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Am I Being Ripped off with Botox and Juvederm? (photo)

I am 27 with some forehead wrinkles when furrowing and when lifting my eyebrows. I am from Michigan and my Dr says I need 80 units of botox at 12/unit=$960 then 4cc's of lip filler at $2200 dollars. Doesn't most offer more syringes of juvederm cheaper, and for mainly forehead botox I just think 80 units is a lot. I posted pics to see the wrinkles. Please let me know opinions asap I scheduled for the 25th of April for the work. If not I will cancel and shop around.

Doctor Answers (13)

Am I Being Ripped off with Botox and Juvederm?

+3

One could argue that 80 units is a lot, but, then again, looking at your photo, you do have deep furrows (the 11s) and lines at rest and if you are adding in crows feet, then 80 units is not a stretch.  $12/unit is not bad pricing depending on where you live (tends to be $10-14).  As far as the fillers go, your quote of $550 per syringe is not far-fetched, again depending on where you live, it may be average.  Do you want 4 cc of filler in your lips is the question, that's a large volume for just the lips - perhaps some of that is going to be injected elsewhere?  You may want to get another opinion so you can compare and also to set your mind at ease pricing-wise and overall treatment-wise.  You would want to find an injector in whom you feel trust and confidence (you might end up with this injector afterall).

(This answer is not intended nor implied to be a substitute for medical advice.  It is posted for patients’ general education only.  Always seek the advice of your physician or other qualified healthcare provider for further evaluation of your individual case.) 


Seattle Dermatologist
5.0 out of 5 stars 1 review

Too much Botox and too much filler

+2

I have been injecting dermal filler for over a decade. I have NEVER injected 4cc's into the lips. The day I do is the day I will retire myself!

Seek another opinion, in my opinion!

Dominic Bray, MBBS, FRCS
London Facial Plastic Surgeon
5.0 out of 5 stars 35 reviews

How much Botox and Juvederm do you need?

+2

Kiki, The others are being much kinder than I would be in answering this. I think that 4cc of filler in a your lips would be a disaster for you. Not only would you look like a freak but that amount can cause compression of vessels and be dangerous. I agree completely with what Dr. Altman said about the Botox. I would start with 40 units and recheck in two weeks. The cost per syringe and unit Botox is just what 'i charge and think that it is middle of market price. 

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 12 reviews

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Am I being ripped off for Botox and Juvederm

+2

The normal amount of Botox used is 50 units for a full treatment, but this can be variable, of course. Even though you are young you do have a very significant 11 area in the middle of your brows, more significant than I've seen in a long time, truly. So you may need more in that area. I prefer to start conservatively with Botox though, because you can always do more, so starting with 80 units, is a lot, to me. I have some male body builders that I do Botox on, and I do 75 units on them. So again staring with 80 units seems excessive to me. Now onto the Juvederm... 4ccs is a lot of Juvederm and again I prefer to start more conservatively and add filler, rather than start with 4ccs all at once. Plus I like to build upon, or stack fillers, as they last longer than injecting a bunch all at once. There are patients who I have done up to 6cc's on, but it's been over several months, not all at once. I think the fact that you are questioning everything perhaps means you should at least see a few other doctors for consultations and opinions. While you shouldn't be shopping around for the cheapest prices, you should be shopping around for someone who makes you comfortable and content with your choices for injections. 

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.5 out of 5 stars 7 reviews

Am I Being Ripped Off with Botox and Juvederm?

+1

Dear kikikokat,

The prices you have described for Botox and Juvederm on a per unit and per syringe basis are in line with typical market prices in the US.

As others have echoed, the Botox and Juvederm dosages suggested for you are too high for most patients and would likely produce a frozen and overdone look, which is typically considered undesirable by most (but not all) providers and patients.

It is worth keeping in mind the importance of finding a highly knowledgeable, experienced, skilled, and honest provider for injectable treatments such as Botox and Juvederm.

Although injectable treatments may be simple to administer from a technical standpoint, they require a sophisticated understanding of facial anatomy, facial aesthetics, and soft tissue biology to maximize both results and safety.

Please see an experienced, Board Certified Plastic Surgeon, Facial Plastic Surgeon, or Cosmetic Dermatologist to address your concerns. Also keep in mind that the bargain bin is not necessarily the best approach when it comes to your health, well-being, and face.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 10 reviews

BOTOX and Filler

+1

BOTOX dosing and filler will vary from Dr to Dr. I personally would use around 50 units of BOTOX, and 1-2 syringes of filler.

Hope that helps,

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.5 out of 5 stars 74 reviews

Am I Being Ripped off with Botox and Juvederm?

+1

I think the prices that you are quoting are very reasonable. With that said, the recommendation that you need 80 units in the forehead/ glabella is excessive. Further, four syringes of filler in your lips is likely more than you need/ want. That amount of Botox and Juvederm will likely create a very unnatural, "done" look which I would guess is not what you are trying to achieve. If you're unsure about your injectors plan, seek a second opinion. I hope this information is helpful.

Stephen Weber MD, FACS

Weber Facial Plastic Surgery

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Botox and juvederm costs

+1

hi 

i agree with the other PS here: the cost per botox and juvederm treatment are in line with the market price. however, the quatity does seem excessive. 

the forehead should be well treated with 40-50 units. more if you asked for "totally frozen" look. although most patients still want to have some expression. 

the 4 cc in JUST the lips is very excessive. I would ask to see examples of other patients who have had 4.

i think 1 cc is a LOT for just the lips. Better to do less, and repeat more often, then go for too much and regret it later. 

best to you. 

Bennett Yang, MD
Rockville Plastic Surgeon
5.0 out of 5 stars 8 reviews

How Much Botox/Filler Should I Get?

+1

Hi Kiki.  We would not be suggesting as much Botox and filler as your practitioner is suggesting.  We would use 20 units of Botox in the area between the eyes (frown lines).  We would use another 16 units on the forehead and if you wanted the sides of the eyes, we would not use more than 16 again.  So, the maximum for us would be 52 units.

As for the filler, if you have 4 cc's in your lips, you will not look human.  Your lower lip is already full, so if anything we would use 1 cc in the upper lip.  

Yes, discounts are normally given for extra syringes.  We charge $500 instead of $550, but the second and third syringes are discounted.  

We would check around for another credible injector.  It's not so much the prices, but the amount of product that is being suggested that concerns us.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

You are paying for service not just product.

+1

Flat out, you don't need 80 units of BOTOX.  This will totally paralyze your forehead.  A frozen look will be very unnatural and inauthentic.  $12 per unit of BOTOX is not unreasonable.  More experienced injectors can charge much more for their treatments with top injectors above approximately $20 per unit.  Remember the basic cost to the doctor of the product is in the $6 per unit range, other costs get factored into to making a final price for the service including the actual consultation, cost to pay for the staff that greets you at the front desk, back office nursing staff, cost to make and maintain your chart, rent and utilities on the office space, paying for your parking if they validated,  cost of marketing the practice, and let's not forget about malpractice cost.  FInally, the doctor doing the service might want to take a few dollars home at the end of the day.  These cost do add up.  

Finally, 4 ml of Juvederm for your lips is ridiculous.  A very nice lip edge treatment should be in the neighborhood of 1 ml.  I personally think that Juvederm is an inappropriate product for lip treatment because of its tendency to drift after service.  I think Restylane is a much better product for this.  If you get 4 ml of treatment, you will look like the Joker.  As I tell my professional women patients, there are basically two types of lip edge treatment: executive lips that look nice and natural and adult entertainment lips: don't confuse the two.

I don't think the basic prices you are being quote are unreasonable.  I think the service being proposed does not make sense.  If you can't afford quality service, please do not get treatment.  Nothing is worse than getting wrecked to save a few bucks.  On the other hand, based on the proposed treatment described, I think you should consider getting some additional opinions.  Start small: well done conservative treatment will save you money in the long run.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.