Botox already in needle?

Question

Should the doctor bring in the vial of botox and dilute it in front of you? Should you be suspicious if the botox is already diluted/mixed in the injection needle?

Michael I. Echavez, MD · Answer

I would not be concerned if the Botox was not diluted in front of you as long as the doctor is reputable.  If the doctor is bringing in the Botox already in the syringe, this is just a way of making the treatment a little more efficient in regards to time.

Jon E. Mendelsohn, MD, FACS · Answer

This is a question that patients seem to ask about a fair amount.  ALL Botox Cosmetic is "diluted."  Botox is delivered in a vial and looks like a small amount of powder inside the vial.  We reconstitute the 100 unit vial of Botox with 2.5 cc of Saline.  This means that each 0.1 cc  4 units of Botox.  The number of units used to treat specific areas is whats important.  Allergan recommends around 20 units in the glabellar region.  Typicallu the number of units will vary from 20-26 units.

Houtan Chaboki, MD · Answer

The method your plastic surgeon or dermatologist brings the Botox into the room should not matter. Ultimately, you should have trust in your Botox injector, otherwise find another specialist.Best,Dr. Chaboki

Kenneth Hughes, MD · Answer

Its very common to already have syringes of Botox prepared, if there is any concern, I suggest you speak to your physician

Stephen Prendiville, MD · Answer

Personally, I prefer to withdraw the Botox and reconstitute the Botox in front of the patient.  The main reason I do this is that patients can sometimes change their minds about how much Botox or which areas they wish to address.  There isn't too much time wastage in doing this, nor is there greater efficiency in pre-loading syringes.  The second reason is that I prefer to keep the toxin refrigerated for the greatest possible period of time.  However, Botox is shipped to the Doctor in 100 unit vials.  Most patients will request a treatment that requires between 20-60 units, effectively making the Botox continer a multi-dose vial.  There is nothing wrong with the Doctor walking into the room with a preloaded syringe as long as you feel your result is commensurate with the number of units you are receiving.

Donald B. Yoo, MD, FACS · Answer

Seeking out an experienced doctor you trust is more important than seeing the Botox mixed in front of you.  Most physicians will mix the Botox and draw the appropriate dosage into syringes at the nursing station before bringing it into your treatment room.  Whether this is done in front of you or at the nursing station will have no effect on the results of your treatment.

Richard Parfitt, MD · Answer

Since Botox comes in 100 unit vials, it would not be practical for the doctor to mix a vial for each individual patient since most treatments are less than 100 units.  Most busy cllinics will have Botox prepared to save both the patient and the doctor time. If you are unhappy with the treatment for any reason, discuss your concerns with the injector.

Rebecca Baxt, MD · Answer

I like to bring the bottle in and draw it up in front of the patient.  I know lots of doctors draw it up and keep it in prefilled syringes in the fridge and just take it out and don't show the bottle, and I personally don't like that practice.  As a patient I think you have the right to ask to see the bottle.  If you aren't comfortable, find another doctor.

Sanjiv Kayastha, MD · Answer

I don't typically reconstitute Botox in front of the patient. However, if a patient requested that I did, I would be happy to oblige. If you don't trust the physician administering your Botox you should seek out another provider.

James A. Kraus, DMD · Answer

It is common for a busy facial cosmetic practice to have syringes prepared but I agree, if you have questions, ask the physician to see the box/bottle and the date of dilution and concentration should be labeled.

Botox already in needle?

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