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Are There Different Grades and Potency of Botox?

A doctor that I had used for Botox recently retired. The 2 doctors that I have visited since have injected the same amount with much less effect.

Also, when being injected, the Botox solution causes a very painful contraction/cramp in the tissue it is being injected into. Can Botox be diluted? What is it being diluted with? Thanks.

Asked 28 months ago by Sugardoughnut in 98004
Sort 11 expert answers by:
+1

Are there different "grades" of Botox?

Hi Sugardoughnut.  While there are not two different grades of Botox, there are alternative dilutions.  Botox comes to your practitioner in a vial that contains 100 "units" of Botox powder.  This powder is then mixed with saline solution according to your injector's preferences.  Some injectors mix the product with more saline, some with less. Although we cannot explain the cramp you are speaking about, we will speak to the effectiveness.  One... more
Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
+1

Questions about Botox

Botox is diluted always as it comes in a powder. The physician dilutes it with sterile saline (salt water). Painful contraction and cramping is extremely rare. The amount of saline used to dilute the Botulinum Toxin is different amongst physicians. The dose, or number of units given, is the important variable . Make sure you are comparing units per zone rather than amount of liquid.
Ronald Shelton, MD
Manhattan Dermatologist
+1

Botox, facial contouring, Dysport

Dear Sugardonut, The amount of BOTOX is important for the overall effect and the length of effect. Also, There are 2 toxins available now- Dysport and BOTOX Cosmetic- they require different amounts of toxin for effect. Also, very important is the agent used to dilute the BOTOX- "NON- preserved saline" has as little alcohol in it and it is much les painful for the injection of the BOTOX. Finally, the needles need to be fresh- i use a different needle for each site- a BD 31 gauge... more
Trevor M. Born, MD
Toronto Plastic Surgeon
+1

Botox Dilution

Botox is delivered as a freeze dried toxin that must be reconstituted with saline in order to be injected. Practitioners can dilute the toxin any way they want. I and many other use 2cc of saline so that each .1cc has 5 units of toxin. But regardless you should be paying for the number of units and this would give you an idea of what the surgeon is doing.
Christopher L. Hess, MD
Fairfax Plastic Surgeon
+1

Always diluted

Botox come in a 100 unit vial with a film on the surface. Physicians will then dilute according to their particular preference. Many prefer to use more than one dilution ( I do). As mentioned on previous real self posts, the dilution is not as important in the ultimate result as the number of units in a given area and proper placement. Peoples musculature varies, most likely your original physician had your musculature down pat. Maybe, his technique was better. Its hard to tell. As... more
Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
+1

Botox

Botox is a brand name for one form of botulinum toxin.  If Botox is being injected, it is the same material.  There are other forms of toxin including that provided in Dysport.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Botox is Botox, but doctors may vary

Botox is the brand name for a safe, highly purified botulinum toxin type A that is FDA approved for glabellar frown lines. The dilution of the 100 unit vial is the docotr's preference. What makes the differences is the number of units and where it is injected, not dilution or volume. Talk to your doctor to get that information. Cramping often means very diluted Botox that requires more volume to get an effect.
Mary Lupo, MD
New Orleans Dermatologist
+1

BOTOX strength

Dear Location 98004, It is important that you are aware of what works for you. Unfortunately not every office is honest about how much BOTOX you are getting in a syringe. The product comes dry in the vial and then is reconstituted by the doctor. Typically office use 2.5 to 4 milliliters of saline to dilute the BOTOX. However, some office dilute much more. I am aware of one office that dilutes their BOTOX with 20 ml of saline so each syringe contains just 5 units of BOTOX. This office... more
Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
+1

Botox Injection Techniques

Botox can give variable results with different dilutions and techniques. If you used to get good result with less pain, then mention it to your physician. She/He should be able to modify the technique to cause less pain and good results. Here is a summary of dosage by units that I use for Botox or Dysport: Glabella 20units botox, 50units dysport Crows feet 20units botox, 50 units dysport Forehead 20units botox, 50 units dysport I use 30 gauge needle which is very small and ask patients... more
Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
+1

Botox is a name brand product of the Allergan company for Botulinum Toxin type A

Botox is a single product that comes freeze dried from the Allergan company. Each physician chooses to dilute it according to their training and experience. It is not the dilution, but the number of units (plus the skill of the doctor) that really determines effectiveness. As for burning, this is unusual, but it is a small needle being used. Some patients can be helped by ice or topical anesthetic prior to injection. However, I have found that using diabetic syringes and a low dilution... more
Steven J. Pearlman, MD
New York Facial Plastic Surgeon
+1

Botox potency and injection diluent.

Ceertainly the botox can be diluted and that can vary from one physician to another. In regards to the pain, this can be related to the diluent. Package inserts recommend unpreserved saline which can actually sting more than preserved saline.
Otto Joseph Placik, MD
Chicago Plastic Surgeon
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