Written by Joy DeRoche, NP. Board-certified Nurse Practitioner and owner of Joyful Beauty NP in Plaistow, NH. Practicing aesthetic medicine since 2015 and former Preceptor who trained injectors for five large med spa chains.
One of the first questions I hear from new patients is, “Should I get Botox or Dysport?” Lately I’m hearing a third one, too: “What’s Letybo?”
Here’s my honest answer. They’re more alike than different. The best choice usually comes down to you.
I’ve been treating patients with neuromodulators since 2015. I also spent years training other injectors as a Preceptor for five large med spa chains. In this guide, I’ll explain how these products compare, how I decide which one to use, and what to expect at your appointment.
What They Have in Common
Botox, Dysport, and Letybo are all neuromodulators. They temporarily relax the small muscles that create lines when you frown, squint, or raise your brows.
Over time, those repeated movements etch themselves into the skin. Relaxing the muscle softens the lines you have. It also helps keep new ones from deepening.
All three are used for similar areas:
- The forehead
- The “11s” between the brows
- Crow’s feet around the eyes
For most people, results last about three to four months.
Meet the Three Options
Botox Cosmetic. The most well-known name. It has been FDA-approved for cosmetic use since 2002 and has decades of research behind it. Many patients start here simply because they know the name.
Dysport. FDA-approved for frown lines since 2009. Some of my patients feel it kicks in a day or two sooner. It can spread a little more, which can be helpful for larger areas like the forehead.
Letybo. The newest of the three. It was FDA-approved for frown lines in 2024. It has been a welcome addition for patients who want another option.
Where They Differ
They aren’t identical. Each has its own formulation, and the units aren’t interchangeable.
Ten units of one is not the same as ten units of another. A Dysport treatment, for example, uses more units than Botox to reach a similar effect. That’s why comparing prices “per unit” between products can be misleading. It’s more helpful to compare the cost of treating the area.
What matters most isn’t the brand name on the vial. It’s how skillfully the product is placed and dosed.
How I Decide
I look at a few things:
- Your anatomy. How strong are your muscles, and where do your lines show up? I watch how your face moves, not just how it looks at rest.
- Your history. If you’ve loved your results with one product, there’s usually no reason to switch.
- Your timeline. If you have an event coming up, onset time may matter.
- Your goals. Do you want to look completely smooth, or keep some natural expression? Both are valid, and I’ll dose accordingly.
If you’re new to all of this, we’ll start conservatively and fine-tune from there.
Who Should Wait or Skip Treatment
Neuromodulators are very safe in the right hands. Still, they aren’t right for everyone. I review your health history at every consultation. I don’t treat patients who:
- Are pregnant or breastfeeding
- Have certain neuromuscular conditions, such as myasthenia gravis
- Have an active skin infection in the treatment area
- Have had an allergic reaction to a neuromodulator
Please tell me about any medications you take, including blood thinners and supplements. Some can increase bruising.
What Your Appointment Looks Like
- Consultation. We talk about your goals, and I watch how your face moves when you frown, smile, and raise your brows.
- Photos. I take before photos so we can see your progress.
- Cleansing. I clean the skin and mark the injection points.
- Treatment. I use a very fine needle. Most patients describe it as a quick pinch. The injections take about 10 to 15 minutes.
There is no downtime. Most patients go right back to work or errands.
Why precision matters. Where the product goes is just as important as how much. Placing it too low on the forehead, for example, can make the brows feel heavy. Knowing the facial muscles in detail is how I keep results natural and avoid side effects like a drooping brow or eyelid.
Aftercare Tips
- Stay upright for about four hours after treatment.
- Don’t rub or massage the treated areas that day.
- Skip strenuous exercise for the rest of the day.
- Avoid facials and other face treatments for about two weeks.
- Gently use the treated muscles, like frowning and raising your brows, for the first hour or so.
Your Results Timeline
- Day 3 to 5: You start to notice the muscles softening.
- Day 10 to 14: You see your full result. This is when I like to check in.
- Month 3 to 4: Movement slowly returns. This is a good time to book your next visit.
Small bruises, mild redness, or a light headache can happen. They usually fade within a few days. Serious side effects are rare. If you ever notice a drooping eyelid, trouble swallowing or speaking, or anything that worries you, call me right away.
My Philosophy on “Natural”
I never want anyone to look frozen or surprised. You should still look like you, just rested and refreshed.
Your friends should say, “You look great, did you do something?” and not be able to tell exactly what.
Want to see what results can look like? I share before and afters on Instagram, including forehead and frown line results.
Botox, Dysport, and Letybo FAQs
None of them is better for everyone. All three are FDA-approved and work in a similar way. I choose based on your anatomy, your history with treatment, and your goals.
Most patients say it feels like a quick pinch. I use a very fine needle, and the whole treatment takes only a few minutes.
Most patients enjoy their results for three to four months. Some find their results last a little longer after regular treatments.
Yes. Some patients like to try another option, especially if they feel their results are wearing off sooner. We’ll adjust your dose, since the units are not interchangeable.
Not with me. I dose to soften lines while keeping your natural expression. We start conservatively and adjust at your follow-up if needed.
Plan for at least two weeks before. That gives your results time to fully settle and leaves time for a touch-up if needed.
Many patients start in their late 20s or early 30s as lines begin to form. Small amounts can help prevent lines from deepening. We’ll talk about whether it makes sense for you.
Come See Me
If you’re curious which option is right for you, let’s talk. We’ll go over your goals and build a plan that fits.
Joyful Beauty NP is located at 155 Main Street in Plaistow, NH. I see patients from Plaistow, Haverhill, Atkinson, Hampstead, and across the Seacoast. Book a free consultation or call 978-702-3736.
This article is for general education and isn’t a substitute for a personal medical consultation. Your treatment plan depends on your own health history and goals.
