What if Botox Was Mixed with Sterile Water Instead of Saline?

The body fluids contain salts.  The salt solution (normal saline) is carefully balanced to matter the concentration of salt in the body fluids.  If one injects more or less concentrated solution,  significant pain is caused as fluids shift to correct the salt imbalance.  Normal saline is profoundly more comfortable when injected than sterile water for this reason.  Diluting Botox with sterile saline almost always the unpleasant cause of painful Botox treatments.  Don't allow yourself to be injected by someone who dilutes their Botox with sterile water.  The treatment will be unnecessarily painful and it suggests the injector does not read or follow directions.

If it was reconstituted with anything other than the company's recommendation, it would sting, hurt, and cause general discomfort, upon injection.

Thank you for the question. In terms of the Botox effect, there should be no difference. However, the sterile water has a different mineral concentration and level of acidity (pH) than saline.  Saline is chosen because it generally more comfortable (i.e., won't cause a burning sensation when injected).