Am I Being Ripped off with Botox and Juvederm? (photo)

I have been injecting dermal filler for over a decade. I have NEVER injected 4cc's into the lips. The day I do is the day I will retire myself!

Seek another opinion, in my opinion!

I think the prices that you are quoting are very reasonable. With that said, the recommendation that you need 80 units in the forehead/ glabella is excessive. Further, four syringes of filler in your lips is likely more than you need/ want. That amount of Botox and Juvederm will likely create a very unnatural, "done" look which I would guess is not what you are trying to achieve. If you're unsure about your injectors plan, seek a second opinion. I hope this information is helpful.Stephen Weber MD, FACSWeber Facial Plastic Surgery

Hi Kiki.  We would not be suggesting as much Botox and filler as your practitioner is suggesting.  We would use 20 units of Botox in the area between the eyes (frown lines).  We would use another 16 units on the forehead and if you wanted the sides of the eyes, we would not use more than 16 again.  So, the maximum for us would be 52 units.

As for the filler, if you have 4 cc's in your lips, you will not look human.  Your lower lip is already full, so if anything we would use 1 cc in the upper lip.  

Yes, discounts are normally given for extra syringes.  We charge $500 instead of $550, but the second and third syringes are discounted.  

We would check around for another credible injector.  It's not so much the prices, but the amount of product that is being suggested that concerns us.

Flat out, you don't need 80 units of BOTOX.  This will totally paralyze your forehead.  A frozen look will be very unnatural and inauthentic.  $12 per unit of BOTOX is not unreasonable.  More experienced injectors can charge much more for their treatments with top injectors above approximately $20 per unit.  Remember the basic cost to the doctor of the product is in the $6 per unit range, other costs get factored into to making a final price for the service including the actual consultation, cost to pay for the staff that greets you at the front desk, back office nursing staff, cost to make and maintain your chart, rent and utilities on the office space, paying for your parking if they validated,  cost of marketing the practice, and let's not forget about malpractice cost.  FInally, the doctor doing the service might want to take a few dollars home at the end of the day.  These cost do add up.  

Finally, 4 ml of Juvederm for your lips is ridiculous.  A very nice lip edge treatment should be in the neighborhood of 1 ml.  I personally think that Juvederm is an inappropriate product for lip treatment because of its tendency to drift after service.  I think Restylane is a much better product for this.  If you get 4 ml of treatment, you will look like the Joker.  As I tell my professional women patients, there are basically two types of lip edge treatment: executive lips that look nice and natural and adult entertainment lips: don't confuse the two.

I don't think the basic prices you are being quote are unreasonable.  I think the service being proposed does not make sense.  If you can't afford quality service, please do not get treatment.  Nothing is worse than getting wrecked to save a few bucks.  On the other hand, based on the proposed treatment described, I think you should consider getting some additional opinions.  Start small: well done conservative treatment will save you money in the long run.

You will probably get many opinions about your situation, but here goes mine:  I think 80 units, based on your photos, is excessive.  80 units of Dysport would make more sense.  For comparison, I typically inject 15 units for the frowners between the eyes, and anywhere from 6 to 12 units in the upper forehead.  Even if you were going to get your crows feet injected (another 9 units, or so, per side), the total would be only about half of what your were told you need.  As for fillers, 4 syringes of filler for the lips only is a crazy amount, in my opinion.  If you are having your smile lines and marionette lines injected as well, then 4 syringes is reasonable. 

Your perception and instincts are very proper. The more you know the better decisions you will make. Always start slowly, add only if needed. Talk to those near you who get these services, assess their results. The word of mouth is always the best method of finding someone good. Ask questions until you are satisfied. If not, change your injector. Always remember your first experience. Good luck!

You need to be able to trust your doctor. You haven't found the right fit. Going into a procedure with such doubts is a setup for disappointment. I do think 80 units sounds like a lot for you. You could definitely get away with less and still have a nice result. However, some docs prefer higher doses and patients can then experience longer lasting results. You have a pretty--and natural--smile. I would be careful about getting 4 vials of filler in your lips. I assume they intend to put the majority of it in the nasolabial folds? But even then, it's still a lot of filler for your face at this young age. I wouldn't put more than a single vial into your lips themselves. 

at the outset please understand  that the doctors vary in their pricing mainly because of expertise and experience there is a tangible and intangible difference,these prices are reasonable , and i know drs who charge much more than the quotes.again there are variations about the units used and the quality of the product used.Trust integrity and credibility are the keystones.normally for forehead we use about 40-50 units in females.it can be more sometimes and we keep some for touch up if needed.regarding fillers i persume it may not be only for the upper lip or lowerlips but also nasolabial furrows and touch up for other areas to have a harmony.transparency is the key if the doctor is trustworthy and explains the charges and details of treatment to your satisfaction,then the freedom lies with you to whether to choose him or someone else you think who will offer value for your money

Dear kikikokat,

The prices you have described for Botox and Juvederm on a per unit and per syringe basis are in line with typical market prices in the US.

As others have echoed, the Botox and Juvederm dosages suggested for you are too high for most patients and would likely produce a frozen and overdone look, which is typically considered undesirable by most (but not all) providers and patients.

It is worth keeping in mind the importance of finding a highly knowledgeable, experienced, skilled, and honest provider for injectable treatments such as Botox and Juvederm.

Although injectable treatments may be simple to administer from a technical standpoint, they require a sophisticated understanding of facial anatomy, facial aesthetics, and soft tissue biology to maximize both results and safety.

Please see an experienced, Board Certified Plastic Surgeon, Facial Plastic Surgeon, or Cosmetic Dermatologist to address your concerns. Also keep in mind that the bargain bin is not necessarily the best approach when it comes to your health, well-being, and face.

Warmest wishes,

Larry Fan, MD

BOTOX dosing and filler will vary from Dr to Dr. I personally would use around 50 units of BOTOX, and 1-2 syringes of filler.

Hope that helps,