What is the Most Common Amount of Saline Mixture to Powder Constitution of Botox?

Question

what is the most common mixture of Saline cc's to Botox powder constitution?

Otto Joseph Placik, MD · Answer

We use 2.5cc of Saline to each vial of Botulinum Toxin as suggested in the package insert for a total of 40 units per 1.0 cc. However according to personal preference, it can be mixed witjh 1-5 cc.

Harold J. Kaplan, MD · Answer

The most common dilution rate is 2.5 cc's of saline solution per 100 units of Botox. If you are a consumer, we would be more interested in the number of Botox units injected as opposed to the dilution rate. The number of units injected is the best way to understand how the treatment you are receiving compares with that of other offices. Good luck.

Kenneth D. Steinsapir, MD · Answer

In the instructions that come with the BOTOX vial, doctors are instructed to dilute the BOTOX with 2 to 4 ml of sterile saline.  As you can see from the other responses, some doctors use more saline and there are other who only use 1 ml of saline.  However the most common dilutions are in the 2 to 4 ml range.  

	This means that when the doctor draws up the Botox solution into a one milliliter syringe, the syringe can literally hold any amount of Botox from 100 units, the entire contents of a Botox vial, or as little as 5 units of Botox in the case of one Newport Beach dermatologist who dilutes a vial with 20 ml of saline.  However the typical office is in the 25 unit to 50 unit per 1 ml syringe range.  Occasional an office uses sterile injectable water for their Botox.  It is extremely painful when water instead of saline is used so you are unlikely to go back to an office that makes this mistake.

Christopher V. Pelletiere, MD · Answer

The most standard dilution used for Botox is 5cc per 100 units, or 2u per 0.1cc.  This is what the manufacturer recommends in its packaging, but it can me reconstituted from as little as 1cc to 10cc.

Steven Wallach, MD · Answer

I think there is no specific standard. It is all about comfort. I personaly dilute about 2 cc's to keep it well concentrated so that it is about 50 units/cc. Some dilute it more to be a total of 4 cc's so that it is 25 units/cc.

Edgar Franklin Fincher, MD, PhD · Answer

This is a very good question. There are a lot of variations in the dilutions used amongst physicians. I use 2.5cc as my most common dilution but will adjust this for sensitive areas such as around the mouth/lips. Many other physicians also use this 2.5cc dilution. Some however, prefer 2cc or 4-5cc. some even use a 1cc dilution for certain areas. The actual dilution is not as important as how many units are placed and the physicians experience using that particular dilution.

Steven F. Weiner, MD · Answer

Vials of Botox come in 50 unit and 100 unit vials. I find the best amount of saline added is 2cc per 100 units. I also add the preserved saline because it is less painful when administered. Some docs will use 1cc per 100 units and some will add up to 4cc. The less saline used, the less diffusion (movement away from the injected area).

R. Stephen Mulholland, MD (retired) · Answer

Botox comes as a frozen powder and must be reconstituted. There are differing opinions on what amount of diluent should be mixed with the powered botox. The botox powder comes in 50 unit and 100 unit vials. Some the of the accepted dilution amounts include 1cc per 100units, 2cc, 2.5cc, 3cc and 4cc per 100 units. Some European and South American physicians will use up to 6 cc per 100 units. 

	The argument for a more dilute botox reconstitution (4cc-6cc per 100 units) is more botox dispersion for a softer appearance, but there may be a higher incidence of dispersion related complications (such as lid droop). Those that use a more concentrated botox reconstitution technique (1-2cc per 100 units) claim less risk of dispersion, a more precise effects and longer duration, with fewer dispersion complications.

	As always, the most important factor in any medical treatment is seeking out a very experienced physician who is very adept at their botox technique and approach. 

	Always consult with a specialist after online advice to see if you are a candidate for the procedures discussed.

Lee Robinson, MD (retired) · Answer

We use 2cc of saline to reconstitute our Botox for facial injections and 5cc for underarm sweating. The greater amount that you use the greater the risk for diffusion into an area that you may not want to treat. (ie eyelid, brow).

John Whitt, MD (retired) · Answer

I always dilute a 100 unit vial of Botox with 2.5cc of saline. This is, however, an individual physician's choice. The most common dilution is probably 2.5cc. You should inquire about the cost per unit rather than per cc. This way you can compare costs more easily.

What is the Most Common Amount of Saline Mixture to Powder Constitution of Botox?

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