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Paying for Botox by the Vial

A few weeks ago, I had Botox for my crow's feet only, but I was charged for an entire vial of Botox (6 cc's)! I have had this procedure before by the same well known plastic surgeon, and I know only 3 cc's were used. He told me we only needed 3 cc's. I am very upset and have been refused documentation of the amount used.

Is there any way an entire vial of Botox could have been used on my crow's feet? Do other doctors charge for a whole vial if all of it isn't used? Is there something I'm missing?

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+1

Don't pay for Botox by the cc!

It sounds like your physician is trying to hide the number of actual Botox units used by selling it by the CC. This is a common practice to dupe consumers about the amount of Botox that is used. While you may be able to request your medical records to determine how much Botox was used, it may not help you recover any fees you paid. Our suggestion would be to go to a practitioner that is fair and open with the amount of Botox UNITS that are being injected.
Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
+3

No way could a whole vial have been used on your crow's feet

There is absolutely NO WAY a whole vial (100 units) of Botox could have been used up on just your crow's feet. Check back with your doctor, something very fishy is going on there!
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+3

Botox by the vial: Purchasing 100 units of Botox

Botox is a trademark of Allergan, Inc. The product is produced in vials of 100 units and requires reconstitution in normal saline prior to use. Typically, less than 100 units is used on a single patient and thus the method of dispensing is through a multi-use vial. Using 100 units along the lateral canthus is unusual, but can occur depending on your degree of dynamic rhytids. Have a frank discussion with your surgeon and this will help clarify the situation and decrease your level of... more
Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon
+2

The amount of Botox used can differ quite a bit

A vial of Botox is actually not necessarily 6cc's. In fact, Botox comes completely dehydrated as 100 units. The amount of saline added to dilute the Botox, so that it can be injected, varies from doctor to doctor. The more saline is added, the "weaker" the Botox becomes, just like when you used to drink Kool Aid and added more water when you started running out, until all you had left was pink water! The point is, a full bottle is not necessarily 6 cc's. The fact that an entire... more
Eric Chang, MD
Baltimore Plastic Surgeon
+1

Botox by the cc is a scam.

The most accurate way of paying for Botox is by the unit. A common popular way to be charged for it is by the area. Both have their pros and cons. Botox by the vial or cc or syringe is not a fair way to measure and charge a patient. As other physicians here say, the fluid volume can vary greatly depending on the dilution your injector uses, and it will be very hard for you to know what is going on. Not fair, I say.
Jessica J. Krant, MD, MPH
Manhattan Dermatologic Surgeon
+1

Botox by vial or by unit

First of all, you did not have 3 cc or 6 cc of Botox - they would be way off the chart.  I assume you are meaning to say 3 units or 6 units were injected in your crow's feet, which is usually about 1/10 of a cc.  In my practice, we charge by the unit so that you know exactly how much Botox you received.   Good luck.
David Shafer, MD
New York Plastic Surgeon
+1

Botox charges

I do not charge botox by the cc's or units, I charge by the region being treated.  This may be as little as 12-15 units or more.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Don't pay for Botox by the cc!

  Thank you for the great question. Botox comes as a dry powder in a small vial. The doctor then chooses to add a certain amount of sterile saline into this vial to reconstitute the Botox. The amount of saline that added depends on the preferences of the doctor. This is why you should never pay for Botox by the milliliter or CC. It is not the saline then you are buying but how much Botox is in the saline. Before your next treatment, ask your physician how many units of Botox... more
B. Pat Pazmino, MD
Miami Plastic Surgeon
+1

Very Strange Indeed!!

There is no way that a whole vial of 100 units could be used to treat crow's feet. The axillae (armpits) for hyperhidrosis ( excessive sweating) yes, but not the crow's feet. Botox for crow's feet, even the most lined, should not run over 30 units. Most women get very good results with 18 units. I do not care what the dilution might be, a whole vial for this sounds like you were scammed, famous board certified plastic surgeon or not.
Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
+1

Botox by the Vial

I have been performing Botox injections since 1998. Botox injections for cosmetic indications was a new concept then, and it was early in my practice. So, unlike today when my office uses multiple vials of Botox each day, I then may have only used 1- 3 vials of Botox per week. Therefore, I had a designated "Botox Day" to ensure that my patients were receiving freshly reconstituted Botox. Each patient given only what would benefit them, and certainly did not pay for Botox they... more
Michael Law, MD
Raleigh-Durham Plastic Surgeon
+1

It is possible to use an entire vial but unnessary

Botox is shipped and stored as a dehydrated toxin. When it is to be used sterile saline must be added to the vial. Different practitioners add different amounts of saline to achieve a certain number of toxins per .1cc. The more saline added the less toxin per .1cc and thus the less injected, leading to less longevity of the paralysis and a need to be injected more often. Most practitioners have gone to 1-2cc of saline per vial. This gives an excellent vial/.1cc ratio and good longevity... more
Christopher L. Hess, MD
Fairfax Plastic Surgeon
+1

Botox by the unit, not the vial

This sounds very strange to me. First of all, there is very little way that anyone could ever require an entire vial (100 units) of Botox to treat their crows feet, regardless of how severe those lines may be. More concerning to me is the refusal of documentation regarding your treatment. You should always have access to the amount of treatment you received and are completely entitled to know the number of units (regardless of how it was diluted into cc's) used. In addition, you should... more
Brian S. Glatt, MD
Morristown Plastic Surgeon
+1

Botox for Crow's Feet - paid too much ?

If the vial was constituted to 6 cc and you now that for a fact and only 3 cc were used, then you should not go back to this practitioner. Even then, it seems like somewhere between 40 and 50 units were used, which seems like a lot for someone who is just treating crow's feet. This amount is usually used for the glabellar area and crow's feet. You should have asked the practitioner why you are paying twice as much this time as opposed to the last time.
Hratch Karamanoukian, MD
Buffalo General Surgeon
+1

Botox usually charged by the unit

We charge by the amount used, or the number of units.  We usually use 25 to 30 units to do the crows feet.  In the glabellar area, we use anywhere from 25 units in most women to as high as 40 units. It would be unusual to use an entire bottle to treat just around the eyes.
Brenda Dintiman, MD
Fairfax Dermatologic Surgeon
+1

Unlikely that an entire vial of Botox was used for the crows feet

You might want to ask your injector how many units were used for the crows feet.  Typical is 15-25 units total for both crows feet.  I do not know of any other physician who charges by the vial.  There is no reason to do so, since the shelf-life of re-constituted Botox is at least 2 weeks.
Bryan K. Chen, MD
San Diego Dermatologist
+1

You usually get what you pay for

Carol, I doubt that you are getting ripped off. It is a basic concept of business that a satisfied customer always comes back. Botox can be charged by the area, or by units used. A full vial is 100 units. It typically takes 15 units or so to treat the crows feet. A question for you, was there a significant change in the price from one treatment to the next? If not, it is likely that you were charged by the area and the number of units or cc's is moot. If so, then you may have been... more
Kenneth R. Francis, MD
Manhattan Plastic Surgeon
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