There’s a new neurotoxin in town, and it’s already sparking conversation among aesthetic injectors across the country. Letybo, a botulinum toxin type A product developed by South Korean manufacturer Hugel Inc., is the newest FDA-approved neuromodulator to enter the U.S. market. Known internationally as Botulax, Letybo has been a top performer across Asia and Europe. Now, it’s positioning itself as a cost-effective, fast-acting alternative to Botox, and clinicians in aesthetic medicine are taking notice.
A Global Heavyweight Finally Hits the U.S.
Letybo’s U.S. debut comes after a multi-year regulatory journey that included three rounds of FDA submissions before gaining approval. Hugel’s persistence has paid off, making it the first Korean company to secure neuromodulator approvals across the three major aesthetic markets: the U.S., Europe, and China.
In South Korea, where the injectables market is saturated with over 70 neurotoxin brands, Letybo holds a dominant share, with decades of widespread clinical use behind it. That real-world experience brings an added layer of confidence as U.S. providers evaluate how Letybo stacks up against Botox, Xeomin, Dysport, Jeuveau, and Daxxify.
Faster Onset, Similar Duration (For Now)
Clinical trial data and anecdotal reports suggest that Letybo kicks in slightly faster than Botox, with visible results appearing within two to three days. That said, not all clinicians agree on the significance of this difference. Some injectors report that the onset feels roughly equivalent to Botox in day-to-day practice.
And what about longevity? The FDA-approved indication for Letybo lists a four-month duration, aligning it closely with Botox and Jeuveau. Claims of longer duration are speculative at best and not currently supported by published real-world U.S. data. If Hugel wants to differentiate Letybo on longevity, they’ll need to produce comparative clinical data in the coming years.
A Cleaner Formulation?
Letybo’s formulation is generating interest for its purportedly lower protein load, a factor some experts believe could reduce the likelihood of antibody formation. While all botulinum toxins carry a theoretical risk of immunogenicity, fewer accessory proteins may translate to better long-term responsiveness for some patients. This could prove especially beneficial for Botox non-responders, or patients experiencing diminishing results over time.
Still, it’s worth noting that all current FDA-approved neurotoxins, including Botox, have demonstrated extremely low immunogenicity in practice. Until there’s comparative immunogenicity data, the protein profile is more of a scientific footnote than a clinical differentiator.
Price Pressure Incoming?
Letybo is expected to undercut Botox’s pricing by roughly 25–30%. Estimates put the per-unit price between $9 and $12, compared to Botox’s $12 to $18. This lower wholesale cost, if passed on to patients, could position Letybo as the go-to for budget-conscious patients or high-volume injectors looking to maintain margins in competitive markets.
That said, profitability for practices isn’t just about price per vial. Injector familiarity, loyalty programs, and branding still matter. Allergan’s Botox has built decades of trust and patient recognition — and commands a premium because of it. Letybo may be cheaper, but that won’t automatically translate to loyalty without consistent, visible, and safe results.
Real-World Data Will Decide
One recurring theme from clinicians who’ve started using Letybo: the difference between clinical trial performance and real-world results. Daxxify, for example, was marketed with a six-month duration based on clinical data, but many injectors report real-world duration closer to four or five months, particularly in the forehead and crow’s feet.
Similarly, Jeuveau was expected to compete head-to-head with Botox but often seems to fade earlier in practice. Letybo’s promise of faster onset and comparable duration is encouraging, but the next six to twelve months will reveal how it truly performs across patient demographics and anatomical zones.
Should You Start Offering It?
Letybo offers a legitimate alternative for aesthetic practices looking to expand their neurotoxin menu. Replacing Botox overnight isn’t the goal. The arrival of Letybo simply adds another clinically validated option to your toolkit, one that may be better suited for patients who are more cost-conscious or who haven’t responded well to other neuromodulators.
If you’re already using multiple neuromodulators, Letybo may integrate smoothly. If you’ve stuck with Botox for its reliability, the decision to trial Letybo will likely come down to whether faster onset or lower cost feels meaningful for your patient base.
Letybo isn’t a revolution, but it could be a valuable evolution. Its global track record, FDA approval, and strong safety profile make it a worthy contender among the neurotoxin options available. Whether it becomes a practice staple will depend on how it performs in real-world hands, yours included! Be on the watch for early adopter feedback, run your own internal trials, and don’t be surprised if patients begin asking for it by name. The coming months will reveal if Letybo truly lives up to the hype and carves out a lasting place in the competitive U.S. neurotoxin landscape.
SOURCES: Real Self, Roy Kim, MD, Medscape, AOL
