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How do you reconstitute the three types of Botox? Which is the best?

Doctor Answers 7

Concerned about BOTOX

February 1st, 2014
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I wonder why are you asking about reconstituting Botox.  This is something that should be done by a qualified physician.  If you somehow obtained Botox I would be very worried.  First BOTOX is not sold to patients so you may have a fake or a counterfeit product which may be dangerous.  Second, if you do have the real BOTOX realize this is a controlled drug which when used incorrectly can easily kill you.

Web reference: http://www.torontosurgery.ca/Botox-toronto-cosmetic-surgery.html

Martin Jugenburg, MD


Toronto Plastic Surgeon
4.9 out of 5 stars 407 reviews

Botox Reconstitution

January 16th, 2014
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Hi Ebtisamya,

Reconstitution of Botox products pretty much depends on the purpose or indication for use. For instance, a dose may range from 2.5 - 10mL of 0.9% Saline Solution for Botox and Xeomin.
For small critical areas with risk of spreading, I prefer a lower volume with the total dose as constant and for a larger where spreading will be more beneficial (like the calf), I prefer a higher volume. 
Mesobotox will always require a higher volume. 

In terms of efficacy, they are comparable at appropriate dose. The main difference is that only Xeomin can be stored outside the refrigerator before use.
Somyos Kunachak, MD

Somyos Kunachak, MD
Thailand Facial Plastic Surgeon
4.8 out of 5 stars 16 reviews

Botox reconstitution

January 15th, 2014
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Botox works best with 2.5 cc dilution for 100 unit vial, in my experience. So 11 cc contains 40 units of botox. And Dysport 2.5 cc for 500 units vial. So 1 cc contains 200 units of Dysport. I have no experience with Xeomine. 
Sanjay Parashar, MD

Sanjay Parashar, MD
Dubai Plastic Surgeon
4.7 out of 5 stars 18 reviews

Botox Reconstitution

January 15th, 2014
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I use about 650 vials of Botox a year.  My best personal success is using preserved saline and mixing 2.5 ml with a 100 unit Botox vial.  This provides five syringes of 20 units each which is my most common treatment dose for upper face.

For Dysport I mix 3 ml of preserved saline in a 300 unit vial. This gives five 60 unit syringes.  Remember 3 to 1 gets it done!  I basically use 3 Dysport units per each Botox unit.  So for 20 units of Botox, I would inject 60 units of Dysport.

For Xeomin, I dilute and inject the same as Botox.

Hope this Helps,

Joe Niamtu, III DMD 
Cosmetic Facial Surgery
Richmond, Virginia
Joseph Niamtu, III, DMD

Joseph Niamtu, III, DMD
Richmond Oral & Maxillofacial Surgeon
4.4 out of 5 stars 10 reviews

Reconstitute of Botox, Xeomin and Dypsort

January 15th, 2014
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Botox, Xeomin and Dypsort all need to be reconstituted before use.  This means that they are mixed with sterile saline solution so that it can be injected in a liquid form.  There are different formulas in terms of amount of saline to end up with various concentrations of Botox, Xeomin and Dypsort "units" per 0.1 cc.  The effect of the treatment is dependent on the number of units delivered and the areas in which they are injected.  I have all three types of Botox plus Myobloc for patients who become immune to Botox available in my office.  There are benefits too all types and these can be reviewed with each patient during their consultation.

Good Luck.  

Web reference: http://www.ShaferPlasticSurgery.com

David Shafer, MD

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

How do you reconstitute the three types of Botox? Which is the best?

January 15th, 2014
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All three types of Botulinum toxin can be reconstituted in one of several ways which makes it very important to seek an experienced and reputable injector. Proper treatment should result in similar effects with each of the three drugs but my personal favorite is Botox due to its longevity, predictability and lower risk of side effects.

Stephen Weber MD, FACS

Denver Facial Plastic Surgeon

Web reference: http://weberfacialplasticsurgery.com/botox-dysport-xeomin-neuromodulators

Stephen Weber, MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 123 reviews

How to reconstitute the three types of Botox?

January 15th, 2014
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Botox, Dysport and Xeomin are all reconstituted with sterile saline.  The amount of saline used for each is up to the personal preference of the injector and this difference in volume does not affect the ultimate result of treatment.  Of the three types, one is not necessarily better than the others although individual doctors may have a preference for one in particular.  

Michael I. Echavez, MD

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.7 out of 5 stars 17 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.