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Does a Vial of Botox Come Pre-mixed?

asked 3 years ago by apeeling one in Winnipeg, Canada
Latest answer by Jessica J. Krant, MD, MPH
Question viewed 5,454 times
Tags: preparation, vial

I have heard Botox has to be mixed each time it is used. Is this true, or does it come pre-mixed? Thanks.

20 answers to Does a Vial of Botox Come Pre-mixed?

Botox does not come pre-mixed

Botox does not come pre-mixed. Botox comes in a powder form and is shipped in a small glass vial. It is then mixed with Saline before use. It does not have to be mixed each time it is used, but 100 Botox units are mixed at a time. Our patients normally have between 20 units and 60 units injected so in many cases a portion of the vial remains for the subsequent patients.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

Botox comes as a powder and needs to be reconstituted.

Each vial of Botox needs to be prepared for injection by adding fluid. Different offices use different dilutions, all of which are potentially valid. There are pros and cons for using different dilutions, but the key is really how many UNITS are being injected into an area, not how many cc's or vials. See a well-reputed board certified dermatologist or plastic surgeon, and make sure you feel comfortable and know exactly what you are paying for.

Jessica J. Krant, MD, MPH
Manhattan Dermatologic Surgeon

www.ArtofDermatology.com

Botox does not come pre-mixed

As answered by my colleagues before me, Botox comes as dried powder that must be kept refrigerated. The vial contains either 50 or 100 units. It is reconstituted in normal saline prior to your treatment. There is no set volume of saline that is used. It is up to the individual provider. It ranges from 1-6 milliliters(cc). I personally use 2 mls based on my own personal experience, and after talking with many of the experts here in the US and in other countries. With that being said, it is... more

Steven E. Rasmussen, MD
Austin Dermatologist

Botox has to be reconstituted

Botox comes in a sealed hologram vial (bottle) in poweded form. The nurse or doctor usually has to reconstitute it before it can be used for injecting. Proper reconstitution is very important successful results.

David A. F. Ellis, MD
Toronto Facial Plastic Surgeon

Mixing Botox

Botox does not come premixed and the mixing parameters varies from office to office. Typically, a vial of botox is sufficient for 2 to 3 patients.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon

www.drkrisreddy.com

Botox bottles do not come premixed

Botox is a powerful and effective medication used to relax muscles and alleviate the wrinkles caused by them. Botox comes to the doctor's office as a frozen powder in an empty bottle. Your doctor will then add a small amount of saline water to the Botox to help resuspend it. This mixture is what the doctor will inject into your treatment areas.

B. Pat Pazmino, MD
Miami Plastic Surgeon

Botox comes in a concentrated powder

Every vial of Botox gets diluted when it is used. Doctors may use different amounts of saline to dilute the powder, resulting in Botox that is more or less concentrated. Depending on the areas being treated, one vial may be enough for 3 patients or it may only be enough for one patient.

Jordana Gilman, MD
New York Dermatologic Surgeon

Botox does not come pre mixed

Botox is stored in a cold environment and has no liquid in it when the manufacturer delivers it. We generally use a minimal dilution as I think more concentrated Botox allows us to use fewer needle sticks. Others dilute it more, but my concern is that higher dilutions may not last as long.

Darrick E. Antell, MD
Manhattan Plastic Surgeon

Botox is mixed the first time it is opened

It is mixed every time it is first opened. The same bottle has enough units of Botox to treat two to three cosmetic units. This rarely is all done on the same patient, and more commonly provides doses for two or three patients.

Ronald Shelton, MD
Manhattan Dermatologist

Each bottle needs to be mixed by the doctor's office

Botox comes from the manufacturer as a dry powder in a small vial. It needs to be reconstituted to its active form by the office using it. The concentration can vary depending on how much saline is added to the 100 unit vial.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Botox--Injector Picks Dilution

Botox does not come premixed. It comes freeze dried (kinda like astronaut food). The injector will help pick the dilution of botox depending on the intended application. Once botox is mixed it should ideally be used within 4 hours of reconstitution but this number is controversial. Botox can be made more dilute but can never be made more concentrated (Add saline to product but do not add actually botox to reconstitution).

Anil R. Shah, MD
Chicago Facial Plastic Surgeon

Botox does not come pre-mixed.

Botox does not come pre-mixed and needs to be reconstituted with normal saline prior to injection. Once mixed, the effectiveness of Botox can last for a certain period of time. Everyone dilutes their Botox with different amounts of normal saline, thus you should know how many 'units' of Botox that you are receiving and not how many 'cc's'. Good luck.

Sanjay Grover MD
Orange County Plastic Surgeon

No, it does not come premixed in liquid.

Botox Cosmetic does NOT come premixed in liquid. It comes as an extremely small amount of powder in a vial that is 'lyophilized', which is a fancy term for 'freeze dried". Botox cosmetic is measured in units. Units are a way of measuring the acrtivity, so all vials will have the same amountof activity, they all have 100 units. The powder can be dissolved with pure sterile saline. The amount of saline used to reconstitute the powder vaires on physician preference, but, in general... more

Charles Crutchfield, MD
Minneapolis Dermatologic Surgeon

www.crutchfielddermatology.com

Botox Cosmetic by Allergan is available in a 100 unit multi-dose vial for injection of wrinkles

Botox cosmetic is manufactured by Allergan. This is the same company that manufactures Natrelle breast implants. Botox is available in the United States in two different packages: Botox Serotype A for cosmetic use and Botox Serotype A for medical use. Only Botox cosmetic should be used by your physician for the treatment of wrinkles. This is available in a multi-use vial containing a powder of 100 units of Botulinum Serotype A. In my plastic surgery practice, I constitute the 100 units... more

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Botox is packaged as a dried product.

Botox does not come pre-mixed. It only needs to be mixed one time with sterile saline. If possible, Botox should be mixed just prior to injection.

Bryan K. Chen, MD
San Diego Dermatologist

Mixing Botox

Hi, Botox comes in a glass vial freeze dried. It comes in 100 unit vials which need to be "mixed" before use. The amount of solution mixed varies from physician to physician, from 2cc to 6cc. The number of total units injected is what determines the effect of Botox. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

It does not come pre-mixed

Botox cosmetic comes as a purified protein - not in suspension. It is reconstituted with some amount of saline - depending on the provider. After it is reconstitued, it should be used within 4 hours - according to the most stringent recommendations. Studies have shown, and it is our experience, that it retains its efficacy far longer than that. I hope this helps! Dr. Kaufman

David L. Kaufman, MD
Folsom Plastic Surgeon

Botox needs to be reconstituted

Apeeling One, Botox come freeze-dried and needs to be reconstituted. It come in 100 unit and 50 unit vials. It needs to be mixed with preservative-free normal saline. The amount of saline used determines the concentration. I hope this is helpful. David Shafer, MD New York City

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Mixed one time

Botox Vial is 100 Units. It is mixed with saline with no preservative. The company recommendation is adding 2.5cm to the vial. Once it is mixed it could be used within a certain time limit.