Dysport in NYC

Leah holding a syringe with a gloved hand

Dysport is a botulinum toxin type A preparation used to soften the frown lines between the brows. It relaxes the muscles that pull the brows together, so the skin over them creases less. The practice stocks Botox and Jeuveau; Dysport is available on request. Dr. Darren M. Smith injects it himself at his Manhattan office, treatment takes about fifteen minutes, and the effect is temporary, so it is repeated.

What Dysport is and how it works

Dysport is an FDA-approved prescription drug, not a cleared device. Approved means the product's own safety and effectiveness data went through a full FDA review. It contains abobotulinumtoxinA, a preparation of botulinum toxin type A. Injected into a specific muscle, it blocks the nerve signal that makes that muscle contract, so the muscle relaxes and the crease that repeated contraction creates softens.

The lines it addresses are dynamic lines, meaning lines produced by movement. Lines that are present when the face is completely still are static lines, and they come from changes in the skin itself. Those are a different problem and are usually addressed with dermal filler, resurfacing or surgery. Most patients have both, in different proportions, which is what the assessment at consultation is for.

The effect is temporary. Nerve endings recover, movement returns, and treatment is repeated rather than done once. The Dysport labeling states that retreatment should be no more frequent than every three months. Results vary from patient to patient.

What Dysport is approved to treat

In cosmetic use, Dysport carries FDA approval for the temporary improvement of moderate to severe glabellar lines, the vertical frown lines between the eyebrows, in adults under 65.

Botulinum toxin is injected into other parts of the face by injectors generally, but those uses sit outside that approved labeling. Dr. Smith discusses any such use with you directly, including what is and is not established about it, rather than listing it as a routine service.

Dysport also has therapeutic indications that have nothing to do with cosmetic practice and are not treated here.

Dysport compared with Botox

Both are botulinum toxin type A preparations and both work by the same mechanism, but they are not the same product and they are not interchangeable.

The units are different. A unit of Dysport and a unit of Botox are not equivalent, so dose figures from one do not transfer to the other.
The approved cosmetic indications differ. Botox Cosmetic is approved for the frown lines between the brows, the lines at the outer corner of the eye, forehead lines and the vertical bands of the neck. Dysport's cosmetic approval is for the frown lines between the brows in adults under 65.
Onset can differ slightly between patients, and some patients report one settling in sooner than the other for them.

Dysport carries a contraindication Botox does not: it is not used in anyone allergic to cow's milk protein, because the product may contain trace amounts. The practice stocks Botox and Jeuveau, and any botulinum toxin available in the United States, including Dysport, can be obtained on request. Which product Dr. Smith recommends depends on the area, your muscle pattern and, where you have had treatment before, how you responded to it. He will tell you which he is using and why.

The consultation and the treatment plan

The consultation begins with what bothers you and how your face moves. Dr. Smith examines the brow at rest and in animation, because brow position and muscle strength vary a great deal between patients and they drive the plan.

A review of your medical history and current medicines, including anything acting as a blood thinner
Any history of a neuromuscular condition, and any allergy, including allergy to cow's milk protein, which is relevant to Dysport
A note of any previous neuromodulator treatment and how you responded to it
An honest account of which lines will change and which will not
A dosing plan by area

Dr. Smith treats conservatively at a first session and reviews the result at the two-week check. Any further treatment is planned individually, with the labeled retreatment interval in mind.

The consultation fee is $500, and it is applied toward any procedure you go on to book.

What the treatment is like

A Dysport session takes about ten to twenty minutes.

The skin is cleaned and injection points are marked while you animate the area
A topical numbing cream is applied if you want one
A small number of injections is placed into the marked muscles with a fine needle
There is no dressing and no stitch, and you go back to your day

Patients describe a brief sting at each point. Small red marks at the injection sites usually settle within an hour.

Dysport recovery and when results appear

Most patients go straight back to their day, and the result develops over the following week. Softening usually begins within two to three days and reaches its full extent at about two weeks, which is when the result should be judged.

Stay upright for about four hours after treatment
Do not rub or massage the treated area that day
Leave strenuous exercise, saunas and hot showers until the following day
Use acetaminophen rather than an NSAID if you need something for discomfort, since NSAIDs make bruising more likely

The Dysport labeling states that retreatment should be no more frequent than every three months. How long the effect lasts varies from patient to patient, and Dr. Smith plans the interval with you. He sees first-time patients back at about two weeks so the result can be assessed and future treatment discussed.

Safety, side effects and who should not have it

The common side effects are local: redness, small bruises and tenderness at the injection points, and headache in the first day or two.

A heavy brow or a drooping eyelid can occur when the medicine reaches a muscle it was not intended to reach. It is uncommon, it is temporary, and it resolves as the effect wears off. Careful placement and conservative dosing are how the risk is kept low.

Dysport carries a boxed warning, which is the most serious form of warning the FDA applies to a prescription drug. It covers distant spread of toxin effect. The labeling states that effects consistent with botulinum toxin, including swallowing and breathing difficulty, have been reported hours to weeks after injection, that these effects can be life threatening, and that there have been reports of death. Difficulty swallowing, speaking or breathing after treatment is a medical emergency.

Dysport is not used in anyone with a known hypersensitivity to any botulinum toxin preparation or to any component of the formulation, and it is not injected where there is an infection at the proposed injection site. Dysport carries one further contraindication of its own: it is not used in anyone allergic to cow's milk protein, because the product may contain trace amounts. Patients with an existing neuromuscular disorder, such as myasthenia gravis, Lambert-Eaton syndrome or ALS, may be at increased risk of serious effects from botulinum toxin, including respiratory compromise. It is not given during pregnancy or breastfeeding. Anything acting as a blood thinner increases bruising, and any decision to hold such a medicine is made with the physician who prescribed it.

Tell the practice before your first treatment about any allergy to a previous botulinum toxin treatment, any allergy to cow's milk protein, any neuromuscular condition such as myasthenia gravis or ALS, any swallowing or breathing difficulty, and any skin infection near where you want to be treated. This is not a formality. It decides whether the treatment happens and which product is used.

What determines the cost of Dysport

Dysport is priced by the amount of product used, so a session's cost follows from how much the treated area needs.

The dose the area requires, which follows from muscle strength
Whether one area is treated or several
Whether anything else is done at the same visit

You are given an exact figure at consultation before anything is booked. Dr. Smith is out of network with all insurance plans, and the practice helps patients use out-of-network benefits toward care; cosmetic treatment is not covered. Financing is available through CareCredit and Alphaeon Credit. The consultation fee is $500 and is applied toward any procedure.

Common questions about Dysport

How long does Dysport last?

The Dysport labeling states that retreatment should be no more frequent than every three months. How long the effect lasts varies with dose, muscle strength and how much you animate, so Dr. Smith sets the interval with you rather than quoting a fixed number.

How soon does it start working?

Softening usually begins within two to three days. The result is complete at about two weeks, which is the point at which it should be judged.

Does it hurt?

There is a brief sting at each injection point. The needle is fine and a topical numbing cream is available. Most patients describe it as easily tolerable.

Is Dysport better than Botox?

Neither is better in general. They are different preparations of the same class of medicine with different unit strengths and different approved indications. The right choice depends on the area being treated and on how a particular patient has responded before.

Can I switch between Dysport and Botox?

Yes. Because the units are not interchangeable, dosing is worked out fresh rather than converted, which is one reason it helps to say what you have had before.

Will I look frozen?

That depends on dose and placement rather than on the product. A dose that removes all movement in a strong muscle will look static. Dr. Smith plans for a face that still moves and discusses your response and goals at the two-week check.

How soon can I go back to work?

The same day. There is nothing to cover beyond small red marks that settle within about an hour.

Can Dysport be combined with filler?

Yes. They do different jobs: Dysport relaxes the muscle producing a movement line, and filler replaces lost volume and addresses lines present at rest.

Why does Dysport mention cow's milk protein?

Dysport contains a trace of cow's milk protein in its formulation, so patients with a known allergy to it should not receive Dysport. Tell Dr. Smith at consultation if that applies to you.

Can I have Dysport while pregnant or breastfeeding?

It is not given during pregnancy or breastfeeding. There is no adequate safety data for that setting.

Who performs the injections?

Dr. Smith performs them himself. He is board-certified by the American Board of Plastic Surgery and a Fellow of the American College of Surgeons, with fellowship training in craniofacial and aesthetic surgery.