Korean-Made or Imported Botox: Which Product Should You Choose?

By Daebbang

“Korean-made Botox costs less. Does that mean it works less well?”
“I’ve heard Xeomin is good. Should I just choose the more expensive option?”

If you are looking into treatment for forehead lines, frown lines, crow’s feet, or a square jaw, the number of names and the price differences can be confusing. It is easy to assume that a more expensive product will work better and last longer.

First, Korean-made botulinum toxin products can deliver good results, too. Some have been directly compared with Botox in clinical trials for frown lines between the eyebrows. Price and country of manufacture alone do not tell you how well a product will work. [1] [2]

“Botox” is actually the name of Allergan’s product. All seven products discussed here contain botulinum toxin type A, a medicine that temporarily reduces muscle activity by reducing the signals reaching the muscle. Their formulations, product-specific units, and available clinical evidence do differ.

In clinical practice, these treatments are used not only for expression lines on the forehead, between the eyebrows, and around the eyes, but also for a wide, square-looking jaw caused by enlarged masseter muscles. Let’s look at how to choose a product for these kinds of concerns. This comparison is based on products available in South Korea; “imported” means imported into Korea. [8]

Approved treatment areas and indications vary by product in Korea; use outside those approvals is off-label and requires an individual medical assessment. [Korean prescribing information]

How do Korean-made and imported products compare?

“Noninferiority” means that a treatment was shown not to be less effective than the comparator beyond a margin set in advance. It does not mean that every feature is identical.

This table is not a product ranking. The participants and assessment methods differed across studies, and most studies evaluated frown lines. These results cannot be extended to mean that jaw-slimming or body treatments have the same effects or duration with every product.

Are Xeomin and Coretox better because they have no complexing proteins?

The active ingredient responsible for botulinum toxin’s effect is itself a protein. Other proteins that bind to it are called complexing proteins. [5]

Xeomin and Coretox are formulations without complexing proteins. Xeomin’s repeat-treatment clinical evidence is one reason to choose it; Coretox offers this type of formulation in a Korean-made product. [6] [7] [Coretox Korean approval data]

I covered why resistance can develop and treatment intervals intended to help prevent it in an earlier article. For more detail, see “Botox Doesn’t Work Like It Used To. Have I Developed Resistance?”

Does Dysport start working sooner?

One potential advantage of Dysport is an earlier initial response. In the frown-line study involving 143 women, the reduction in skin strain—the amount the skin deforms during expression—at day 3 was greater than with Botox or Xeomin. At 1 month, however, there were no significant differences between products. [4]

This points to an advantage worth considering if you want to see an early change, rather than a guarantee of a stronger final result. The study assessed frown lines, so it does not show that Dysport reduces masseter muscle volume faster. If you have an important event coming up, leave enough time for treatment rather than relying only on a change of product.

So, do you need the more expensive product?

You do not need to start with a high-priced option. For forehead lines and crow’s feet, the aim is to reduce expression-related movement. For a square jaw caused by enlarged masseter muscles, the aim is to reduce muscle volume. Choosing the right treatment area and dose for your concern comes before the product’s country of origin.

If you have had good results with a Korean-made product and no particular problems, continuing with it is a reasonable choice. Rather than switching simply because another product costs more, switch when it offers an additional feature that matters to you, such as an early initial response or considerations relevant to repeated treatment.

Also, units (U) are not defined in the same way across products. A higher number, particularly when comparing Dysport with other products, does not automatically mean a stronger treatment or better value. Your clinician should select the dose for the specific product and treatment area. [Korean prescribing information]

Take-home messages · How to choose

1. Your first treatment → I recommend starting with a Korean-made product.
   Choose a Korean-made product suitable for the treatment area. Good results are achievable with these products, and they can reduce the cost burden.
2. An event is coming up, and you want an early effect on expression lines → I recommend Dysport.
   This recommendation is based on the early response seen in the frown-line comparison trial. It does not mean that a square jaw will become smaller faster.
3. You are willing to pay more and want to prioritize reducing resistance risk → I recommend Coretox or Xeomin.
   Both are formulated without complexing proteins. Choose Xeomin if repeat-treatment clinical evidence is your priority, or Coretox if you want this type of formulation in a Korean-made product.

References

1. Kim BJ, et al. Double-blind, randomized non-inferiority trial of a novel botulinum toxin A processed from the strain CBFC26, compared with onabotulinumtoxin A in the treatment of glabellar lines. J Eur Acad Dermatol Venereol. 2014;28:1761–1767. DOI: 10.1111/jdv.12408.
2. Won CH, et al. Efficacy and safety of a novel botulinum toxin type A product for the treatment of moderate to severe glabellar lines: a randomized, double-blind, active-controlled multicenter study. Dermatol Surg. 2013;39:171–178. DOI: 10.1111/dsu.12072.
3. Wu Y, et al. IncobotulinumtoxinA for Glabellar Frown Lines in Chinese Subjects: A Randomized, Double-blind, Active-Controlled Phase-3 Study. Plast Reconstr Surg Glob Open. 2023;11:e4956. DOI: 10.1097/GOX.0000000000004956.
4. Lemdani MS, et al. Comparison of Botulinum Toxin A Formulations for Glabellar Strain Treatment in Women: A Double-Blind Randomized Clinical Trial. JAMA Dermatol. 2025;161:723–730. DOI: 10.1001/jamadermatol.2025.1335.
5. Gu S, et al. Botulinum neurotoxin is shielded by NTNHA in an interlocked complex. Science. 2012;335:977–981. DOI: 10.1126/science.1214270.
6. Fischer T, et al. Safety, Tolerability, and Efficacy of Repeat-Dose Injections of IncobotulinumtoxinA in the Treatment of Upper Facial Lines: Results from a Prospective, Open-Label, Phase III Study. J Drugs Dermatol. 2020;19:461–469. DOI: 10.36849/JDD.2020.5013.
7. Hefter H, et al. Significantly lower antigenicity of incobotulinumtoxin than abo- or onabotulinumtoxin. J Neurol. 2023;270:788–796. DOI: 10.1007/s00415-022-11395-2.
8. Nobre BBS, et al. Exploring botulinum toxin’s impact on masseter hypertrophy: a randomized, triple-blinded clinical trial. Sci Rep. 2024;14:14522. DOI: 10.1038/s41598-024-65395-5.

Product composition and Korean approval information: the Korean Ministry of Food and Drug Safety’s drug information portal entries for Wondertox, Coretox, Xeomin, and Botox. Official Korean product information from Hugel, Medytox, and Ipsen Korea was also consulted.