Neuromodulators (often called “wrinkle relaxers” or “tox”) like Botox®, Daxxify®, or Dysport®, are some of the most popular non-surgical treatments in aesthetic medicine – because they can soften expression lines while keeping you looking like yourself.
Now, Galderma is seeking FDA approval for a next generation tox called RelabotulinumtoxinA, known internationally as Relfydess. The clinical trial results are drawing attention for two patient-loved reasons:
- Faster onset, as soon as Day 1
- Longer-lasting results (up to 6 months for frown lines and crow’s feet).
At our plastic surgery practice, we stay at the forefront of aesthetic innovation, Relfydess is one of the most exciting developments in wrinkle relaxers in years.
If you’re considering wrinkle relaxers, or you’re a long-time Botox or Dysport patient, here’s a patient-focused guide to what’s different, how dosing works, and what to expect at a plastic surgery practice like ours.
What Makes RelabotulinumtoxinA (Relfydess™) Different?
There are three primary differences between Relfydess and the cosmetic botulinum toxin products currently available in the United States:
- It comes as a ready-to-use liquid formulation rather than a powder that must be reconstituted before injection.
- It may have a faster onset of action for some patients.
- It may offer a longer duration of effect in certain individuals. Longer duration may be useful for (off-label) injections such as lip flip or nose tip flip procedures.
Relfydess is a Ready-to-Use Liquid (No “Mixing” Step Required)
Relfydess is a ready-to-use liquid that appears to be shelf-stable for at least 18 months. Currently, all cosmetic neuromodulators in the U.S. are supplied as a powder, including:
- Botox Cosmetic
- Dysport
- Daxxify
- Daxxify
- Xeomin
- Letybo
What This Means for Patients:
- No variability from reconstitution or dilution technique
- No questions about when the vial was mixed
- Standardized concentration directly from the manufacturer
- Designed for precise, consistent volumetric dosing
While our practice and many others maintain strict handling protocols for all neuromodulators, a ready-to-use formulation removes an entire preparation step. In aesthetic medicine, precision matters. And consistency from treatment to treatment helps maintain natural-looking, reliable results.
Does Relfydess Work Faster Than Dysport or Other Tox Products?
In Galderma’s Phase III READY clinical trial for Relfydess, some patients demonstrated visible improvement as early as Day 1 for frown lines and crow’s feet, with most showing benefit on Days 2-3.
In comparison, most other cosmetic neuromodulators such as Botox or Daxxify begin working in:
- 3–5 days (initial changes)
- 10–14 days (full effect)
Faster onset can be beneficial, if you are preparing for:
- A wedding
- Travel
- A photoshoot
- An important business event
That said, as with any neuromodulator, individual response varies. It is likely that some patients will still follow a typical multi-day onset pattern.
Does Relfydess Last Longer Than Dysport, Botox, Daxxify, Letybo, or Xeomin?
Patients often ask if Relfydess will last longer than other neuromodulators such as Botox, Dysport, Letybo, or Daxxify.
The answer? Maybe. Maybe not.
Below is a chart from one of the clinical trials evaluating Relfydess.3
Timepoint
Relfydess (N=223)
Placebo (Saline) (N=74)
Post Injection
GL-ILA
GL-ILA
Day 7
93.2%
4.3%
Day 14
96.4%
6.3%
Month 1
96.4%
4.7%
Month 2
92.9%
8.9%
Month 3
73.7%
7.9%
Month 4
53.7%
6.3%
Month 5
39.7%
6.3%
Month 6
23.6%
1.5%
This data shows that about 1 in 4 patients had some lasting effects at 6 months. This suggests that Relfydess might offer somewhat longer-lasting results than other neuromodulators for some patients. However, there as two important caveats.
Caveat 1: Some Effect at 6 Months≠ Frozen at 6 Months.
As with all botulinum toxin products, peak smoothing occurs earlier, followed by gradual return of muscle activity over time. Given this, Relfydess’s six-month data likely reflects measurable improvement compared to baseline, not continued full correction. So, the appropriate interpretation is not “six months frozen,” but rather “six months of detectable improvement for a subset of patients.”
Caveat 2: Dose Affects Duration
How long a neuromodulator lasts depends on both the dose and your individual biology.
A smaller dose works once it blocks enough nerve signals to relax the muscle. A larger dose typically lasts longer because it affects more nerve connections – with more connections disrupted, the body needs more time to do the necessary “repairs.” However, there is a natural ceiling. Once all available nerve connections are blocked, adding more product will not extend duration.
So yes, dose matters.
But comparing dose between different products is not straightforward. The “units” of one brand are not biologically equal to the units of another. For example, 10 units of Botox is not the same as 10 units of Daxxify or 10 units of Dysport. Each company defines and measures its own “unit” using a proprietary testing system.
So when you hear that one product “lasts longer,” interpret that claim carefully. In the end, duration depends on the specific product, the dose used, and your individual biology.
What Areas is RelabotulinumtoxinA/Reflydess Being Used to Treat?
RelabotulinumtoxinA is being reviewed by the F.D.A. in the U.S. to treat two areas:
- Glabellar lines (“11s” between the brows)
- Lateral canthal lines (crow’s feet)
International labeling also describes dosing for both areas treated in the same visit.
Unit Dosing: How Relfydess Does Compare to Daxxify, Botox, or Dysport?
In clinical trials, Relfydess has been studied using 50 units for treatment of the glabellar lines (the “11s” between the eyebrows) and 60 units for treatment of crow’s feet. Other products use 20-60 units to treat these areas. However, as discussed above, units of one product CANNOT be compared to another product.
That means:
- 1 unit of Botox Cosmetic is not equal to 1 unit of Dysport
- 1 unit of Daxxify is not equal to 1 unit of Botox
- 1 unit of Relfydess is not equal to 1 unit of Botox
The word “unit” can be misleading. It’s not like measuring something in teaspoons or milligrams. Each company defines its own unit using its own testing system, so the numbers cannot be directly compared between brands.
What are Patients Saying About Relydess?
Based on early international experience, many patients have been pleased with their results. One commonly cited advantage is the consistency of the product. Because it comes pre-prepared with a long shelf life, patients do not have to wonder when it was mixed or whether dilution may vary from visit to visit.
Some patients have reported a slightly stronger burning or stinging sensation during injection compared to other botulinum toxin products. This appears to be related to the formulation itself.
International injectors have found that simple technique adjustments – such as allowing the product to reach room temperature before treatment and injecting more slowly – can improve overall comfort.
What Are Physicians Noticing About Relfydess?
What This Means Clinically
- Dysport has traditionally been perceived as spreading further from the injection point than Botox.
- Early physician experience suggests Relfydess may remain more localized after injection.
- Some injectors initially used a Dysport-style spacing pattern but later adjusted to a more Botox-style injection pattern based on observed performance.
For patients, this mainly affects injection technique and placement strategy rather than safety. Experienced injectors adjust spacing and dosing patterns based on how each product behaves to achieve balanced, natural-looking results.
As always, ongoing clinical experience and longer-term data will further clarify these characteristics.
Do Patients Like Relydess?
Patients have frequently commented on:
- A natural appearance
- Smooth but not “frozen” results
- Sustained improvement over time
Ready to Explore Your Options?
If you’re considering a neuromodulator treatment and want to understand which approach makes the most sense for your anatomy, goals, and lifestyle, a personalized consultation is the best next step.
As of February 2026, RelabotulinumtoxinA (Relfydess™) remains under late-stage FDA review in the United States. Our practice plans to begin offering Relfydess promptly if and when it receives FDA approval and becomes commercially available.
If you would like to be among the first notified or pre-book a consultation to discuss your options, we invite you to contact our office.
To schedule a consultation or learn more about neuromodulator treatments, please call 305-403-2922 or request an appointment via email, concierge@ArthurMD.com.
[1] FDA Labels: Daxxify, Botox Cosmetic, Dysport, and Xeomin
[2] Australian Label for Relfydess
[3] United Kingdom, Electronic Medicines Compendium for RelabotulinumtoxinA
[4] Field M, Splevins A, Picaut P, van der Schans M, Langenberg J, Noort D, Snyder D, Foster K. AbobotulinumtoxinA (Dysport®), OnabotulinumtoxinA (Botox®), and IncobotulinumtoxinA (Xeomin®) Neurotoxin Content and Potential Implications for Duration of Response in Patients. Toxins (Basel). 2018 Dec 13;10(12):535. doi: 10.3390/toxins10120535. Erratum in: Toxins (Basel). 2019 Feb 13;11(2):E115. doi: 10.3390/toxins11020115. PMID: 30551641; PMCID: PMC6316182.
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