Korean vs European Botox: Fortox, Metox, Innotox and Xeomin — what is the difference

At a first visit to the cosmetologist one question comes up again and again: "Which Botox is better — Korean or European?" At SANLE we work with four products: the Korean Fortox, Metox and Innotox and the European Xeomin. This guide explains in plain words what they share, how they differ and how your cosmetologist picks the right one for you.

Botox and filler are not the same thing

These four products are often called "fillers", but they work differently:

• Botox (botulinum toxin) relaxes a muscle. Wrinkles caused by expression — on the forehead, between the brows, at the corners of the eyes ("crow's feet") — soften because the muscle no longer folds the skin;
• Filler (hyaluronic acid) adds volume — to lips, cheekbones or chin. We cover it in our lip filler guide.

So all four products below belong to the Botox family. "Botox" is originally one American brand name, but in everyday speech it is used for every product of this kind.

How botulinum toxin works

The product is injected in tiny doses with a very fine needle into a specific muscle. It temporarily blocks the signal from the nerve to the muscle, the muscle relaxes and the skin above it smooths out. The effect is temporary: within a few months the nerve restores the signal and the muscle gradually returns to its usual movement.

All four products share one active substance — botulinum toxin type A. They differ in manufacturing technology, form (powder or ready solution), accessory proteins and price. Units are not interchangeable one-to-one between brands, so the dose is always set by the cosmetologist for the specific product.

Korean Botox: Fortox, Metox, Innotox

Korea is one of the largest producers of botulinum toxin, with more than ten such products registered there. Korean products are a popular choice for a first treatment and for anyone who wants a natural result at an accessible price.

• Innotox (Medytox, Korea) — according to the manufacturer, the world's first liquid, ready-to-use botulinum toxin: most products are powders that are dissolved in saline before the treatment, while Innotox already comes as a solution. The manufacturer says it uses no human serum albumin or animal-derived ingredients.
• Metox (Maypharm, Korea) — a 100-unit product. According to the manufacturer it is made by vacuum drying instead of conventional freeze-drying, so almost no powder residue stays in the vial.
• Fortox — botulinum toxin type A, 100 units per vial. According to the manufacturer the toxin is free of complexing proteins (150 kDa) with 99.8% purity.

European Botox: Xeomin

Xeomin (Merz, Germany) is one of the best-studied botulinum toxins in Europe and the US. What sets it apart:

• A "naked" toxin — complexing (accessory) proteins are fully removed during manufacturing, so only the active molecule is left in the vial. In theory this gives the body less reason to build antibodies that could weaken the effect over time, which is why Xeomin is often chosen by people who have Botox regularly for years;
• Stored at room temperature — no fridge needed, so it is less sensitive to transport;
• As a European product it is usually more expensive than the Korean ones.

Korean or European — which to choose?

There is no single "best" product: each works well when it is chosen and dosed correctly. As a rough guide:

• First treatment, or budget matters — a Korean product (Fortox, Metox or Innotox) is a good start;
• You have Botox regularly, for years — many choose Xeomin as a "clean" European product;
• Your last result faded quickly — tell the cosmetologist which product you had; switching brands may be worth it.

The final choice is made at the consultation, together with you, based on your face, your expressions and what you want.

Which areas are treated

• Forehead — horizontal lines;
• Between the brows — the vertical "frown" line;
• Eye corners — crow's feet;
• Face, neck and shoulders — so-called Barbie Botox (550–600₾): the neck and shoulders look longer and more refined.

How the treatment goes

1. Consultation — the cosmetologist asks about your health and medicines, looks at your expressions and picks the product;
2. Marking and disinfection — the injection points are marked and the skin is cleaned;
3. Injection — with a very fine needle at a few points; most people feel only a light prick;
4. Check-up — you can come back in two weeks to check the result.

The injection itself takes a few minutes; the whole visit, consultation included, about 1 hour.

Aftercare

• For 4 hours do not lie down and do not rub the injection area;
• On the first day avoid exercise, sauna, bathhouse and alcohol;
• For 1–2 weeks skip facial massage and do not sleep face down;
• Slight redness or a small bruise fades on its own within a few days.

Botox is not done during pregnancy or breastfeeding, with inflammation at the injection site, with neuromuscular disease (e.g. myasthenia) or while taking certain antibiotics. If in doubt, be sure to mention it at the consultation.

How long the result lasts

The effect starts in 2–5 days and is complete in about 2 weeks. It usually lasts 3–4 months, sometimes longer, depending on the product, dose, muscle strength and metabolism. With regular treatments the muscle "learns" to relax and results often last longer.

Why SANLE

• Our cosmetologist Tako chooses the product with you at the consultation — Korean or European;
• You hear the price before the treatment — no surprises;
• The salon is next to Marjanishvili metro, at 34 Kote Marjanishvili St;
• You can plan other treatments in the same visit — see our cosmetology guide, and for skin renewal read the Exo PDRN article.

Frequently asked questions