Does Botox Have to Be Diluted Before Injecting?

I agree with the other docs that it needs to be reconstituted, and that the most important variable is not dilution but total dose.  So you want to make sure you get at least 20 units of botox in the glabella, for example.  But since you can survey a number of docs here in one place, I will give you specifics, since we have done internal studies in our office that have fine tuned our approach.  For the glabella (between the brows) we use a 1 cc dilution.  For the rest of the face, we have tried a 4, 3, and 2.5 cc dilution.  We now stick with the 2.5cc.  The only place I tend to favor dysport is in the crows feet, as it has been disappointing at times when used in other sites compared to botox cosmetic.   And we are currently working with Xeomin to see how it stacks up against Botox right now-it's too early to tell how it will do.

Botox comes as a freeze-dried powder in a sterile vial which is then mixed by the physician prior to use, with a sterile saline liquid.  Different doctors use different volumes so that the concentration can vary but the number of units delivered per area is the important number to compare from treatment to treatment.

Dear Wegiddy-

Botox is shipped in a dry powder, and has to be mixed with fluid to make it injectable.  The plastic surgeon mixing it has control of how strong, or dilute, it is.  However, you HAVE to mix it with fluid to give Botox. 

How strong or dilute it is depends on your injector, where it's injected in your face, and your personal reaction to it.  Many plastic surgeons choose to make the muscles between the eyebrows have stronger Botox.  The areas of the crow's feet typically get less Botox units, and so may be more dilute. 

So, yes, Botox needs to be diluted before injection, but the amount of dilution is variable.

 

Best Wishes,

Roy

Botox is shipped as a powder. Sterile saline is added to the bottle, with the amount of volume added determining the dilution. There is an acceptable range, and there are benefits and drawbacks to each endpoint.

With higher concentrations it may be a little harder to control the dose, but there is less diffusion. Lower concentrations make it easy to measure dosages; however, the more dilute botox spreads farther. This is bad when nearby muscles are inadvertantly paralysed, but can be good for treating larger areas like the central or upper forehead.

Yes, the product must be diluted during the reconstitution process according to current protocols since it arrives with a freeze dried powder in the vial.