How Can I Tell if the Doctor is Actually Giving Me the Amount of Botox He Says I'm Getting?

Question

They could be charging me for 50 units and only giving me 40, right? How would I ever know? Is there any way for a patient to tell just by watching what the doctor is doing?

Ron Shelton, MD · Answer

Please see a board-certified licensed physician who has taken the oath to provide the best medical care in an ethical manner. Most physicians hold themselves to the highest standard. Doctors know how many cc's of the liquid they need to inject based on the amount of diluent (saline) they use to mix the Botox powder. The doctor can tell you how many units are in each cc. 

	Physicians can be brought up on charges with the Office of Professional Misconduct and their license be in jeopardy if they are found to be not delivering care to a patient in the manner in which it had been told to the patient. 

	Let's hope you are seeing a doctor you trust because of reputation and the referral source.

Sam Naficy, MD, FACS · Answer

If you are going to a provider that is well-credentialed and reputable in the industry, I would trust they are giving you what you are paying for. Different providers reconstitute their Botox based on personal preference, so no, there is really no way to tell how much you are getting by the amount you see in the syringe.

Farhan Taghizadeh, MD · Answer

The reality is that for patients, it is dificult to know exactly how many units one is getting injected. There are a few different strategies for diluting the botox in a vial, and thus looking at the volume eing injected can be somewhat misleading in trying to figure this out.

	 

	If one is motivated, one can ask the physician their dilution stratedy for their botox. For example, many physicians dilute botox such that every .1 cc has 2.5 units in it. Thus every 1 cc syringe will have 25 units. You can then check to make sure that there is a whole 1 cc being injected for every 25 units you purchase.

	 

	The reality is that when you are sitting in a chair nervous about the injection, the last thing on your mind is checking units. To this end, your practioner's reputation for honesty and integrity is very important when considering a clinic for botox. While many patients focus on price per unit, I think this issue is the most important when having this procedure done.

Kenneth D. Steinsapir, MD · Answer

This treatment should profoundly freeze your forehead, droop your eyebrows and the effect should last 4 months. If you are not experiencing effects like this, then you are probably getting less BOTOX than you are paying for. If your treatment is wearing off in weeks rather than months, or you are experiencing a lot of residual forehead movement with this dose, then it is probably time to try another injector. Please stick with core aesthetic specialists (i.e. dermatology, facial plastic surgery, plastic surgery, and oculoplastic surgery) with a good reputation.

Michael A. Persky, MD · Answer

Hi Non-monster,

	There is no way that you can tell how much Botox is being given to you.  The American Academy of Facial Plastic and Reconstructive Surgery has a slogan, "Trust Your Face to a Facial Plastic Surgeon", but as importantly you must trust the ethics, morals, and character of your treating physician.  That is why it must be emphasized, "Choose your physician most carefully".  Good luck and be well.

	 

	Dr. P

Jeffrey Zwiren, MD · Answer

A unit of botox is not a unit of measurement but a unit of efficacy.  The standard recommended dilution is 2.5 cc of saline  per 100 unit vial.  This will yield 4 unit of botox per.1cc

David Finkle, MD · Answer

What a great question!  If you are getting the result that you want from the Botox, then it doesn't matter if it is 30-40-50 units, right?  Unless the injector gets paid per unit, then they might adjust the dose to increase their profits.  Very unethical.

	That is why I have always charged my Botox patients per area treated, rather per unit dose.  My patients get the amount of Botox that works best to alleviate the wrinkles in the area treated, regardless of the amount of units used.  That way the patient knows they are getting the best value for the dollar.  I want my patients to get the best possible result, so I don't care if one patient needs 10 units for her crow's feet and another patient needs 20 units, it all evens out in the long run!!

	Ask your injector if they will charge you a set fee to perform your Botox injections, then you will not have to worry about units used any more either.

Benjamin Barankin, MD, FRCPC · Answer

There is no real way for you to tell how much Botox your doctor is giving you. That said, if you go to a trusted and highly trained professional such as a dermatologist or plastic surgeon, it would be almost unheard of for them to risk their reputation and cheat you the number of units you had paid for.

Edwin Ishoo, MD · Answer

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	As you can tell by numerous responses from my colleagues, there is no certain way to tell how many units of Botox you are getting; however, I recommend that patients ask to see the Botox vial to make certain it is an FDA approved vial with the lot number and expiration date stamped on it and not a potentially counterfeit bottle from a non-American pharmacy. I also recommend making certain that if you are paying for Botox, you get Botox and not Dysport or any other neuromodulators, which are significantly different in unit conversions. Lastly, if you have had previous Botox treatment of the same area, you would be able to tell by treatment efficacy and response as compared with your experience in the past. Never be hesitant in asking your doctor to explain how many units of Botox you are getting and you can also ask for a copy of the treatment map.

Paul Gill, MD · Answer

I think there has to be a level of trust and confidence in your plastic surgeon when it comes to any procedure performed.  

	You can ask your plastic surgeon how they mix the botox.   Some mix 40 units per cc, some 20 units per cc.     Another important question is how long has the botox been reconstituted or mixed.   We prefer to use a vial of botox during a single day or within 3 days to optimize its efficacy.

	 

	I hope this helps.
	
	Dr Gill

How Can I Tell if the Doctor is Actually Giving Me the Amount of Botox He Says I'm Getting?

Answers (18)

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