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Thank you for your question about botox. Botox does not start working for at least 10-14 days post treatment. However, the benefits should last 3-4 months. The amount of units needed differs from person to person. The reconstitution of botox varies from office to office. You may hear terms of "1:1 or 2:1" this is done in order to achieve different looks in different areas. Either way, a unit of botox does not change. It is reconstituted differently in order to target specific muscle groups and achieve natural results. It is also important to keep in mind that several treatments may be required before more severe lines soften. Regardless, it is important to decrease the muscle movement in order to improve moderate to severe wrinkles and fine lines. To be sure, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.
You can dilute Botox to nearly any concentration you desire. Generally the botox insert recommends that it be prepared at 4 units per cc
Moast doctors use more concentrated units than you have had but that dilution of 5 ccs of water to one vial of 100 units of Botox was used more in the earlier days of Botox. If it is diluyed more then there is a concern of affecting nearby muscles that should not get treated.
Docs can mix up the botox or Dysport to whatever concentration they feel is best for the patient and the areas being treated. As long as you are getting good results, then be happy and trust your doc. 1 area is usually $300-350, 2 areas is $500-600 and 3 areas is $675-800. (glabella or frown creases are 1 area, lateral canthi or smile lines on the sides of the eyes together are 1 area, and forehead creases are 1 area).
The number of units per cc I a mathematical measure of concentration. I depends on the dilution that your doctor uses. The Botox comes feeze dried and your doctor must add saline. Adding 5 cc of saline makes the concentration 2 units per 0.1 cc. Different doctors use different dilutions and it depends in what they are most comfortable with. It is the number of units injected that matters, not the concentration.
Botox units and dilutions are often confusing to patients. Botox is packaged as 100 units of dry powder in a vial. The physician needs to dissolve it in saline solution to make it a liquid for injection. The amount ranges from 1 cc to 5 cc of saline. The vial still contains 100 units of Botox. For example: with a 1 cc dilution each 0.1 cc of liquid Botox would be 10 units of Botox. with a 2 cc dilution each 0.1 cc of liquid Botox would be 5 units of Botox Most doctors use 1, 2 or 2.5 cc of saline. It doesn't matter, as long as the physician is an experienced injector of Botox. The only logical way to discuss Botox is by units, since cc's and syringes varies depending on dilution.
I prefer to hydrate my Botox so that there are 5 units per each 0.1 ml of inejction. This is a mixture of 2 cc's of saline per vial. I like it concentrated.
The important thing is to get enough UNITS. Your doctor is using very diluted Botox (he dilutes with 5 cc, most doctors use 1-2.5cc). This is OK as long as he uses enough units to get the lasting result and as long as the increased volume does not result in unwanted diffusion.
Typically, dermatologists use anywhere from 2- 2.5 cc normal saline to dilute one 100 unit vial of Botox. That means if 2 cc are used precise concentrations may be calculated. At a 2cc dilution, there are 50 units per cc or 5 units per tenth (.1) of a cc.
I would recommend that you seek evaluation by an oculoplastic surgeon who in familar with the technique for Botulinum Toxin (Dysport and Botox) for strabismus
There may be two reasons for the observed findings: 1) swelling due to the immediate injection which may resolve by 7-10 days or 2) muscle imbalance which may take 4-6 months to resolve.
Botox relaxes muscles, so great care must be taken when treating the lips or mouth so as not to impair their motion. As always, the success of a dermatologic procedure depends not so much on the method used as on the skill and expertise of the practitioner. A skilled Botox injector can use the...