Am I Overpaying for Botox?

I have good skin. I stay out of the sun and use Dr. Brandt's skincare line faithfully. My plastic surgeon injects me with Botox every 3 to 4 months. Each time I go, I am charged with different amounts, although he treats on the same areas: my forehead, my 11 lines and the sides of my eyes. I have paid from $750-$1,100 per visit. He tells me he is giving me a 10% discount. Shouldn't I require less Botox instead of more b/c if I go to him every 3-4 mos?

Doctor Answers 11

Botox fees reflect both product cost and injector experience

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There is probably no more diificult subject to get a handle on than Botox fees. In general, you need to know what you are paying per unit in order to make comparisons. And, as Dr. Lupo pointed out, you would not necessarily get the same amount each time. Comparing the skill and experience of your injector is more difficult, and it is not a good idea in my opinion to shop for the lowest per unit price. Some practices have loyalty incentives, so to know whether you are really getting a 10% discount you need to know more specifically what the fee structure is. It does sound like you are getting good care.

Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Cost for botox injections

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Every one charges differently for Botox.  Typically it is between 8 and 14 dollars  per unit. So you do the math to see if you are paying too much. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Botox pricing

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I think the key is that you have a provider with expertise to give you results you are happy with. The price you are being charged when you come in for your follow-up treatments depends on areas your surgeon focuses on, based on your feedback and what he/she thinks will help get you great results.

If it is helpful to you, you may want to keep track of how many units of Botox you are receiving per treatment session, how much you paid, and how long the treatment lasts. Since you have been going back with some regularity over some time, you may find that you will need less injected into the same areas. You may find that you only need to go every 4 to 6 months depending on how your expression line show, as the effects of Botox wear off.

Want more of a discount? Ask your surgeon or the office manager to see what customer loyalty or VIP incentives they offer.

Good Luck!

These fees are slightly high but reasonable.

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HI.  If you are happy with your results, stay with your doctor.  Go every 4 months.  You are paying for the artful injection as well as the material. At RealSelf, we are constantly answering questions about Botox gone wrong.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Botox comparison shopping

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Comparison shopping for Botox is not exactly like shopping for a TV in different stores. The t v sets are a fixed and known commodity made by one manufacturer while the treatments are rarely if ever the same.

But you can be an informed consumer. In your case for $1100 you probably received some where in the range of 50 units. You can do the math with a 10% discount. If you consult with another practitioner ask about the exact same treatment and what the fee is per unit. Also how many treatments per year, do the math again and you have a unit per dollar per year.

But remember that your are dealing with a commodity tempered with art and experience.To put this into proper perspective see my prior answer about the costs of Blepharoplasty.

Barry H. Dolich, MD (Retired)
Bronx Plastic Surgeon

Botox injections

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The duration of Botox effects varies. You may want to wait until you first begin to notice the effects wearing off before returning for more Botox if you are concerned that your treatments do not appear to be long lasting. If you are satisfied with the results of the work of your plastic surgeon, I would advise you to stick with him.

For reference, you ought to keep a record of how many units of Botox are injected into each site during your visits.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Probably Reasonable for New York

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You might ask whether you are being charged per unit or by the area. Generally, women come out better with units and men by treatment area. This is because males stronger musculature requires more units.

The variance in price most likely is that your plastic surgeon is using more or less units in the different areas you are having corrected. You eventually will need less units in areas that have repeatedly undergone treatment so your cost will go down.

Of course, there is a large price differential depending on region. New York City being the most expensive. I can charge $8/ unit because my overhead is substantially less.

It sounds to me like you are being charged an appropriate amount for New York City. If you are pleased with the results, I would stick with the plastic surgeon.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

It really is dependent on the individual, but usually doing Botox regularly over time requires less

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Thanks for your question.

The best way to find out what you're paying and if it is fair, is to ask how many units you received in each area at the individual office visits. Then, find out what the price is per unit, compare it to what you paid, and then see if the 10% discount was included.

Generally, a forehead will take around 20 units, the 11 lines will take 20 units, and the crows feet will take around 12-24 units (average 18). The total average would be around 58 units, and if they charge $13 per unit, you would be looking at a total of $754.

That's fairly reasonable for Botox for 3 areas by an experienced and skilled physician.

As far as doing less Botox with future injections, some people (including myself) believe that doing Botox regularly will weaken or atrophy the muscle and lead to less Botox being needed, or, wider intervals between injections.

However, this effect is not proven or documented, so it can't be assumed that that really does apply or pertains to everyone.

I can just say that doing Botox will prevent your wrinkles, and as long as you continue to prevent them, you will not have to work as hard to get rid of them as those people who have long-standing, established wrinkles. In light of that fact, doing regular Botox regardless of the dose used has excellent benefits.

Hope this answers your question!

Don Mehrabi, MD
Beverly Hills Dermatologist

Sometimes you don't always get what you pay for with Botox

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Dear Choyce

You will definitely pay more for a more experienced physician or surgeon injector. In many cases, the extra skill and knowledge makes a huge difference in the quality of the service.

I don't agree that with repeat treatments, you require less BOTOX. As we have gotten better at getting more aesthetically pleasing results with BOTOX and not simply treating to the point of paralysis, these results don't seem to last longer and longer. Much of this is how you feel about your treatment. It is my experience that more dramatic treatment results usually prompt patients to come back sooner for retreatment because they are enthusiastic to maintain a great look.

On the other hand, you are in Stockton, California, which is a very depressed market. It may very well be that with a little effort, you can find another highly skilled physician, be just as happy with the results (or more happy) and spend much less on the service. You are describing a pretty generic type of treatment. I have a highly specialized, patent pending microdroplet BOTOX technique that produces a forehead lift. Patients love the treatment and I am in West Los Angeles and I charge less than your doctor does. I am not suggesting that you need to come see me but I support your feelings that perhaps you are paying too much.

Do some research and try another physician in your area. Be aware that you may discover that after trying other physicians, that it is more than just the BOTOX service you are paying for. The staff and doctor who is treating you may be more comforting than other offices, spend more time than other offices, and in general provide more care. You may decide that even though you can get the same basic service for less elsewhere, these it is this higher level of treatment that you appreciate and sometimes this is worth paying for and sometimes it is not.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Hard to say

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It is difficult to second guess other doctor's work. In general, the price charged reflects not only the cost of the Botox, but the overhead of the business. That is why things are much more expensive in New York than here in New Orleans.

The price likely varies becasue the doctor thinks you need different amounts depending on the recovery of the muscles. Best idea is to discuss openly with your doctor your concerns. In my practice, you'd be getting over 50 units and as much as 75 units. That is quite a lot for a woman with good skin texture.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.