Dysport™
Before(top) and after(bottom) Dysport™ treatment to smooth and relax wrinkles in the brow and forehead. Photo is showing contraction in the brow and forehead before and after Dysport. Photos courtesy of Advanced Dermatology.
What is Dysport™?
Dysport™ (abobotulinumtoxinA) is a purified botulinum neurotoxin that is derived from the Clostridium Botulinum Type A bacteria. Although the Clostridium bacteria cause botulism, the Dysport™ extract does not. Dysport™ is approved in the US to treat cosmetic facial wrinkles (of the brow) and cervical dystonia (muscular spasm of the neck). All other uses that are discussed are considered off-label (non-FDA approved) uses of an FDA approved product.
Who is a candidate?
People with frown lines, forehead lines, crow’s feet, and smile lines around their eyes who wish to appear more relaxed, calmer, and less tired are good candidates for the injections of Dysport™.
People who should NOT receive Dysport™ are those with the presence of infection at the proposed injection site(s), those who have neuromuscular junctional disorders (such as multiple sclerosis, myasthenia gravis, or Lambert-Eaton syndrome), or pregnant women.
What is Dysport™ like?
At your visit, the area to be treated will be cleansed and you will be asked to use the target muscle(s): ie; frown, smile, and look surprised. Your muscles will be marked with a washable pencil at the point of maximal exertion. This will pinpoint exactly the area it is best to inject. You will the receive anywhere from 5-20 injections.
A very tine needle is used along with cold air and/or ice packs to minimize discomfort. The vast majority of people find this to be a very tolerable procedure. If you have never had the injections before, a certain amount of anxiety is normal. We have found that people experiencing the procedure for the first time are greatly relieved afterward and find that it was far easier than anticipated. The treatment usually takes 10 minutes.
How does Dysport™ work ?
Dysport blocks the chemical signal that causes certain facial muscles to contract. This causes the muscle to relax and the wrinkles that are caused by certain facial expressions to become smoother.
What type of equipment is used?
We only use FDA approved Dysport™ purchased directly from the manufacturer, Medicis®. We use small, fine needled syringes to maximize comfort and precision.
What desired results can be expected?
Results for treatment with Dysport™ depend on the area being treated, but may include the following: resolve of frown, forehead, and crow’s feet wrinkles; a more relaxed alert looking appearance; as well as a potential lifting of the brow and opening of the eyelid.
The duration of improvement with Dysport™ varies between patients. Treatment effects typically last 4 months for wrinkles. Repeat treatments need to be performed to maintain the desired effect.
Are there any negatives?
There is a minor degree of discomfort from the small-gauge needle that is inserted under the skin. There may be a slight burning discomfort as the Dysport™ is being injected into the muscle. There will be some swelling in the injection area for a couple of hours. Bruising occurs uncommonly and can take up to 7-10 days to clear, but may be camouflaged with makeup immediately following treatment.
Occasionally Dysport™ accentuates the natural asymmetry in most people’s faces or causes an abrupt transition from a relaxed area to an active area leading to pointy looking eyebrows (“Spock-effect”). Either of these can be correctly with a small amount of additional Dysport™.
Dysport™ may migrate to nearby tissues, and may cause functional or esthetically displeasing effects such as brow ptosis (drooping of the brow), eyelid ptosis (drooping of the eyelid), diplopia (double vision), or lagopthalmus (weakness of eye closure). Fortunately these side effects are rare (as the Dysport™ effect wears off in a few months) and temporary. There are also prescription eye drops that can mitigate these effects if they occur.
Occasionally Dysport™ can cause headaches. These are usually transient and occur because other muscles are contracting trying to make up for the ones that have been relaxed. There have been rare reports of severe headaches lasting up to 2 weeks after Dysport™ injections.
Anyone with neurological disease or history of temporary paralysis, loss of vision, or double vision should not have this treatment. It is believed that these increase the risks of complications with Dysport™ or worsening of an underlying disorder.
What happens after Dysport™?
Usually you will have a mosquito-bite looking area for 20-60 minutes which resolve without a trace. Occasionally little red areas at areas of injection appear but resolve within a couple of days. It may help the Dysport™ to be absorbed more quickly if you make the facial expressions we are trying to relax (ie: frown, raise the eyebrows, smile/squint) a few times over the couple of hours after the injection. Try not to fall asleep or relax in a recumbent position as this may rarely lead to some diffusion or spreading of the Dysport™ to adjacent areas. Your regular skin care regimen can be resumed immediately following a treatment, and makeup may be applied if desired.
Try to avoid aspirin containing products or high-dosage vitamin E supplements for 48 hours unless medically necessary. Avoidance of these for 10 days prior to the procedure is recommended to avoid bruising. The vitamin E contained in a typical multi-vitamin is fine to take during this time.
Is there another way to get the same effect?
Alternative forms of treatment for wrinkles of the forehead and eyes include injectable fillers, brow lift with resection of the brow muscles, blephroplasty, laser resurfacing, tissue tightening, topical muscle relaxers, and topical therapy.
How is this different than other procedures?
Dysport™ works directly on the chemicals that cause the muscles to contract (the source of wrinkles caused by muscle contraction).
Can this be combined with other treatments?
Dysport™ may be combined with many other cosmetic treatments in our office. Many patients choose to undergo combination treatments in order to achieve the maximum aesthetic result.
What is the cost of Dysport™?
Treatments depend on the amount of Dysport™ needed and vary from patient to patient. We charge based on the amount of units that are utilized. This is individualized for each person (men usually need more than women, because their muscles are larger).
