Botox types,

resistance depends on 900kDa vs 150kDa protein size

Last Wednesday, a 29-year-old client came to my clinic and said

she had been getting the same Botox for the past five years.

"Doctor, the effect seems to wear off so quickly these days.

Is this resistance?" she asked,

and I really get asked this a lot in clinic too.

To answer that, we need to start with the types of Botox.

Xeomin and Coretox,

are not just different names

Botox is an injectable that purifies the neurotoxin

and blocks the signals that cause muscle contraction.

Domestic products are broadly divided into two groups.

Products such as Nabota and Liztox are

900kDa complex protein formulations,

while Xeomin and Coretox are purified

150kDa toxins without that complex protein.

So it is not just the name that changes;

the molecular structure itself is different.

Why do some people develop resistance

while others do not?

"The difference between 900kDa and 150kDa is

simply whether a complex protein is present.

The larger the protein, the more likely the immune system is

to recognize it as a foreign antigen,

which also increases the chance of resistance."

— Dr. Wi Young-jin (Beautystone Clinic, Hongdae)

From the immune system's point of view, the larger the protein,

the higher the chance it will be recognized as a foreign antigen.

Once antibodies form,

the Botox gets neutralized before it reaches the muscle,

and that is what we call "resistance."

A client who came in last month had been

receiving a 900kDa product every three months,

but its duration had dropped from 8 weeks to 4 weeks.

I said, "Let's take a 6-month break and try switching products,"

and declined the procedure.

When in doubt, the first step is to stop

and wait for the immune response to settle down.

Botox types,

how to choose the right one for your situation

This becomes much clearer at a glance.

If you only get it once or twice a year before an event,

either option is fine and there is not much difference.

But if you are receiving treatments regularly every three months

for areas like the square jaw,

I recommend the 150kDa option for your long-term skin health over the next 5 to 10 years.

If the effect wears off quickly and you shorten the interval to two months,

the risk of antibody formation becomes even higher, so please be careful.

The three questions I hear most often in clinic

Q1. Can I switch

from the product I am using now?

Yes, you can switch. But the timing matters.

If the effect lasts well for 3 to 4 months,

you can switch at the next treatment,

but if resistance is already suspected,

it is safer to take about a 6-month break.

Q2. How big is the price difference, and

is the more expensive one better?

A higher price does not necessarily

mean better results.

An expensive brand is not automatically better; what really matters is whether, based on your treatment pattern, a product with less protein would be more suitable.

It is best to evaluate that point carefully.

Q3. Are the side effects or precautions

different depending on the type?

Bruising or swelling right after treatment is influenced more by

the injector's experience and dose adjustment than by the product type.

Please just follow the common precautions, such as not lying down

or massaging the area.

If you take only one thing away today,

it is that Botox is divided not by brand, but by

protein size.

In the next post,

I will explain how long a break period should be

when resistance is suspected.

This has been Dr. Wi Young-jin.

Frequently asked questions

Q. Can I switch to a different product from the one I’m currently receiving?

A. Yes, it can be changed. However, the timing is important.

Q. How much is the price difference, and is the more expensive option better?

A. A higher price does not necessarily translate into better results.

Q. Do the side effects or precautions differ depending on the type?

A. Immediately after the procedure, bruising or swelling is influenced more by the practitioner’s skill and dose adjustment than by the type of product.

Q. If the effects wear off quickly, is it okay to get Botox treatments closer together?

A. Actually, we don't recommend doing that. Narrowing the interval to 2 months can increase the risk of antibody formation. If you suspect resistance, it is best to take a break for about 6 months first to allow your immune system to settle.