. Filler into a moving crease that still has strong muscle pull tends to migrate or create lumpiness. Calm the muscle first, reassess the line, then add a micro strand of filler if the line is still visible at rest.
Choosing among Botox, Dysport, and Xeomin based on your priorities
If you need a first choice and you are open to a wide field of results with predictable dosing, Botox is a solid standard. It is versatile for botox for frown lines, botox for forehead, and botox for crow feet. If you are impatient for onset or have robust facial muscles and a broad treatment area, Dysport often earns the nod. If you prioritize crisp, precise placement with a lighter feel, or you have a history of feeling heavy on other products, Xeomin is worth trying.
There is no single winner, only a best fit for a specific face at a specific time. Many of my long-term patients move between Burlington botox products over the years. A thirty-something on camera with early lines and lots of expression might love Xeomin for botox face enhancement. The same person a decade later, with deeper static lines and a board presentation on Monday, may switch to Dysport for faster botox smoothing treatment and broader coverage. Another patient sticks with Botox year after year because it gives exactly the botox wrinkle softening she wants without surprises. Consistency is underrated.
Practical tips to get the most from your treatment
- Give it the full two weeks before judging your result. Muscles switch off at different speeds, and symmetry settles as the effect spreads and binds. Avoid strenuous workouts, saunas, and heavy facial massage for the rest of the day after treatment. The risk of migration is small, but heat and pressure do not help. Keep a simple log with dates, product, and doses for each area. Over time, that record becomes the blueprint for reliable botox facial rejuvenation. If you bruise easily, pause non-essential blood thinners like fish oil and high-dose vitamin E for a few days prior, after clearing it with your physician. Do not stop prescription anticoagulants without medical guidance. Schedule before a busy season, not during it. If you appear in photos or on stage, plan your botox cosmetic procedure at least two weeks ahead so you are past the build phase and any tweaks.
What I tell friends and family
Pick the injector, not the brand. A thoughtful plan and skilled placement are the foundation of every good outcome. Healthy skepticism about miracle claims is wise. Excellent botox cosmetic care does not erase who you are. It lets the best version of your face show without the distraction of deep creases or muscle-driven heaviness.
If your goals are realistic, your schedule allows for that two-week check, and you maintain good skin habits, any of the three products can deliver a refreshed, natural look. The brand becomes a tuning dial. Botox provides a balanced, classic botox facial lines treatment. Dysport gives a nimble, fast-acting botox wrinkle reduction in larger areas. Xeomin offers surgical-like precision for botox skin smoothing around delicate muscles. None of them will fix sun damage, poor sleep, or a life lived in a squint without sunscreen, but they will give your skin a chance to recover and smooth out.
When you are ready, bring your priorities, your timeline, and a photo you like. We will map the muscles, choose the product that aligns with your face and calendar, and build a plan you can live with at work, on camera, and across a dinner table under bright lights. That is the test of good neurotoxin: your mother says you look rested, your colleague asks if you changed your skincare, and you stop noticing the creases every time you wash your face.