Are the Average # of Botox Units Calculated Before or After Dilution?

For the "11" between the brows, are we getting 20-25 units of botox plus dilution or 20-25 units of diluted botox?

Doctor Answers 11

Botox units and dilution

Botox comes as a dry material in a vial which contains 100 units.  The doctor needs to add saline to mix and dilute the Botox.  The amount of saline that different injectors add to the vial is variable and ranges from 1 cc up to 5 cc or more.  What matters most is the number of units, not the dilution.  You can give the same number of units with any dilution.  A more concentrated dilution will require a smaller volume for a given number of units, while a more dilute dilution will require a larger volume for a given number of units. 

Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 27 reviews

Botox dilution

The 25 units are calculated after dilution.  Some doctors prefer to add more sterile saline to make a more dilute concentration of Botox.  This means that they would inject a larger amount of the solution to make up 25 units.  25 units is still 25 units, regardless of the dilution.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Botox Dilution

Botox usually comes in 100 unit bottles. Sterile saline fluid is then mixed into the bottle. It can be diluted to different concentrations, but essentially 20 units would be one fifth of the fluid in the bottle. 25 units would be one quarter of the fluid in the bottle. The reason for pricing by unit is that much of the cost of the treatments is the cost of the botox.

Michael Horn, MD
Chicago Plastic Surgeon
4.3 out of 5 stars 57 reviews

Calculating Units of Botox

When you get a number of "units" of Botox, it is the same amount of active product despite the amount of sodium chloride that is used to mix the powder into a solution. Therefore, it doesn't matter where you go or how the solution is reconstituted, you're getting the same amount of "active" product. 

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon
4.5 out of 5 stars 35 reviews

Calculating Botox units

It is not important to calculate the dilution, the number of units before or after etc. Every physician has their own preference as to how much saline they use to reconstitute (you use the term dilution which is technically incorrect) Botox since it comes as a freeze dried powder that can't be injected without saline put into it. What is important is in the end, how many units were used, how and at what depth they are placed, and the artistic and experienced eyes of a trained injector.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 53 reviews

Botox is econstituted into Solution and Injected

Cosmetc Botox is a dry powder and is reconstituted into a solution (by dilation). The final concentration depends on how much normal saline is added to the bottle. Most physicians add 5 cc to 6 cc of solution and calculate the amount injected by how many cc's of reconstituted Botox is used. So, if the bottle has 5 cc and 1 cc is used, it is 20 units. If it is 4 cc and 1 cc is used, it is 25 units. If it is diluted to 8 cc and 25 units is desired, 2 cc should be injected.

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Botox Dilution & Units

Botox dilution is usually standard in each practice. Amount of saline [salt solution] used for dilution varies from 1 cc -5 cc, per liking of the treating physician. However , most all physicians stick with one dilution & do not vary it, except on rare occasions. The key factor in Botox injection is the NUMBER of UNITS used, regardless of the dilution used. In my practice , I always dilute in 2.5 cc of saline. I use whatever number of units needed for a particular area: glabella, forehead, crow's feet etc... The amount of units used varies from one patient to the other. This is where the injector's experience comes in.

Khaled El-Hoshy, MD
Detroit Dermatologic Surgeon

Botox unit calculations

I calculate the units after Botox is diluted.  I follow the manufacturer's guidelines.  There are 100 units per vial regardless of what dilution ratio the physician uses.   I think what you are getting at is the question of whether some doctors try to "stretch" the Botox by overdiluting.  If so, you will not achieve the desired result.  I would caution that, when some practices promote Botox at prices that seem too good to be true, they are probably too good to be true!

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Botox and reconstitution

The number of units between the brow is calculated by your injector, and typically is dependent upon the size and strength of the musculature. Botox is reconstituted differently among practices and there are guidelines provided by the manufacturer for an effective treatment range and amount of normal saline added.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Are the Average # of Botox Units Calculated Before or After Dilution

Each vial of Botox contains (dry) 100 units. Saline is added to make it a solution. Depending upon how much saline is put in, this can dilute the Botox more, or less. So, let's say one injector puts in twice as much saline as another into the vial. That means the "units" are therefore 1/2 as effective because they are over-diluted. No matter how much saline is put in, there is only 100 units of Botox in a vial.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 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.