This study carried out in the UK compared the clinical effectiveness and efficiency of switching patients from Botox® injections to Xeomin®. This was carried out in 20 essential blepharospasm, 12 hemifacial spasm and six aberrant facial nerve regeneration patients. Patients were masked and had three Botox® injections compared to three subsequent Xeomin® injections of the same unit dose. Xeomin® was equivalent to Botox® in effectiveness and statistically subjectively better in hemifacial spasm. Patients felt the duration of maximal effect was one week longer for Xeomin®. Side-effect profile was also similar. Xeomin® is 33% cheaper per unit and does not require refrigeration. This was an interesting study as it directly compared these patients with a number of injections over several years. From personal experience at several different NHS trusts where botulinum toxin can vary between clinics, this article provides evidence to obtain a consistent supply of one brand.