How much saline should be used to dillute Botox for optimal result?

I've gone to different facilities using the same amount of unit injection however I've gotten different results. Such as more or less movement in those areas and shorter a longer amount of time between next treatment.

Doctor Answers 14

Botox reconstitution

Thank you for your question lisamks. Botox is a purified protein used to address wrinkles associated with facial expressions. According to the manufacturer's guidelines Botox is to be reconstituted in 2.5 mL saline. This is what we use in our office. However every office is different and doctors commonly reconstitute Botox in 1-4 mL. It is the number of units that should determine the results. However, when Botox is reconstituted with higher volumes there can be more spread. This is desirable in areas such as the underarms. When reconstituted in lower volumes there is less spread. This can be desirable for precise placement in areas such as around the eyes or mouth. Please consult with a doctor for specific recommendations.  Good luck!


Encino Physician
5.0 out of 5 stars 1 review

Botox and Dilution

There is a standard recommended dilution by Allergan for Botox. What you are describing may be from placement or dilution. Please consult a board certified dermatologist with expertise in Botox for the best cosmetic results.  Best, Dr. Green

Botox concentration

Hello, and thanks for your question. The typical range is 1-4 units per cc. More dilute preparations will have greater diffusion, which is why I often use lower concentrations on the forehead to achieve a more natural results. In order to determine the best treatment plan for you, I recommend an in-person consultation with a board-certified dermatologist or plastic surgeon. Best of luck, Dr. Frucht.   

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox Dilution – What Is Optimal

Usual dilution is 2.5 cc per 100 units. Each practitioner has his/her preference based on procedure and patient. Please see an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

How much saline should be used to dillute Botox for optimal result?

An expert injector can achieve excellent results, regardless of the dilution of the Botox.  However, each injector will have their personal preference on what to work with.  In general, a more dilute mixture will spread more from the injection site.  The dilution should not effect the efficacy.

How much saline should be used to dillute Botox for optimal result?

I prefer Dysport in the equivilent of a 2 cc per vial of Botox solution.  Dysport is preferred throughout the world and in a double blind randomized comparison to Botox done in the US preferred two to one. There are reasons to have results vary between injection facilities but moderate variations in dilution is not one of them.

Curtis Perry, MD
Downey Facial Plastic Surgeon
4.8 out of 5 stars 16 reviews

Botox Reconstitution

The most commonly recommend botox reconstitution instructions are 2.5 cc sterile saline per 100 unit vial. That being said, an acceptable range is 1cc to 4cc.  When you achieve a treatment that you are happy with, it is reasonable to ask your provider how they specifically reconstitute the product and stick to that regimen even when going to different facilities. When I am administering botox, I routinely give the patient the information on how the product was reconstituted, what the total number of units used were, and also a detailed schematic of exactly where injections were placed. I find that this helps to achieve consistent results and improves patient satisfaction. 

Ann Jayaram, MD
Menlo Park Oculoplastic Surgeon

Proper Mix of Botox and Saline

Allergan, the manufacturer of Botox, recommends 2.5 cc for the 100 unit vial. Different injectors do have preferences and may change dilution depending on the area to be injected. The key is to ensure that injector is an experienced an expert injector who maintains the dilution within acceptable boundaries.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 36 reviews

Saline and Botox

The amount of saline used in the clinical trials and in the package insert is 2.5 cc for the 100 unit vial, but some doctors use different amounts. THe effect of Botox is the dose not the dilution amount, but the more it is diluted the more likely it is to spread beyond the area of injection

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Saline For Botox Preparation

Dear lisamks:The amount of saline used for dilution of botox 100 U vial can range from 1-4 mls depending upon clients' needs and injectors' expertises.  Hope this information helps.

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.