Procedure

Letybo

Letybo is the newest botulinum toxin brand on the US market, approved in early 2024 for frown lines and nothing else. It is a conventional toxin from a Korean maker, entering as a lower-priced alternative to Botox.
At a Glance

Letybo is a brand of botulinum toxin (letibotulinumtoxinA-wlbg) made by Hugel and approved by the FDA in February 2024 for one use: moderate to severe frown lines between the eyebrows in adults. It is the most recent addition to a crowded shelf, and there is nothing structurally novel about it — the same active protein, the same albumin stabilizer, the same 20-unit dose and the same three-to-four-month duration as several older brands. Its argument is price and a long track record outside the US.

Key Facts

What It IsBotulinum toxin type A (letibotulinumtoxinA-wlbg), made by Hugel in South Korea and approved in the US in February 2024
Best ForFrown lines between the eyebrows — its only FDA-approved use
Sessions NeededOne appointment, repeated no more often than every three months
DowntimeNone
CostCommonly around $9–$13 per unit in US markets, with a 20-unit approved dose, so roughly $180–$280 a session. Often positioned at the lower end of a clinic's price list. Per-unit prices cannot be compared between brands
Results TimelineFirst changes at three to five days, full effect at about two weeks
Evidence LevelGood for frown lines, from the trials supporting approval and years of use outside the US. Nothing published for other facial areas

How It Works

Muscles contract when a nerve releases acetylcholine, a chemical messenger. Letybo blocks that release. The corrugator muscles that pull your brows together and the procerus that pulls the skin down between them stop working, the skin above them stops folding, and the vertical frown lines flatten over the following weeks. After three to four months the nerve endings form fresh connections, the muscles return, and the effect fades.

There is nothing unusual in the vial. It contains the toxin, human albumin as a stabilizer, and sodium chloride — the same basic design as Botox and Jeuveau, rather than the accessory-protein-free Xeomin or the albumin-free Daxxify. Nobody is claiming a new mechanism for it, and no one should.

What Letybo has instead is history in other markets. Hugel has sold this toxin outside the United States for well over a decade, and it is widely used in South Korea and approved across much of Europe. So while it is new to American clinics, it is not new to the world — a distinction worth making when a product is described as brand new.

Its approved frown-line dose is 20 units, given as five injections of four units. That is the same number Botox, Xeomin and Jeuveau use for the same muscles, but it does not mean the units are equivalent. Each manufacturer defines a unit using its own laboratory test, and Letybo's label states that its units are specific to its own preparation and assay and are not interchangeable with other botulinum toxin products. Compare what a clinic charges to treat the area. A per-unit price across brands is a meaningless comparison.

Who It's Right For & Who It's Not

Who it's right for

People who want frown lines treated and are price-sensitive. As a newer entrant, Letybo is often offered at a lower price or with introductory promotions, and it does the same job.

Anyone who has done well with a conventional toxin like Botox or Jeuveau and is happy with an equivalent product.

People being treated for the area the approval actually covers.

Anyone whose injector has adopted it and uses it routinely. Comfort and experience with a specific product matter more than which brand is newest.

Who it's not for

People chasing a novel benefit. There is not one. Letybo is a competent conventional toxin, not a step forward.

Anyone who suspects they have become resistant to another toxin. Letybo carries the same accessory protein complex, so it is not the logical alternative — Xeomin is.

People whose target is forehead lines, crow's feet, the jaw or the neck. Letybo's US approval covers frown lines only, and it has no medical indications either.

Anyone with a neuromuscular disorder such as myasthenia gravis, Lambert-Eaton syndrome or ALS.

Anyone with an infection at the injection site.

People who are pregnant or breastfeeding.

Anyone whose lines are visible with the face completely relaxed. Those come from sun damage and lost collagen, and need retinoids, resurfacing or filler.

How to Prepare

Before you start

Ask your injector how much experience they have with it specifically. It is new to the US, and a first-week product in unfamiliar hands is not where you want your frown line to be. Plenty of injectors have used it extensively; some have not.

Tell them what toxin you have had before, the dose if you know it, and how long it lasted. Planning is done from your history and your anatomy, never by converting units.

Bring a medicine list. Aminoglycoside antibiotics such as gentamicin and tobramycin amplify the effect; muscle relaxants and anticholinergics matter too.

Ask about the price per area, not per unit — particularly if the clinic is running an introductory offer.

On the day

Avoid alcohol for about 24 hours beforehand. It raises the bruising risk.

If your prescriber confirms it is safe, hold aspirin, ibuprofen, fish oil and vitamin E for a few days. Do not stop a prescribed blood thinner on your own.

Come with a clean face and something to eat beforehand.

Say clearly how much movement you want to keep. It changes the dose, and it is easier to add more at two weeks than to undo too much.

What Happens During It

Your injector watches you frown and marks five injection points against your own muscle pattern.

The skin is cleaned. Ice or numbing cream is usually offered and often turned down — the needle is very fine.

Five injections of four units each: two into each corrugator muscle and one into the procerus. Each one is a brief sting.

The appointment takes under ten minutes, and most of that is assessment and marking.

Small raised bumps show up at each site and settle within about half an hour.

You will be told to stay upright for a few hours and to leave the area alone for the rest of the day.

Recovery

No downtime at all. You leave and carry on.

Pinprick redness and small bumps clear within the hour.

Bruising affects a minority — a small purple dot that fades over three to seven days and can be covered with makeup from the next day.

Headache in the first day or two was the most common side effect in the trials, though it was reported by only a small percentage of participants.

Stay upright for around four hours, and skip vigorous exercise, saunas and face-down massage for 24 hours.

Movement starts changing at about day three to five, and the result is final at two weeks. Two weeks is also the right time to ask for a small adjustment if anything looks uneven — not at day four.

Side Effects & Risks

Letybo carries the boxed warning common to all botulinum toxin products: the toxin can rarely spread beyond the injection site and cause swallowing or breathing difficulty. That warning is driven by high-dose medical use in people with serious underlying conditions and is very rare at cosmetic doses, but it is why this is a prescription medicine administered by a trained clinician.

Common and expected
  • Headache in the first day or two
  • Redness and small bumps at the injection points, gone within the hour
  • Bruising
  • A tight or heavy sensation between the brows as it takes effect
Uncommon but possible
  • A drooping upper eyelid. Reported in a small number of people in the trials. It is temporary and prescription eye drops can help while it wears off
  • Heavy or lowered eyebrows
  • Asymmetry still visible at the two-week mark, which a small top-up usually corrects
  • A result more frozen than you wanted — not dangerous, but it should reduce the next dose
Rare but serious
  • Difficulty swallowing, slurred speech, breathing trouble, or muscle weakness spreading well beyond the treated area. Very rare at cosmetic doses, but seek emergency care rather than waiting
  • Swelling of the lips or throat, widespread hives or wheezing

Results

The frown starts to soften around day three to five, and the final result lands at about two weeks.

For the area it is approved for, it works. The vertical lines flatten when you frown, and creases that were visible at rest usually soften without disappearing entirely — deep, long-established creases have a structural component that no muscle relaxant addresses.

Duration is three to four months, in line with the rest of the class. There is no credible evidence that Letybo lasts longer or shorter than its competitors, and the label allows retreatment no more often than every three months.

Who ends up disappointed: people who expected the newest option to be the best one; people who booked it on an introductory price and then wanted their forehead and crow's feet handled too, where it is off-label; and anyone hoping a fresh brand would solve a problem that other toxins had not. It will not, because it is the same drug class doing the same job.

The fair summary is that Letybo is a legitimate, well-established toxin that is simply new to the American market, priced accordingly. Choosing it over another brand is a decision about cost and about who is injecting you, not about the molecule.

At-Home Versions

There is no home version. Letybo is a prescription biologic that has to be reconstituted correctly and injected into named muscles by someone who knows facial anatomy. It is not sold over the counter in any market.

Peptide serums marketed as needle-free wrinkle relaxers, most built around argireline, are not botulinum toxin, do not reach muscle, and have a small effect at best.

Buying toxin online is a real danger, and it is a particular risk with newer and Korean-made brands, because unapproved versions of the same manufacturer's products circulate on grey markets. Counterfeit and improperly stored toxin has caused hospitalizations for botulism-like illness. Get it from a licensed clinic that can tell you exactly what is in the vial.

FAQ+
Is Letybo new?New to the United States, approved in February 2024. Not new as a product — Hugel has sold this toxin in other countries for well over a decade, and it is widely used in South Korea and approved across much of Europe.
What is it approved for in the US?Moderate to severe frown lines between the eyebrows, in adults. That is the entire approval. It has no medical indications.
Is it as good as Botox?For the frown line, it does the same job by the same mechanism with a very similar dose and duration. Botox has a much longer US track record and approvals for several more areas. If your only concern is the frown line and price matters, Letybo is a reasonable choice.
Why is it cheaper?New entrants price competitively to get on clinic menus, and Hugel is positioning it as a value option. It is not cheaper because it is weaker or diluted.
Are 20 Letybo units the same as 20 Botox units?No. The matching number is a coincidence of how each company set up its own scale. The label states Letybo's units are specific to its own preparation and assay method and are not interchangeable with other products. Compare the cost of treating an area, not the cost per unit.
How long does it last?Three to four months for most people, the same as the rest of the class. No more often than every three months between treatments.
Will it work if Botox stopped working for me?Unlikely to be the answer. It has the same accessory protein complex that suspected resistance is usually attributed to. Xeomin, which has those proteins removed, is the more logical switch.
Can it be used on forehead lines or crow's feet?It is being used that way, but off-label — there is no US approval or published data for those areas with this product. Botox and Xeomin are approved for them.
Does it hurt?Five quick stings with a very fine needle, over in a couple of minutes.
Should I be concerned that it is made in South Korea?No. It went through the FDA's standard biologic review, including manufacturing inspection and clinical trials, exactly as any other approved toxin does. What you should avoid is unapproved product bought outside the licensed supply chain.
Can I have it while pregnant or breastfeeding?No. There is no adequate safety data, and there is no urgency to a cosmetic injectable.
What if I don't like the result?No botulinum toxin has a reversal agent. You wait three to four months. A conservative first dose is the way to protect yourself from that.