Six FDA-Approved Neurotoxins. One Is Our Favorite. Here's Why.
Botox is a brand name, not a category. There are now six FDA-approved neurotoxins available in the U.S. — each with meaningful differences in formulation, onset, duration, and precision. Here's an honest breakdown of all of them, and why Évry chooses Letybo® as our primary neurotoxin.
Most patients walk in asking for "Botox." It's the word that has become synonymous with the entire category — the way people say Kleenex when they mean tissue, or Google when they mean search. But Botox is a brand name, manufactured by Allergan, and it represents just one of six FDA-approved botulinum toxin type A products currently available in the United States. The others — Dysport, Xeomin, Jeuveau, Daxxify, and Letybo — are distinct formulations with their own manufacturing processes, protein structures, onset profiles, durations, and clinical characteristics. They are not interchangeable. And for a growing number of patients and providers, they are not equal.
At Évry Aesthetics in Elmhurst, IL, our primary neurotoxin is Letybo® — the newest FDA-approved entry, developed in South Korea, and in our clinical experience one of the most precise and naturally behaving neurotoxins available. This blog is a complete, honest breakdown of all six options — because an informed patient is a better patient, and we believe in earning your trust with transparency rather than marketing.
The shared mechanism — before we get to the differences
All six products are FDA-approved and contain the botulinum toxin type A molecule produced by the bacterium Clostridium botulinum, which temporarily blocks the release of acetylcholine — the neurotransmitter that activates muscle movement — so the muscles can't contract. When injected into targeted facial muscles, this relaxation smooths dynamic expression lines — the wrinkles formed by repeated movement — and prevents them from etching deeper over time.
The differences between products arise in how the botulinum toxin molecule is stabilized, what proteins or peptides surround it, how quickly it takes effect, how far it diffuses from the injection site, how long it lasts, and how the body metabolizes it over time. For a patient, those differences translate to: how fast you see results, how natural the movement feels, and how often you need to come back.
All six FDA-approved neurotoxins — compared honestly
Letybo®
letibotulinumtoxinA-wlbg · Hugel (South Korea)
South KoreaFDA 2024Évry's Choice
ONSET3–5 days
DURATION3–4 months
DOSING1:1 with Botox
Letybo received FDA approval in 2024, making it the newest addition to the U.S. market. Developed by Hugel, South Korea's leading biopharmaceutical company, Letybo has been the #1 neurotoxin in South Korea for years — arriving in the U.S. with an extensive clinical track record and Phase 3 data confirming efficacy, safety, patient satisfaction, and noninferiority to onabotulinumtoxinA in a large clinical trial. Its 1:1 dosing with Botox makes transitioning seamless. The formulation is engineered for controlled, precise diffusion — minimizing spread beyond the target muscle, which translates to tighter, more predictable placement. In dynamic areas like the crow's feet, brow, and glabella, this precision produces natural-looking results that preserve expressive movement rather than flattening it. Letybo is generally offered at a lower price point than Botox — making clinical-grade precision accessible without the premium cost of the legacy brand.
Why we chose it: Letybo's precision diffusion profile, extensive Korean clinical history, 1:1 dosing familiarity, and natural movement results align exactly with our philosophy. We want results that make you look like yourself — and Letybo delivers that consistently.
Botox Cosmetic®
onabotulinumtoxinA · Allergan (USA)
USAFDA 2002
ONSET4–7 days
DURATION3–4 months
DOSINGStandard reference
The original and still the market leader — Botox makes up approximately 70% of the neuromodulator market in the United States and has been FDA-approved for cosmetic use since 2002. Its track record is unmatched, its safety data the most extensive of any neurotoxin, and its results reliably predictable in trained hands. Botox received expanded FDA approval for platysma bands in October 2024, further extending its already broad indication list. The limitation is largely market-based: at a premium price point and with no meaningful clinical advantage over newer formulations, it remains the gold standard by reputation more than by differentiation.
Dysport®
abobotulinumtoxinA · Ipsen (UK/France)
UK / FranceFDA 2009
ONSET2–4 days
DURATION3–4 months
DOSING~2.5:1 vs. Botox
Dysport is valued for its fast onset and slightly wider diffusion, making it ideal for larger treatment areas like the forehead or masseter muscles. It works quickly — often within 2–4 days. The wider diffusion profile is a clinical tool in the right context — excellent for the forehead, where coverage across a broad surface is beneficial — but requires experienced dosing in precise areas where containment matters. Dysport's higher unit-per-area requirement relative to Botox makes pricing comparison more complex than it appears at first glance.
Xeomin®
incobotulinumtoxinA · Merz (Germany)
GermanyFDA 2011
ONSET4–7 days
DURATION3–4 months
DOSING1:1 with Botox
Xeomin is unique for its "naked" formulation — it contains no accessory proteins, reducing the risk of antibody formation while blocking nerve signals responsible for muscle movements. Often called "naked Botox," Xeomin is the purest formulation of the six — the botulinum toxin molecule with nothing else attached. Recent literature on immunogenicity is more nuanced than older marketing claims that any single product is automatically "best" for antibody risk in every aesthetic scenario — but for patients who have developed resistance to protein-containing formulations, Xeomin is a clinically meaningful option.
Jeuveau®
prabotulinumtoxinA-xvfs · Evolus (South Korea/USA)
South KoreaFDA 2019
ONSET3–5 days
DURATION3–4 months
DOSING1:1 with Botox
Marketed as "Newtox" at launch, Jeuveau is also manufactured in South Korea and was positioned as the modern, aesthetics-only neurotoxin — never approved for therapeutic use, only cosmetic. Jeuveau has the fastest onset and newer high-dose data suggest duration can extend further when dose is increased. It is also clinically more precise than some competitors. It is most similar to Botox of any alternative, with 1:1 dosing, and typically offered at 20–30% lower price. A solid, well-studied option, particularly popular among cost-conscious patients who want Botox-equivalent results.
Daxxify®
daxibotulinumtoxinA-lanm · Revance (USA)
USAFDA 2022
ONSET3–5 days
DURATION">6+ MONTHS
DOSINGHigher per area
Daxxify utilizes a unique peptide (RTP004) to stabilize the botulinum toxin, eliminating the need for human or animal-derived additives. Its defining characteristic is duration — differentiated by longer median duration in glabellar-line studies, which is the main reason it is often discussed as a "fewer appointments per year" option. Daxxify offers the longest duration among botulinum toxin type A products at a median of approximately 6 months — nearly double the standard neurotoxin. The higher per-session cost is often offset for patients who value fewer visits. Not available at Évry currently; we mention it because an educated patient deserves a complete picture.
The specific qualities that made it our clinical choice
WHAT SETS LETYBO® APART — THE CLINICAL REASONING
Precision diffusion profile
Letybo® is engineered to minimize spread beyond the target muscle — a property that matters enormously in areas where placement precision is critical. The brow depressors, the orbicularis around the eyes, the upper lip borders, the mentalis — these are zones where a neurotoxin that migrates even slightly beyond its intended placement produces visible, unwanted effects. Letybo's controlled diffusion gives us confidence in exact placement, particularly in patients requesting subtle, highly specific results.
Extensive Korean clinical history
Letybo® has been the dominant neurotoxin in South Korea — arguably the most sophisticated aesthetic medicine market in the world — for years before its U.S. FDA approval in February 2024. Korean aesthetic medicine applies neurotoxin at higher frequencies, in more anatomical areas, and with more nuanced technique than the U.S. market has historically. The product's track record in that environment — millions of treatments, highly trained injectors, demanding patients — is a meaningful data point that U.S. FDA approval timelines don't fully capture.
Phase 3 noninferiority data vs. Botox
Letybo's FDA approval was supported by Phase 3 clinical trials demonstrating noninferiority to onabotulinumtoxinA (Botox) in glabellar line treatment, with equivalent safety profiles and high patient satisfaction scores. The clinical evidence supports using it with the same confidence as the market leader — at a price point that allows us to offer more accessible treatment without compromising clinical quality.
Natural movement preservation
Anecdotally and in clinical observation, Letybo® patients consistently report that their results feel natural — that their face moves authentically while the targeted muscles are relaxed. This aligns with the philosophy at Évry: our goal is never to immobilize the face. It's to refine expression without erasing it.
The neurotoxin category has never been more sophisticated — or more crowded. Six FDA-approved options, each with genuine clinical nuance, means the conversation has moved beyond "how many units of Botox do I need?" to something more interesting: which product, placed where, in what amount, by whose hands, serves my face best? At Évry Aesthetics in Elmhurst, we've done the work of answering that question on your behalf — and we're happy to walk you through the reasoning in person.
If you're in Elmhurst, Oak Brook, Wheaton, Lombard, or the greater Chicago area, a complimentary consultation is where the conversation starts. Bring your questions. We have answers.
Book your complimentary neurotoxin consultation
Évry Aesthetics · 597 N York St, Elmhurst, IL · (630) 333-4285