Can You Dilute Botox with Lidocaine 1% ONLY Instead of Normal Saline? Will It Have the Same Effect?

There is no reason to dilute Botox with Lidocaine. Doing this would make the injections uncomfortable. 

Most likely the lidocaine would not effect the efficacy of the medicine, however it won't make your injection any more comfortable.  The mild discomfort associated with a Botox injection is due to the needle and the tiny amount of medicine that comes out.  The injection is over and done with before the lidocaine can have any effect.  In fact, the lidocaine may burn more than the saline because it has a lower pH.

My patients report their injections are pretty much painless just using a cold pack as a topical anesthetic.  If you are having significant discomfort from the injections, I would consider a topical numbing cream like Emla or BLT (benzocaine/lidocaine/tetracaine).  Ask your injector for your options.

Best Wishes

Yes you can dilute botox with 1% lidocaine and you will have the same effect. However the injection will sting because of the ph in lidocaine and the area will be numb for about 30 minutes. The Botox and normal saline will not sting. The way I inject Botox is gentle, I use a small fine needle, little topical anesthetic and icing and the injection is painless.