Botox vs. Dysport vs. Letybo: How the Three Neurotoxins Compare

Botox, Dysport and Letybo are all FDA-approved forms of botulinum toxin type A, and for most patients treating forehead lines, frown lines or crow’s feet, all three will produce a similar result that lasts roughly three to four months. The differences are real but modest: Dysport tends to take effect a day or two sooner and spreads a little more from each injection point, which some injectors prefer for broad areas like the forehead. Botox has the longest track record and the most published data. Letybo is the newest of the three in the United States, approved in 2024 for frown lines, and behaves much like Botox. The product matters less than the injector’s understanding of your anatomy and how conservatively it is dosed.

At Anato Aesthetics in Scottsdale I carry all three, so this comparison is not a sales pitch for one. It is meant to explain what is actually different, what is not, and how I choose between them for a given face. You can read more about the treatment itself on my neurotoxins page.

What all three have in common

Each product contains botulinum toxin type A, a purified protein that temporarily blocks the signal between a nerve and the muscle it controls. When a small dose is placed in a specific facial muscle, that muscle contracts less forcefully. The skin above it stops folding as deeply, existing lines soften, and new lines are prevented from etching in. None of the three changes the skin directly; they all work through the muscle.

All three:

• Are FDA-approved for glabellar (frown) lines, and Botox is additionally approved for forehead lines and crow’s feet, though all are used across these areas in practice.
• Begin working within about three to five days, with full effect at roughly two weeks.
• Last about three to four months on average, with some variation by individual and by area.
• Carry the same category of risks, including bruising, headache, and the uncommon possibility of a temporary eyelid or brow droop if product migrates to an unintended muscle.
• Are not recommended during pregnancy or breastfeeding, or for patients with certain neuromuscular conditions.

Botox vs. Dysport vs. Letybo at a glance

	Botox Cosmetic	Dysport	Letybo
Active ingredient	OnabotulinumtoxinA	AbobotulinumtoxinA	LetibotulinumtoxinA
Manufacturer	Allergan (AbbVie)	Galderma	Hugel
US cosmetic approval	2002 (glabellar lines)	2009 (glabellar lines)	2024 (glabellar lines)
Onset	About 3 to 5 days	Often 2 to 3 days	About 3 to 5 days
Full effect	About 14 days	About 14 days	About 14 days
Duration	Roughly 3 to 4 months	Roughly 3 to 4 months	Roughly 3 to 4 months
Spread from injection point	Moderate	Slightly wider	Moderate, similar to Botox
Unit conversion	1 unit reference	About 2.5 to 3 Dysport units per Botox unit	About 1:1 with Botox
Accessory proteins	Yes	Yes	Yes
Strengths	Longest track record, precise placement	Fast onset, smooth coverage of large areas	Newer option with a profile similar to Botox

Dosing figures in this table are general clinical conventions, not a substitute for an individualized plan. Units of one product are not interchangeable with units of another, which is why per-unit prices between brands cannot be compared directly.

The real differences, explained

Onset

Dysport is often noticed a day or so earlier than Botox or Letybo. For a patient treating a few days before an event this can matter; for most people on a maintenance schedule it does not, because by two weeks all three have reached full effect.

Spread and precision

Each injection creates a small zone of effect around the needle tip. Dysport’s zone is slightly larger. That is an advantage across a broad, flat muscle like the frontalis of the forehead, where a smoother, more even result can be achieved with fewer injection points. It is a consideration near the brow or around the eyes, where a more contained product may allow tighter control. Botox and Letybo behave similarly in this respect. In practice, an experienced injector adjusts dilution and placement to get the intended spread from any of the three.

Dosing and units

The three products are measured in different units. Roughly two and a half to three Dysport units are equivalent to one Botox unit, and Letybo is dosed approximately like Botox. This is purely a labeling difference and does not mean one is stronger or weaker at an equivalent dose. When you see a lower per-unit price for Dysport, remember that more units are used to achieve the same effect.

Duration

Head-to-head studies have not shown a consistent, clinically meaningful difference in how long the three last. Individual factors dominate: your metabolism, muscle strength, the dose used and how often you have been treated. Patients who have treated the same area consistently for years often find that lines stay softer even as the product wears off, because the muscle has stopped creasing the skin as deeply.

Why an injector might choose one over another

As a conservative, anatomy-first injector, I choose based on the area and the goal rather than brand loyalty. I often reach for Dysport on a large forehead or for a patient who wants faster onset. I often choose Botox where precise, contained placement matters, such as a brow lift or around the eyes, and for patients who have used it successfully for years. Letybo is a sensible option for patients curious about a newer product with a Botox-like profile.

Who is the right candidate?

Neurotoxin treatment suits a wide range of adults, but the fit depends on what you are trying to change.

• You have dynamic lines that appear when you frown, squint or raise your brows and soften at rest. This is the ideal scenario for any of the three products.
• You have early static lines that remain faintly visible at rest. Neurotoxin will soften them and slow their progression, but a deeply etched line may also need skin-quality work such as SkinPen microneedling or, in some cases, a small amount of dermal filler.
• You are in your late twenties or thirties and want to prevent lines from forming. Lower doses at longer intervals are typical.
• You want faster onset for a specific date. Dysport is a reasonable first choice.
• You have used Botox for years and are happy with it. There is no reason to switch. Consistency is valuable in neurotoxin treatment.
• You have felt your usual product is wearing off sooner than it used to. Trying an alternative is a reasonable, low-risk experiment, though the more common causes are dose and dosing interval.

Neurotoxin is not the right tool for volume loss, skin laxity or texture. Hollow cheeks call for Sculptra or filler; a softening jawline may be better served by XERF skin tightening. Part of a good consultation in Scottsdale, or anywhere, is being told which concern a neurotoxin will not fix, and I will tell you.

Cost considerations without the numbers

I do not publish per-unit prices here because they change and because unit counts vary so widely between faces that a per-unit figure is easy to misread. What I can say is that the total cost of a treatment depends on the number of units your muscles need, not on the brand, and that a lower per-unit price on Dysport does not translate to a cheaper treatment once the unit conversion is applied. I will give you an exact quote at your consultation before anything is injected, and Skinvestment members receive member pricing on all three products.

Frequently asked questions

Is Dysport better than Botox?

Neither is better overall. Dysport may act a day or two faster and spreads slightly more, which suits large areas like the forehead. Botox has the longest track record and is often preferred for precise placement. Results and duration are similar for most patients.

Is Letybo as good as Botox?

Letybo was approved by the FDA in 2024 for glabellar lines and has been used in other countries for longer. Its onset, duration and behavior are similar to Botox. It has less long-term US data simply because it is newer, not because of any identified difference in performance.

Which neurotoxin lasts the longest?

There is no consistent evidence that one lasts meaningfully longer than the others at equivalent doses. Duration depends more on your muscle strength, metabolism, the dose used and how regularly you are treated.

Can I switch between Botox, Dysport and Letybo?

Yes. Many patients try more than one over time. Switching does not cause problems, and because I carry all three you can change products at your next visit if you want to compare how they feel.

Why does Dysport look cheaper per unit?

Because Dysport units are smaller. Roughly two and a half to three Dysport units equal one Botox unit, so a treatment uses more of them. Compare the total treatment cost, not the per-unit price.