Patients often come into aesthetic practices with one big question: Which neuromodulator should I choose? With several FDA-approved options on the market, the answer isn’t always simple. To help break down the differences, we sat down with Dr. Rebecca Weiss, Medical Director of Paradise Medspa & Wellness in Phoenix, Arizona, to talk about Botox, Dysport, Xeomin, Daxxify, and what patients really need to know before choosing a treatment.
Q: Many patients only know about Botox. How many neuromodulators are available today?
Dr. Weiss:
Many people are surprised to learn that there are currently five different FDA-approved neuromodulators available in the United States. Most patients recognize the name Botox, but when they come in for treatment, they may actually be recommended Dysport, Xeomin, or another product—and that can be confusing if you don’t realize these options exist.
Q: Are these neuromodulators really all that different?
Dr. Weiss:
At their core, they all share the same active ingredient, and they can all work extremely well. What differentiates them is the way the product is made—the proteins associated with the active ingredient that help it penetrate the cellular membrane. Those proteins vary between brands, but the foundation is essentially the same.
The real key to great results isn’t the product itself—it’s the injector’s expertise. When these neuromodulators are administered appropriately and precisely, patients can achieve remarkable outcomes with any of the FDA-approved options.
Q: The newest neuromodulator, Daxxify, has been getting a lot of attention. What makes it different?
Dr. Weiss:
Daxxify is the newest addition to the neuromodulator market, and it’s definitely unique. It uses a specially formulated protein with positive charges, which helps the product bind more effectively and stay active longer. Because of that, Daxxify is FDA-approved for up to six months of duration—longer than the typical three to four months seen with other neuromodulators.
In my own clinical experience, I’m generally seeing results last four to five months. I haven’t seen many patients reach the full six months yet, but it’s a newer product, and we’re still fine-tuning dosing to find the sweet spot for different patients.
Q: Speaking of dosing—how much does dosage impact results and longevity?
Dr. Weiss:
Dosing plays a big role. For example, Daxxify’s on-label recommendation is to use twice as many units compared to traditional neuromodulators. Across the board, we’ve seen that higher doses tend to produce longer-lasting results.
So if someone feels their treatment doesn’t last as long as it used to, dosage may be a factor to discuss. Most products ideally last three to four months, but adjusting the dose can improve both longevity and satisfaction.
Q: With several brands available, how should a patient decide which one to choose?
Dr. Weiss:
The best thing someone can do is simply come in for a consultation with us. They can then explain their history, goals, concerns, and ask questions. Based on the conversation and our assessment, we can then recommend a certain product. You want to make sure you’re being treated by an experienced aesthetic injector who understands the nuances of each neuromodulator.
A skilled provider will evaluate your anatomy, your goals, and your past treatment history to recommend the best option—not just the brand you’ve heard the most about.
Q: Any final advice for someone considering their first (or next) Tox treatment?
Dr. Weiss:
Don’t get too hung up on the brand name. Focus on finding a provider you trust—someone who has a deep understanding of these products and who can tailor the dosing and placement to your unique needs. With the right injector, you can get beautiful, natural-looking results with any of the FDA-approved neuromodulators.
