Did You Get Botox, or Something Else? How to Know Which Toxin Is in Your Syringe

The short version

• "Botox" is one brand. Six toxins are FDA-approved for frown lines in the US, and many clinics call all of them "Botox." We stock five: Botox, Dysport, Xeomin, Daxxify and Letybo.
• Getting a different FDA-approved toxin from the one you asked for is rarely a safety problem on its own. Not being told is the problem, because the brands use different unit scales, last different lengths of time and cost different amounts.
• You can check for yourself. Ask for the brand when you book, ask to see the vial before you're injected, and make sure your chart and receipt name the brand, the units and the lot number.
• A real vial shows a full generic name such as onabotulinumtoxinA, a lot number and an expiry date. In 2024 the FDA warned about counterfeit Botox labelled only "Botulinum Toxin Type A."
• If you want the lowest price per treatment, the longest gap between visits or the fastest start, a different toxin suits each one. We'll tell you which one we're using and why.

Is "Botox" the name of every wrinkle injection?

No. Botox is the brand name of one product, onabotulinumtoxinA, made by Allergan Aesthetics. It became so well known that most people, and many clinics, now say "Botox" for any toxin injection, the way people say "Kleenex" for any tissue.

Six botulinum toxin products are FDA-approved for frown lines in the US. At The Injection Room we stock five of them:

• Botox (onabotulinumtoxinA)
• Dysport (abobotulinumtoxinA)
• Xeomin (incobotulinumtoxinA)
• Daxxify (daxibotulinumtoxinA-lanm)
• Letybo (letibotulinumtoxinA-wlbg)

The sixth, Jeuveau, isn't on our menu.

All five are purified botulinum toxin type A. All five relax the muscle they're injected into by blocking the signal from nerve to muscle. They differ in how they're made, what else is in the vial, how their units are measured, how fast they start and how long they last.

Why would a clinic use a different toxin from the one you asked for?

Usually for an ordinary reason. The injector prefers a different product for your area, the clinic ran out of one brand, another brand costs the clinic less, or "Botox" on the booking page simply means "a toxin treatment." None of those is a problem if you're told before the needle goes in.

The regret threads online are full of a different story: someone books Botox, finds out afterward that they got something else, and only learns it because the result felt different or the receipt named another product. That's the part that breaks trust. You should know what's being injected into your face, and a good clinic will tell you without being asked.

Does it matter which toxin you get?

It matters in four ways, and safety is usually the smallest of them when the product is genuine and the injector is trained.

1. The units aren't interchangeable. Every toxin's FDA label says its units are specific to that product and can't be converted directly to another. For frown lines, the labelled dose is 20 units of Botox, Xeomin or Letybo, 40 units of Daxxify and 50 units of Dysport. If you're told "you got 20 units," that number only means something once you know the brand.

2. The price only makes sense with the brand. Because the unit scales differ, a lower price per unit doesn't always mean a lower price per treatment. You can only compare clinics if you know which product each one is quoting.

3. Timing differs. Some toxins start within a day or two, others take closer to a week. Most last three to four months, and Daxxify lasts around six months for many people. If your last treatment wore off early, the brand is one of the first things worth checking.

4. Your history matters. If one toxin worked well for you, knowing its name lets you ask for it again. If one didn't, you can ask for something different. Very rarely, people stop responding to toxin over time. Some injectors switch those patients to Xeomin because it has no accessory proteins, although the evidence on how much that helps is limited.

How do the five toxins we stock compare?

Onset and duration vary from person to person and depend on the dose, the area and how strong your muscles are. Every treatment has a 20-unit minimum. See our neurotoxin page for today's prices, and our guide to what tox really costs in a year for totals by area.

How can you check which toxin you're getting?

Five steps, and none of them should make a good clinic uncomfortable.

1. Ask for the brand when you book. If the booking page just says "Botox" or "tox," ask which product your injector plans to use and why.

2. Ask to see the vial before you're injected. A genuine vial carries the brand name, the full generic name (onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA, daxibotulinumtoxinA-lanm or letibotulinumtoxinA-wlbg), a lot number and an expiry date.

3. Check that the units match the brand. Twenty units makes sense for Botox, Xeomin or Letybo. For Dysport, the same treatment uses more units. If the unit count looks wrong for the brand, ask.

4. Make sure your chart and receipt name the product. Your record should show the brand, the number of units, the areas treated and the lot number. That's what lets you ask for the same product next time.

5. Know the signs of a counterfeit. In 2024 the FDA and Allergan warned about counterfeit Botox in several states. It carried lot number C3709C3, came in 150-unit vials (genuine Botox comes in 50, 100 and 200 units), listed the active ingredient as "Botulinum Toxin Type A" instead of "onabotulinumtoxinA," and had outer cartons in a language other than English. The CDC linked counterfeit or mishandled toxin to 22 people in 11 states who became ill, Texas among them, and every case involved an unlicensed injector or a non-healthcare setting.

What if you've already been given a different toxin?

If it was a genuine, FDA-approved product dosed for that brand, your result will usually be similar to the one you expected. The differences between brands are smaller than the differences between a full dose and a thin one.

Note which product you got and how long it lasted, and ask the clinic for your treatment record. That tells you what to ask for next time.

If you had symptoms after treatment, such as difficulty swallowing, breathing or speaking, double vision or a drooping eyelid, get medical care straight away. If you think a product was counterfeit, report it to the FDA's Office of Criminal Investigations at 800-551-3989.

Which toxin should you choose?

Start with what matters most to you.

• The lowest price per treatment: Xeomin has the lowest price per unit on our menu and uses the same 20-unit dose as Botox for frown lines.
• The longest gap between visits: Daxxify lasts around six months for many people, so you may need two visits a year where others need three or four.
• The fastest start: Daxxify and Dysport tend to start working within a day or two.
• The most research behind it: Botox has been approved for frown lines since 2002 and has the most approved uses.
• A newer option on the familiar scale: Letybo uses the same 20-unit dose as Botox at a lower price per unit.

And if one toxin has worked well for you, staying with it is a perfectly good reason to choose it. Your injector will match the product to your muscles and your goals at your consult.

How do we handle this at The Injection Room?

We name the toxin before we inject it. Your injector will tell you which product they recommend for your treatment and why, show you the vial on request, and record the brand, the units and the lot number in your chart. If you'd rather have a specific brand, ask for it, and we'll use it.

Preguntas más frecuentes

Is Xeomin the same as Botox?

Xeomin and Botox contain the same type of toxin, botulinum toxin type A, and use the same 20-unit dose for frown lines. Xeomin has no accessory proteins and can be stored at room temperature before it's mixed. At The Injection Room, Xeomin costs $10 per unit and Botox $13.

Is Dysport stronger than Botox?

Dysport's units are measured on a different scale, so the same treatment takes more units of Dysport. It isn't stronger unit for unit. Dysport often starts working a day or two sooner.

Which Botox brand lasts the longest?

Daxxify lasts the longest of the toxins we stock, around six months for many people. Botox, Dysport, Xeomin and Letybo usually last three to four months.

Is Letybo the same as Botox?

Letybo is a different product from a different manufacturer, Hugel, with the same type of toxin and the same 20-unit dose for frown lines. It was FDA-approved in 2024. At The Injection Room, Letybo costs $12 per unit and Botox $13.

Can a clinic use a different toxin without telling you?

You should always be told which product you're getting before you're injected. If you weren't told, ask the clinic for your treatment record, which should name the brand, the units and the lot number.

How do you know your Botox is real?

Ask to see the vial. Genuine Botox shows "onabotulinumtoxinA," a lot number and an expiry date, and comes in 50, 100 or 200 units. Get injections only from a licensed injector in a licensed healthcare setting.

Is Daxxify worth the higher price?

It depends on how often you want to come in. Daxxify costs more per treatment and can last around twice as long for many people, so the yearly cost can come out similar with fewer appointments.

Book your consult

We have three locations: South Congress in Austin, and South Flores and Eilan in San Antonio. Your consult is free. We'll tell you which toxin we recommend for you and why, and you'll leave with a written plan and a price.

Neurotoxin at The Injection Room: five toxins, from $10 per unit, from $9 on Tox Days, 20-unit minimum.

Fuentes

• U.S. Food and Drug Administration prescribing information for Xeomin, Daxxify and Letybo, plus the Botox Cosmetic and Dysport labels, for doses, unit statements and ingredients.
• U.S. Food and Drug Administration, Counterfeit version of Botox found in the United States.
• GoodRx, Real vs. fake Botox, summarising the April 2024 FDA and Allergan alert.
• Centers for Disease Control and Prevention, Adverse effects linked to counterfeit or mishandled botulinum toxin injections, April 2024.
• American Med Spa Association, Hugel receives FDA approval of Letybo, 2024.

This article is general information and does not replace a consultation with a qualified medical provider.