We carry and inject all three, so we have no horse in this race. Botox (Allergan), Dysport (Galderma) and Xeomin (Merz) are the same class of medicine (botulinum toxin type A) made by three different manufacturers. The differences are real but smaller than the marketing suggests. Here's what actually matters.
What do all three have in common?
Everything fundamental. Same active molecule, same mechanism (relaxing the muscles whose movement creases skin), same FDA-approved uses in aesthetics, same three-to-four-month duration in head-to-head studies, and the same safety profile built over decades. If you were treated blind with any of the three by the same injector, you would very likely not be able to tell which you received.
What's actually different about Dysport?
Two practical things. Dysport tends to show results a day or two sooner, useful when an event is close. And it diffuses slightly more from each injection point, which is an advantage across broad areas like the forehead (smoother blending, fewer injection points) and a reason for extra precision near small muscles. Its units are also measured on a different scale: a Dysport treatment uses roughly three times the unit count. We convert the units to the same basis when we quote, so you aren't doing math to compare brands; if you see very cheap per-unit Dysport advertised somewhere, it's because you'll need two to three times as many units.
What's actually different about Xeomin?
Xeomin is the minimalist: the same active molecule without the accessory proteins the other two carry, sometimes marketed as the "naked" neurotoxin. The practical relevance is the resistance question: in rare cases, long-term patients develop antibodies to those accessory proteins and notice their results weakening. Xeomin sidesteps that possibility, which makes it our usual recommendation when someone reports "Botox just doesn't seem to work on me anymore." It also often runs a bit less overall.
The brand decision takes about two minutes of a consultation once we've seen your anatomy and history, and consultations are free, with no obligation to book.
Does one brand last longer?
Not meaningfully: controlled comparisons put all three in the same three-to-four-month window. Individual patients do sometimes find one brand outlasts another for them, and that lived result is worth honoring: if your face has a favorite, we treat with it.
So how do we actually choose?
Anatomy first, history second, logistics third. Broad forehead with many injection points: Dysport's spread earns its place. History of fading results: Xeomin's clean formulation. Small, precise areas like a lip flip: Botox's tight stay-where-placed behavior. First-timer with no history: often Botox, simply because its track record makes your future comparisons easiest. Whichever we recommend, we quote every brand on the same converted-unit basis, and you'll know the number before we start.