The eyes are perhaps one of the most significant areas of the face to betray the tell-tale signs of ageing. Not only do they express a person's emotions, but through a loss of volume in the cheek and fine lines surrounding them, they can give away a person's age almost instantaneously.

 

Thankfully, we work in a continuously advancing industry, in which the techniques used to inject dermal fillers and botulinum toxin, for example, are improving on a daily basis; one can turn the clock back at the insertion of a needle.

And while the preferred toxin of choice varies from physician to physician, it is not surprising that a recent study published in the Archives of Facial Plastic Surgery1 has ignited furious debate among the Twitterati with regard to which is better — Botox or Dysport? Well, when examining the effect of either toxin on crow's feet at least.

In a randomised, double-blind trial (funded by the makers of Dysport, Medicis Aesthetics Inc.), patients received injections of Botox (onabotulinum toxin A) on one side of the face and injections of Dysport (abobotulinum toxin A) on the other. According to the researchers, after 30 days two thirds of patients said they preferred the side of the face that had been treated with Dysport.

However, the difference between the way in which both the participants in the study and the researchers rated the effect of Dysport and Botox were only statistically significant when the eye muscles were contracted, rather than when they were at rest.

Regardless of the outcome, whether the results of the study will affect the physician's or patient's choice of toxin remains to be seen. It seems that most practitioners will often use the same product they've used for years, and that they are comfortable with, whether that is Botox/Vistabel, Dysport, Bocouture/Xeomin, or Azzalure.

And the patient, on the other hand, will not necessarily be aware of the differences between the range of botulinum toxins available. Should we then, perhaps, consider the issue of patient choice when it comes to non-invasive cosmetic surgery? Should he or she be allowed to request a specific filler or botulinum toxin, just as he or she is able to choose treatment on a specific area?

While patient choice is certainly advocated in many of the world's healthcare systems, it seems that cosmetic surgery — whether invasive or non-invasive — remains one of the few medical professions in which the physician is King. Far from being left in the dark with regard to treatment, the patient should be confident that the treatment will be safe, and that the health professional carrying out the procedure has the sufficient knowledge and skill to know exactly what to do with the product.

So while Dysport might be better at reducing the appearance of crow's feet, the physician might be much better at using his/her choice of toxin or filler to the satisfaction of the patient. And ultimately, that's what counts.

 

Rosalind Hill

Managing Editor - PRIMEJournal

Informa Healthcare