Got a New Doctor Now Botox Doesn't Last As Long - What Gives?

asked 2 years ago by Ilbia
Latest answer by Harold J. Kaplan, MD
Question viewed 828 times
Tags: duration, effectiveness, reasons

Do some doctors dillute or "water-down" Botox? When I lived in Arizona, my old doctor stressed that his Botox was not diluted (my injections lasted about 5 months). I recently received injections from a reputable Austin plastic surgeon, and the Botox only lasted 2 months! What gives?

11 answers to Got a New Doctor Now Botox Doesn't Last As Long - What Gives?

My Botox only Lasted 2 Months - What gives?

The only way to know for sure what's going on is to figure out how much Botox was injected with each practitioner. If you are having the same areas worked on either the second physician is not using as many units of Botox or he/she is not a good injector. Start by asking for your medical records from both offices. Compare the number of units used and then share your concerns with the second physician. Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

Botox effect is dependent on amount of units and injection method

Each vial of Botox contains 100 units of Botox, which is in a powder form. Therefore, if one places one cc of solution in the bottle, a 1cc syringe (which is typically used) will contain ALL the Botox in the vial. However, injecting 100 units of Botox in one area is over-kill, and may produce an unnatural look. For most areas of the upper face, 15-20 units will produce natural results which can last 3-6 months, depending on the patient. I typically use 5cc of solution to dilute the powder,... more

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Botulinum toxin preparation, dose and dilution

Yes, dilution can be a factor in the longevity and effectiveness of the injection. Practitioners vary in their preparations and may add anywhere from 1 to 10 cc with the package insert advising administration of 2.5cc in order to achieve a concentration of 4 units per 0.1cc. Discuss your resutls with your surgeon, I have coocationally seen variations in the effectiveness of different lots which I cannot explain even when the dilutions are prepared identically.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Length of Time Botox Lasts

The likely explanation is that you were probably getting more units injected at your previous doctors office. Botox has to be diluted or reconstituted in order to inject it as it is a powder. Different surgeons dilute the powder differently. But this does not change things if you get the same amount of units injected. So it really comes down to units injected and not the volume injected. There is the possibility that the botox was sitting around for a prolonged period of time and may not... more

Farbod Esmailian, MD
Orange County Plastic Surgeon

Botox not lasting as long with another doctor

Botox comes in powder form in a vial. The physician must dilute it with some salline in order to inject it. The amount of saline that is used to dilute the Botox is different in different practices. The total number of units injected into an anatomical site is the most important variable that should be kept in mind. You might consider authorizing the first physician to send a copy of your record to the current treating physician so you can get the same number of units of Botox as you did... more

Ronald Shelton, MD
Manhattan Dermatologist

Botox longevity

Botox is always diluted to some degree. It must be reconstituted with some volume of saline (I use 2.5cc, others may use more or less). The variables are the number of units injected and the technique. I usually see Botox actually last longer with repeat injections. I, too, would suggest getting your next injection from a different practitioner.

John Whitt, MD
Louisville Plastic Surgeon

More Botox units last longer.

HI. The most likely explanation for your Botox result lasting only two months is that you did not get enough units. The other possibility is that the Botox was old, or not mixed properly. Try another plastic surgeon or dermatologist.

George J. Beraka, MD
Manhattan Plastic Surgeon

Got a new doctor now Botox doesn't last as long - What gives?

Hi, It's not the Botox that's different, it's the doctor. You are either getting fewer units of Botox, or the Botox is being injected incorrectly, in either case, sounds like it is time to find a different Botox gunslinger down there in Austin. Good luck and be well. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Buyer beware when it comes to Botox

Never be afraid or shy about asking pointed questions to a physician. Some doctors are not as reputable as others. Botox can be over-diluted to make you think you are getting a lot when, in fact, you are getting fewer units. If Botox sits, it looses potency. Expert, experienced Botox injectors go through several vials everyday, so you know your material is fresh. Botox works. It is the provider that I'd question.

Mary Lupo, MD
New Orleans Dermatologist

Botox results longevity

First, all physicians dilute their BOTOX. Botox comes in a thin film enveloping a vial. Saline is injected into the vial in various amounts. If 1 cc is injected, the resultant Botox is going to be five times more potent than if 5 cc is added. However, if a physician deems five units of Botox is needed in a certain area, he/she will inject five times the amount of Botox if they have used the 5 cc dilution than the physician who has used a 1 cc dilutioin. Does it come out the same in... more

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Botox "Does not work on me", "Does not last" and other Urban Legends...

All Plastic surgeons repeatedly hear the "Botox does not work on me" and Botox does not last long in me" comments and cringe. Because we KNOW what the reasons. To work well, Botox must be- Original (not gray market or fake)- Fresh (not old or outdated)- be Reconstituted Properly (without shaking or turbulence)- Potent (NOT over diluted)- be given by a Skilled Injector who thoroughly knows Anatomy and has an artistic sense There is A LOT of BAD BOTOX out there. A lot of it is... more