Relfydess (relabotulinumtoxinA) is a new ready-to-use liquid wrinkle relaxer aka neuromodulator from Galderma, the makers of Dysport. Below are answers to the questions we hear most often from patients considering treatment.
What is Relfydess?
Relfydess is a new ready-to-use liquid neuromodulator developed by Galderma, the same company behind Dysport. Its active ingredient, relabotulinumtoxinA, is a purified form of botulinum toxin type A that temporarily relaxes the small facial muscles responsible for expression lines. It is the first liquid wrinkle-relaxing injection of its kind and is already approved in more than 20 international markets.
Is Relfydess FDA-approved in the United States?
Not yet. As of February 2026, the U.S. FDA accepted Galderma’s resubmitted Biologics License Application (BLA), meaning the application is now under formal review. The earlier FDA response cited only manufacturing-related items, not safety or efficacy concerns, and Galderma has since addressed those updates. Outside the U.S., Relfydess is currently approved in more than 20 international markets.
Does Dr. Shridharani have experience with Relfydess?
Dr. Shridharani was a clinical trial investigator for two of the pivotal studies assessing the safety and efficacy of this first of kind neuromodulator. In addition to studying this neurotoxin for over two years, he was also involved with launching the product in several international markets where approval already occurred. This makes Dr. S, one of the most experienced clinicians in the world with this new wrinkle eraser.
What makes Relfydess different from Botox, Dysport, or Daxxify?
The biggest difference is the formulation. Botox, Dysport, Xeomin, Letybo, and Daxxify all arrive as a powder that has to be reconstituted with saline before injection. Relfydess arrives as a ready-to-use liquid, produced with a manufacturing process Galderma calls PEARL (Precipitation-free Extraction and Activity-preserving Refined Liquid). It is also a notably pure formulation — only the active neurotoxin molecule, with no complexing proteins, lactose, or human- or animal-derived components. That high purity is associated with consistent dosing and may reduce the chance of the body developing antibodies that can blunt the response to future treatments.
How quickly does Relfydess start working?
In Galderma’s pivotal READY clinical trials, up to 39% of patients saw a visible difference as early as Day 1, with most patients seeing results within two to three days. Full effect typically develops by seven to fourteen days after injection.
How long do the results last?
Clinical studies show that Relfydess can last up to six months, with the median time to return to baseline reported between 24 and 27 weeks for both frown lines and crow’s feet. Most established neurotoxins last around three to four months by comparison.
What areas can Relfydess treat?
Relfydess is indicated for the temporary improvement of glabellar lines (the vertical “11s” between the eyebrows) and lateral canthal lines (crow’s feet). Some providers internationally also use it for forehead lines and other facial areas, depending on local regulations and clinical judgment.
How does Relfydess work?
Like all botulinum toxin type A products, Relfydess works by temporarily blocking the release of acetylcholine — the chemical messenger that tells facial muscles to contract. When the targeted muscles relax, the overlying skin smooths and the dynamic wrinkles caused by repeated expressions soften.
Is Relfydess safe? What side effects should I know about?
Relfydess has been studied in large clinical trials and has a safety profile consistent with other established neuromodulators. The most common side effects are mild and local to the injection site — bruising, redness, swelling, tenderness, or itching — and usually resolve within a few days. Less common effects include temporary headache, mild flu-like symptoms, eyelid drooping, dry eyes, blurred vision, or light sensitivity. Rarely, as with any botulinum toxin, the effect can spread beyond the injection site and cause more serious symptoms such as muscle weakness, difficulty swallowing, changes in voice, or breathing difficulties. Any of these should be reported to your provider right away.
Who should not receive Relfydess?
Relfydess is not recommended if you are allergic to any botulinum toxin or to an ingredient in the formulation, have an active infection at the proposed injection site, have a neuromuscular condition such as myasthenia gravis, Lambert-Eaton syndrome, or ALS, are pregnant or breastfeeding, or are under 18 years of age. Your provider will review your full medical history during your consultation.
What should I expect at my appointment?
Your appointment begins with a brief consultation to review your medical history and your aesthetic goals. The treatment itself is quick — typically about 10 to 15 minutes — and involves a series of very small injections to the targeted muscles. Because Relfydess is liquid, there is no on-the-spot mixing, which can shorten preparation time. Most patients describe the sensation as a brief pinch.
Is there any downtime?
There is virtually no downtime. You can return to most of your normal activities right away. We do ask that you avoid strenuous exercise, heat (saunas, hot yoga), and lying flat for four hours after your treatment to keep the product where it was placed.
What aftercare should I follow?
For 24 hours after treatment, stay upright for at least four hours, avoid intense exercise and heat, avoid massaging the treated areas, and minimize alcohol and blood-thinning medications when possible. You can resume your normal skincare routine the next day. Any mild redness or pinpoint bruising can be covered with makeup once the injection sites have closed.
When will I need a follow-up treatment?
Most patients return for a maintenance treatment around the five- to six-month mark. Because Relfydess tends to last longer than traditional toxins, your visits may be spaced further apart than what you are used to with Botox or Dysport.
Can I switch from Botox or another neurotoxin to Relfydess?
Yes. In most cases, patients can transition between neurotoxins without a washout period. Your provider will determine the appropriate dosing based on your previous treatments and your desired outcome — units are not interchangeable one-for-one between brands.
References
Shridharani SM, Moradi A, Donofrio L, Gold MH, Biesman B, Chiang M, George R, Polder K, Solish N, Schwarcz, Lin X, Axén E, Prygova I. Efficacy and Safety of RelabotulinumtoxinA, a New Ready-to-Use Liquid Formulation Botulinum Toxin: Results From the READY-1 Double-Blind, Randomized, Placebo-Controlled Phase 3 Trial in Glabellar Lines. Aesthet Surg J. 2024 Nov 15;44(12):1330-1340. doi: 10.1093/asj/sjae131. PMID: 38913088; PMCID: PMC11566037.
Gold MH, Donofrio L, Shridharani S, Moradi A, Biesman B, Chiang M, George R, Polder K, Solish N, Schwarcz R, Berg AK, Weinberg F, Axén E. Patient-Reported Outcomes for Glabellar Line Improvement and Satisfaction With the RelabotulinumtoxinA Ready-to-Use Liquid Formulation: Data From the Phase 3 READY-1 Trial. Aesthet Surg J. 2025 Jul 15;45(8):828-835. doi: 10.1093/asj/sjaf063. PMID: 40242960; PMCID: PMC12260373.
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Bigalke H, Frevert J, Dressler D. Therapeutic botulinum toxin preparations: an update. J Neural Transm (Vienna). 2026 May 5. doi: 10.1007/s00702-026-03121-3. Epub ahead of print. PMID: 42084637.
Di Gregorio C, Iozzo I, Belmontesi M, De Santis A, Leone L, Innocenti A, Picaut P, Tretti-Clementoni M. Objective Assessment of the Onset of RelabotulinumtoxinA in the Elevation of the Eyebrow and Its Clinical Implications. J Cosmet Dermatol. 2026 Mar;25(3):e70745. doi: 10.1111/jocd.70745. PMID: 41772706; PMCID: PMC12953746.
Honndorf S, Kühbach K, Eisele KH, Shokurova A, Buch P, Jatzke C, Taylor HV, Fink K. Comparative Analytics and Pharmacodynamics of the Complex Protein-Free Botulinum Toxin Type A Formulations DaxibotulinumtoxinA, IncobotulinumtoxinA and RelabotulinumtoxinA. Toxins (Basel). 2026 Mar 14;18(3):142. doi: 10.3390/toxins18030142. PMID: 41893565; PMCID: PMC13030755.
