Injecting Botox or Dysport every three months can be a bit of an inconvenience for some of my patients. So what kind of options do we have and what impacts the length of duration of Botox and Dysport? I inject my own patients in my Fort Worth and Southlake, Texas offices and get asked a number of these questions daily.
- Increase the dose – There is evidence that higher dosages of Botox and Dysport can result in longer duration of action. There are trials using twice the dosage which can show duration of action closer to 4-5 months in about 60 percent of patients. This may or may not be worth the added cost.
- Metabolism plays a role in duration of Botox/Dysport. For patients that exercise daily and participate in high intensity exercises, neurotoxins may last a shorter period of time. Extreme examples may be 2-3 weeks, but on average in my practice these patients can have a length of duration of around 6 weeks. Decreasing frequency or intensity may not be worth the trade-off, but is considered an option.
- Product resistence. This is a real phenomenon that we see in our practice. Patients may become resistant to one product or the other, but the alternative therapy may last longer or be more effective. The reasoning behind this may have to do with the proteins that allow delivery of the botulinum toxin. Trying Dysport if you are showing decreased response to Botox, or vice versa is an option.
- Next Generation Botox? There are new products on the horizon, although a year or two out. One promising agent is Daxibotulinumtoxin which may last up to 6 months from preliminary data. Check out our Daxibotulinumtoxin page for more details/updates.
- Nerve Destruction. There are methods of permanently cutting or damaging the nerves that travel to the forehead or glabella (corrugators or frown lines). These methods are performed using a radiofrequency probe which can locate and weaken the nerve.
If you have any questions please let me know by emailing me at jordan@rihanimd.com
-JR
