Different dilution rates can still yield similar results

Jonathan Hoenig, MD answers: How to know if agreed Botox units are all applied?

I got 50 units of Botox for the forehead, crows feet, and eyes: 10 each eye, 20 frown line, and 10 forehead. My face only has just lines; not wrinkles. I did not get good results this time. I saw the powder, but how can I know if there are really 50 units? She it diluted in 1 cc.

In my previous procedures, the injectors would dilute more and made up to 3 shots on each eye; but this time she just applied 2 and concentrated in an area. Which method makes Botox be more well-applied or evenly distributed?

My previous treatments showed results in 24 hours; this time I have waited 5 days to see some results. What happened?


Jonathan Hoenig, MD
1 month ago

The only way to know for sure how many units of Botox are injected is to ask your provider.  You should be able to trust him or her. If you don't trust him, you should go elsewhere, but there are several explanations that might account for the variances you're noticing.

The Botox comes to us as a freeze-dried powder in a glass vial. Each injector reconstitutes the powder with a saline solution. They can put in 1, 2, 2.5 or even 4 ccs of fluid. The more saline, the more dilute it will be and the more fluid will need to be injected to achieve the desired effect. One way is not better than another - they are just different and each injector will have his/her preferred method.

If your previous results appeared in 24 hours, this may have been a more concentrated solution (less saline per unit of botox). It is normal for botox to take 3-7 days or more to see the full effects.

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