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Botox Dilution: How to Be Sure You Get the Units of Botox Paid for

asked 3 years ago by Laura E Burton
Latest answer by Harold J. Kaplan, MD
Question viewed 4,636 times
Tags: units

How do you know if you are getting the actual number of units (Botox) that you are paying for, when should you notice results and can you tell if the Botox has been diluted? Also, recently at a local MedSpa in Fresno California, I paid $440 for Botox..the nurse left the room for more than a few minutes to get the product and then when asked about "dilution" of the product, advised that there is a "range" of the amount of saline (hopefully preservative free)she uses to dilute the dry form. Is this true, if so, what is the range. Of all the research I've done on the prescribing information, no where does is say to use "anywhere from" 1.0 mlto 2.5 ml. It says to use 1.25ml for a 50 unit vial and 2.5 for a 100 unit vial. Should this nurse be using less than either of these?

19 answers to Botox Dilution: How to Be Sure You Get the Units of Botox Paid for

2.5 cc per 100 unit bottle of Botox is the usual dilution. Avoid bargain prices when it comes to Botox.

Botox can be diluted from 2-3 cc per 100 unit bottle and that is acceptable. Only your doc will know the exact amount of units you get. It takes about 1 week to get the full affect of botox and should last about 3-4 months on the average. Sometimes it works better than usual and sometimes it may not seem to work as well as usual. It can vary alittle sometimes. Don't go to the cheaply advertised Botox places because they may not be giving you what you need or paid for. You are also paying for... more

David Hansen, MD
Beverly Hills Dermatologic Surgeon

www.DrDavidHansen.com

Making sure you're getting all Botox units you pair for

Botox dilution has nothing to do with the number of units received and dilution amounts will vary depending on injector preference. We will say that in our experience if you are being sold Botox by the "syringe", then you can almost certaily assume it is being overdiluted or diluted at the high end of the acceptable range. With regard to how you will know how many units you are getting. I am not sure you will ever know exactly. But regardless of whether your injector is board... more

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

Botox dilution can vary

As answered many times on Real Self, the dilution can vary. While the official recommendation from Allergan is to dilute Botox with 2.5 cc of unpreserved saline, nearly all physicians (including myself) stray from this recommendation. Dilutions differ: I personally use a 1 cc dilution in places where I do not want Botox to stray and 2-2.5 cc where I want diffusion. Thus, the dilution does not matter. What may matter is such factors as where the Botox is obtained, how long it has been in... more

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

See a reputable board certified physician to get best Botox results

My simple recommendation is to get your Botox done by a Core Cosmetic Medicine Doctor like a board-certified Dermalogist, Plastic Surgeon, Oculoplastic Surgeon, or Facial Plastic Surgeon (ENT) only and avoid the spas, hair salons and mall quick fix places that dilute Botox and may not even be using a legal form of Botox as there is so littel quality control. I do all the Botox and Filler injections in my office myself and all the dilutions are done with the patient viewing us...and we show them more

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Dilution of botox

Botulinum toxin comes in a powder, always, and must be diluted. Physicians legally may perform off-label uses, and many use preserved sterile saline to dilute the Botox. The dilutions range from 1 cc to 2.5 ccs or even more. The number of units given is the absolute variable and this is what is discussed at conferences and medical journal articles when describing Botox injections from site to site and from physician to physician.

Ronald Shelton, MD
Manhattan Dermatologist

Botox dilution for best results

As you know Botox dosing is measured in biological units, not weight or volume. An honest provider will give the number of units you are paying for regardless of dilution. Here are a couple of things to keep in mind: Although the on-label dilution uses preservative-free saline, most experienced injectors use preserved because it hurts less and doesn't seem to affect the potency. Some experts also use different dilutions for different areas to try and control the spread more precisely,... more

Richard Baxter, MD
Seattle Plastic Surgeon

Dilution of Botox

With regards to the dilution of Botox, it can vary, however, only a skilled injector can properly calculate the ratio. I would highly recommend seeking a dermatologist or surgeon that has years of experience and whom is board certified.

Nissan Pilest, MD
Irvine Dermatologic Surgeon

Botox dilution - determining the right dilution - seeking the right doctor

Your best insurance for having a proper dilution of Botox is to go to a top plastic surgeon or dermatologist and have your treatment. Their reputations are your best guarantee of having the procedure done artistically and effectively. There is no way you can supervise how much saline a doctor is putting into a Botox bottle. If you are even asking this question, you are in the wrong office. If you go to an unlicensed practitioner or think you can get top notch treatment for $10 a unit in... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Botox dilution can vary

I completely agree with the others that in receiving treatments like Botox, you are best off going to a board-certified core cosmetic physician (dermatologist, plastic surgeon). Having said that, the dilution can vary for certain areas in which you are being injected. For example, it would be perfectly reasonable to dilute more for forehead injections where you may want a little more diffusion and less so for the glabella (area between the eyebrows) for a greater effect. The problem... more

Ritu Saini, MD
New York Dermatologic Surgeon

Botox Dilution

If is impossible to know how much you are really getting, that is why you go to someone you trust. The dilution really does not make a difference, but you just need to know how many units you are getting. That is what matters not how the dilution is done. In general, I inject 20 units per muscle area. Doctors charge per unit of botox injected. This is why you need to get your plastic surgery procedures and injectables performed by a board certified plastic surgeon.

Farbod Esmailian, MD
Orange County Plastic Surgeon

Botox Dilution

Hi, The only way you'll ever know how much botox is diluted is if you actually see the person take the botox out of the box (unopened) and watch them dilute the freeze dried botox. There are some studies that show that over diluted botox can dissipate into the tissue more readily and therefore seep into areas that you dont want...also, over diluted botox may not last as long. Find someone you trust and dont go for too much of a bargain.. Best, Dr. S

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

Making sure you get the right units of Botox

Great question. You will never know the dilutions use for the Botox vial. It is called integrity of the injector to be honest. Very hard to find these days. I have been using Botox since 1996. The dilution I use is 4 cc's of sterile saline for each 100 unit Botox vial. I am the only injector NOT a nurse! The fees are quite high these days, I remember when 50 units of Botox fee was $300 now it is $600. So why have a non MD inject you? You are paying top $ get the best bang for your buck. And... more

Darryl J. Blinski, MD
Miami Plastic Surgeon

Botulinum Toxin (Dysport, etc) dilution and p

There is no practical method to measure the botulinum toxin concentration. The end result is the bottom line. Results can be seen in as little as 24 hours but typically take between 3-5 days to take effect.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Botox and dilution

Everyone dilutes the Botox a bit differently. I usually dilute it with 2-2.5 cc's of saline and so I get about 50 units per cc or just under. This seems to work very well for me. I can usually inject the entire upper 1/3 of their face with this amount with long lasting results.

Steven Wallach, MD
Manhattan Plastic Surgeon

My suggestion: SEE A REPUTABLE PHYSICIAN

It is my firm belief that you will get your money's worth if you see a board certified dermatologist or plastic surgeon for all cosmetic procedures. There is simply no way to know the dilution someone uses when preparing the Botox, so you must seek a reputable medical practice. Med spa's have a different paradigm than medical practices. They are both businesses, but medical doctors are also bound by ethics codes to be truthful to patients. Besides, don't you want a physician doing these... more

Mary Lupo, MD
New Orleans Dermatologist

Botox is about units used and skill of the injector

The dilution of Botox is not very important. What matters is the number of units used in each area. A skilled Botox injector can also get better results because they treat each patient differently, according to their needs. Rookie injectors sometimes take one day courses then treat all patients with a set pattern. So, when seeking Botox treatment, ask how long the doctor has been using Botox and how often instead of what dilution they use.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

There is no fixed formula for this dilution.

Offices vary in how they dilute BOTOX. Some used 1 ml of saline to 100 units of BOTOX. This makes a very concentrate solution. The range typically varies from 1 ml to 4.0 of saline. I generally recommend that offices use a single dilution to avoid confusion unless there is a very good reason for having multiple dilutions. For example Eye plastic surgeons treating a medical condition called blepharospam may use very concentrated BOTOX solution but a more dilute preparation for cosmetic... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Get Botox from a reputable clinic

Botox is a medication that should be administered under the supervision of a certified physician. As such, the injector is duty-bound to administer Botox in a precise and reproducible dose for each patient. Your injector should perform a complete examination of your face at rest and with animation. Based on this exam, a Botox dose is calculated. The dosing of Botox is in 'unit' format. There are 100 units in a bottle (although a 50 unit bottle is also available) Clinics dilute Botox using... more

Scott Sattler, MD
Bellevue Plastic Surgeon

Botox Results And Not Units Is the Question

It is immaterial as to how many units are injected in the area of interest. If you get the desired result then don't worry. If you feel that you did not get the desired result then go back to your physician and ask about the reason for no result. If you continue to have issues then see a physician that charges NOT by units but per site. This way your result is guaranteed and you don't have to worry about how many units were put in. Regards