How do most doctors usually handle patients who need to return for symmetry issues or additional units after Botox? (photos)
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Botox Touch Ups?
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How do most doctors usually handle patients who need to return for symmetry issues or additional units after Botox?
Charging for Botox "touch up"
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1. By the area.
2. By the units.
I used to charge by the area (site) and if patients needed a little touch up within the first two weeks after the injection, there was no charge.
Lately I have switched to charging by the unit. If patients need a few more units to achieve symmetry then they pay for those extra units.
Either method is ok to use. The most important thing is communication and clarity in explaining to the patient the method of calculating the price. As a patient you should not hesitate to ask the doctor or staff to explain it. It will only make things easier for everyone. I have a written protocol that I give to patients to explain things in detail.
Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case
The other situation (usually with first time patients) is that something about the injection did not turn out exactly as we thought it would. While this does not happen often, it does happen. When it happens, we correct it on our own dime. Usually once the "formula" is developed with new patients, it becomes easier to inject and these situations are avoided. This is also why there is value in trying to find one injector you are comfortable with and sticking with that person.
To view Dysport before and after photos, take a look at the link below.
Hybrid of Area and Unit pricing
I used to charge by the area $450 for the first area (no specific dose) and $300 for additional areas. Since I started injecting Botox for patients with enlarged masseter muscle from grinding their teeth, I created a hybrid pricing of both area and unit.
I treat 4 areas with botox: The frown lines, forehead, crow's feet, and masseter muscles. For the first area treated there is an injection fee of $150, additional area injection fee is $100. Then there is a separate unit dosing fee of $10/unit.
For the typical dose of 20 for the frown lines, the hybrid calculation is now $150+(20x$10)= $350. A second area which also uses 20 units is then $100+(20units x$10/unit)= $300.
If a male patient needs 30 units for the frown lines, then they would pay $450, but a petite older lady who doesn't want to be overly frozen may only use 15 units which would then cost them $300.
The injection fee is for the time and supplies used to perform the procedure. 1 syringe, 2 needles, 6 injection sites (3 on each side for frown lines). It doesn't matter to me if they use 15 or 30, the number of injections performed is the same. However, the man using 30 units should pay more than the older woman who only used 15. If the woman comes back in a week or two and decides it was too weak and wanted another 5 or 10 units, then I will not charge another injection fee, only $10 per unit for as much as they want to finish treating that area.
By charging for an area only, some repeat injection and more botox is essentially bundled into the cost whether the patient uses the extra or not. I think this hybrid pricing helps to separate out the labor from the cost of the supply. If more botox is needed, it is usually a small fee.
Occasionally there can be a Botox "dud" in which all of the patients treated with the same vial did not get any result. If this can be proven, then the company will provide a replacement vial and I will perform the re-do at no charge. However, this is rarely the case. The patient may report that the botox worked for one or two of the areas, but the crow's feet was not enough or it is wearing off faster than the frown line or forehead (which is usually the case.) Since the botox clearly worked, I can only offer more units of botox without charging a second injection fee for the same area. This seems fair to my patients and we have not had any complaints.
Botox touch ups
I comp any additional botox required in that meeting for a couple of reasons. One, I consider myself an expert in neurotoxins, capable of providing the best outcome that is available with the medication. So I hold myself to a standard that is different than "discount" and non-core specialty providers. Two, I feel we are well versed in how the medication is supposed to behave, and where it provides the best outcomes. So I think a re-do isn't a failure, because we all will have areas we can touch up. But personally I want to see the full result as much as the patient does, so I don't mind comping a few units to get there. And three, I want the customers to receive boutique care. So they need a little something for the effort.
And they the patients are happy, they return in the future, and I apply what I learned from the touch up to make future injections more effective.