What questions to ask the clinic to ensue Botox is coming from the company & not being mixed down?

Question

What questions do you ask the clinic to ensue the Botox is coming from the company, not being mixed down, anything to look out for? I was going to ask surgeon who charged $17 a unit and recently one who charged $13 a unit but was a step under doctor (went to med school/was certified). Is there specific reasons to be partial to a medical doctor doing the injections? I just don't know what to ask bout what I don't know. Thank you in advance!

Ella Fedonenko, MD · Answer

Every Botox vial that originated at Allergan Aesthetics has its own unique lot number and an expiration date. You could always ask to see this information to make sure that Botox you are getting is manufactured by Allergan Aesthetics.

Anna Chacon, MD, FAAD · Answer

When considering Botox injections, it's important to ensure the product's authenticity and the qualifications of the person administering it. Here are some questions and considerations to help guide your decision:

Source of Botox:
Ask, "Can you confirm that the Botox used in this clinic is sourced directly from the manufacturer, Allergan?"
Request to see the packaging or labels to verify the authenticity of the product.

Dilution Practices:
Inquire, "How do you ensure the Botox is not diluted beyond the recommended guidelines?"
Ask about the clinic’s standard dilution practices and how they align with manufacturer recommendations.

Provider Qualifications:
Ask, "What are the qualifications of the person who will be administering the Botox?"
Verify whether the injector is a board-certified dermatologist, plastic surgeon, or another qualified healthcare professional.

Experience and Training:
Inquire about the injector’s experience, "How many years have you been performing Botox injections, and do you have any specialized training or certifications?"

Safety and Protocols:
Ask about the safety protocols in place, "What measures do you take to ensure patient safety and manage any potential complications?"

Price Differences:
Discuss the pricing, "Can you explain the difference in pricing between your clinic and others, and what factors contribute to the cost per unit?"

Consultation:
Ensure a thorough consultation is provided, "Will there be a consultation prior to the procedure to discuss my goals and any potential risks?"

Regarding the choice between a medical doctor and other certified professionals:
Medical Doctor Preference: While other healthcare professionals can be highly skilled, choosing a board-certified medical doctor for Botox can provide additional assurance due to their extensive medical training and understanding of facial anatomy. A doctor can also better handle any complications that might arise.

By asking these questions and considering these factors, you can make a more informed decision about where to receive your Botox injections.

Ran Y. Rubinstein, MD · Answer

Hello and thank you for your question. There are currently 5 FDA approved neuromodulators available in the United States. These include Botox, Dysport, Xeomin, Jeuveau and Daxxify. Oftentimes, neuromodulators are referred to as Botox since that is what is most familiar, however any of these 5 may be used. Some of these products are more expensive than others, so ask about which specific product you will be getting. In our practice we bring in the actual box with vial so patients can see the exact neuromodulator they are receiving. If you are worried about it being mixed down, you can ask how they reconstitute their neuromodulators. This will be variable based on area of the face (or body) being treated, as well as the size of the vial and specific neuromodulator being used. For a standard 100-unit Botox vial, the diluent should definitely be no more than 2.5mL which is what is recommended in the package insert from the manufacturer. Keep in mind that you are also paying for the injector's skill and experience, so it is normal for there to be slight variation in pricing. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein MD, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Laurie A. Casas, MD, FACS · Answer

To add to the above well explained rights that you have as a patient, each accredited practice that is purchasing the product directly from the manufacturer or the distributor will be listed in the company's roster. So lets say you would like Botox, you go to the manufacturer's website, Allergan, and you can search providers by the zip. It will only show providers who are 1) purchasing directly from the manufacturer and 2) have a license to do so. But, if you want to be extra sure, when in clinic, you can ask to see the license or bottle.

Eric M. Joseph, MD · Answer

Specifically, I am referring to an outcome from Botox. Visit a physician who has been using BOTOX for many years, and if there are favorable before and after photos, this is probably the best way to choose your initial specialist. Hope this helps! Sincerely, Dr Joseph

Kenneth D. Steinsapir, MD · Answer

There are several brands of botulinum toxin A including Botox. While it is an FDA dogma that each of these products is different, the truth is that they are clinically equivalent. Botox comes in a vial dry. It must be reconstituted by the injector. How it is reconstituted determines the concentration of the Botox that is injected. Some injectors make it highly dilute, and some use much more concentrated preparations. Obviously, salt water is much cheaper than Botox. A license physician is accountable to the medical board of your particular state. For example is they use bogus botulinum toxin to save money, they can loose their medical license. Non licensed injectors are in many markets operating illegally. Someone who has set themselves up in the illegal practice of medicine to offer these injections is also likely to be less than honest about the source of their botulinum toxin and if you are actually getting a certain number of units. Of course seeing a licensed physician is going to be more expensive. You decide what makes sense.

Patrick Davis, MD · Answer

You have the right as a patient to request to see the bottle of Botox that is being drawn up and physically ask the provider to draw up the liquid from that bottle. This will ensure you are receiving the product you requested, i.e. Botox and not an alternative (which is fine, but needs to be discussed with you ahead of time). 
As far as ensuring facilities are not diluting the Botox, that is more challenging to police. This comes from making sure the medical practice you are going to is reputable, and has great reviews. If facilities are diluting their product, patient's will tend to quickly realize this as the product will tend not to last as long. Additionally, a bargain basement price for the area can also be a strong tip off that the product may be diluted or is a Botox alternative.
Medical doctors are the highest trained, however that is not to say Nurse Practitioners or RNs wont have more specific experience in aesthetic medicine than MDs who only rarely perform these procedures. It's simply important to go to someone who has long experience in aesthetic medicine, is well trained, and is properly credentialed to perform the procedure in question.

Camille Cash, MD · Answer

Botox is manufactured by a company called Allergan.  You can ask to see the vial for verification.  It should have an Allergan hologram as well as a lot number and expiration date.  Botox needs to be reconstituted before use, meaning saline has to be added.  The dosage is typically measured in units. You want to visit with an experienced injector.  Ask to see before/after photos of other patients.  Prices per unit can be set by the provider.

What questions to ask the clinic to ensue Botox is coming from the company & not being mixed down?

Answers (8)

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