Patient Satisfaction and Safety of Dysport in an Oral and Maxillofacial Surgery Practice
Botulinum toxin A, produced by the bacteria Clostridium Botulinum, is a potent neurotoxin that causes localized flaccid muscle paralysis. It is approved for the treatment of a variety of medical problems including cervical dystonia, strabismus, axillary hyperhidrosis, blepharospasm and glabellar wrinkles. Its use in facial cosmetic rejuvenation accounted for over 25% of all non-invasive surgical cosmetic procedures performed in the United States in 2008 (Jewell 2009). Botox (Allergan, Inc., Irvine, CA) and Dysport (Medicis Aesthetics, Scottsdale, AZ) are both approved by the FDA for the treatment of glabellar wrinkles and are used “off-label” for the treatment of forehead and periorbital wrinkles. Botox and Dysport are each derived from a unique strain of C. Botulinum using different proprietary methods, and as such have different chemical properties. Multiple studies have shown Botox and Dysport to be comparable in efficacy and safety but there are claims that Dysport has several advantages. These include longer duration, quicker onset, and a decreased risk of patients developing antibodies to the toxin (Nestor 2011). In addition, Dysport has a lower cost per treatment (Basil 2011). These potentially desirable characteristics make Dysport an attractive alternative to Botox. The objective of this study is to evaluate patients in our private practice in order to compare their Dysport experiences.
Materials and methods: A retrospective study was conducted on a patient population (n=20) who received Dysport for treatment of glabellar and forehead rhytids in an Oral and Maxillofacial Surgery office. Phone interviews were conducted which asked ten unique questions. These questions included: Patient satisfaction (0-10 scale), side effects, duration as well as the onset of action of the toxin. All patients were treated by the same surgeon and most patients were treated with Botox in the past. Most patients received 50-80 units of Dysport in the glabellar area and 25-50 units of Dysport in the forehead area.
Methods of data analysis: Results:Patients who received Dysport were very satisfied with the treatment (9.5/10) and there were no reported major complications. Onset of action was observed to be on same day up to a week after injection. Most patients noted full effect within a few days to one week. Reported adverse effects included redness, tingling, and discomfort at the injection site. All resolved within a day after treatment. There was no reported “down time” as patients returned to work immediately and were able to use other muscles of facial expression without limitations. Patients reported that they would undergo this treatment again and recommended it to others.
Conclusions: This pilot study on using Dysport in the glabellar and forehead areas demonstrated great success in an OMS practice. High patient satisfaction rates and great safety record of Dysport make this medication a competitive alternative to Botox for glabellar and forehead rhytids. A larger prospective study is required to evaluate these observed effects.
References:
De Boulle, Koenaad, et al. Treating glabellar lines with botulinum toxin type A-hemagglutinin complex: A review of the science, the clinical data, and patient satisfaction. Clinical Interventions in Aging2010(5): 101-118.
Nestor, Mark S. and Glynis Ablon. Duration of action of abobotulinumtoxinA and onabotulinumtoxinA: A randomized, double-blind study using a contralateral frontalis model. J Clin Aesthet Dermatol2011;4(9):43-49.
Basil M, Csank G, Ryb G, Eko F, Rubin A. Prospective Randomized Comparison of OnobotulinumtoxinA (Botox) and AbobotulinumtoxinA (Dysport) in the Treatment of Forehead, Glabellar, and Periorbital Wrinkles. Aesthic Surg J2011;31(1):96-102.
Jewell ML, Monheit GD. An overview of clinical trial data on a new formulation of botulinum neurotoxin type A. Aesthetic Surg J 2009;29:531-533.