Can Botox and fillers be watered down?

Can Botox and fillers be watered down? Some on line reviews of my provider of these are accusing him of doing so. Is this something that can be done? I have opted to find another provider whom I have used on occasion

Doctor Answers 14

Botox reconstitution...

Thank you for your question.  Yes, both can be diluted and I would be wary of that possibility if you believe it is a concern with your physician.  Botox comes as a powder that needs to be reconstituted with saline so it is possible it can be watered down.  Fillers typically come as preformed gels and can be diluted with local anesthetics or saline, there may be reasons to do this in some cases.  Needless to say, I would recommend following up with a Board Certified Dermatologist who has an excellent reputation as a cosmetic injector.  Regards, Dr. Matt Elias

Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Botox and fillers and dilution

Botox comes in a powdered form and needs to be reconstituted with saline into a liquid prior to injection. So in a sense all Botox is "watered down". However, it is not the concentration of Botox that matters but the number of units used. As long as you are getting AUTHENTIC Botox and the appropriate number of units injected by an experienced injector, you will see a nice result from Botox. I recommended you go to an experienced injector. There are several in your local (Vancouver).


Depending on how the Botox is stored and how long ago it was reconstituted (it comes as a freeze dried powder and must be mixed with saline before use) the activity of Botox can in fact decrease.  Dilutions do vary amongst providers, but the number of units is the determining factor in efficacy.

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

Can Botox and fillers be watered down?

Botox needs to be reconstituted with saline in order to be used.  If you go to a reputable place "watered down" product should not be an issue.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 415 reviews

Botox and Filler Dilution

Botox needs to be reconstituted with saline or salt water before it can be injected.  Therefore, by definition, it is watered down.  The real question is whether you are getting real Botox or bootleg Botox that may not have the same potency and whether or not the physician is injecting the number of units he or she says they are injecting.  When this is done, usually the Botox does not last as long.
Fillers are hard to dilute but it can be done.  The result is a little volume than yo might be wanting or getting.  If they take the product out of the package in front of you, it is very unlikely that they will be diluted.
I hope that helps.
Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 50 reviews

Botox and Fillers

Botox and fillers can be "diulted" or "mixed" in with saline or lidocaine. I suggest you see an expert who does what is in your best interest.  Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Watered down product

Botox comes as a powder and saline is added to it so it can be injected. A number of different amounts can be put into the vial but 2.5 cc is the amount in the package insert. some doctors try to dilute it more to make more money but it does not work as well. it is more difficult to dilute filler but it can be done with xylocaine

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Can Botox and fillers be watered down?

Thank you for sharing your excellent question.  Botox comes as a dehydrated powder that requires reconstitution, so based on the amount of fluid placed it will affect its dilution.  That is why it is important to understand the number of units administered as this is the only way to compare effects across injectors.  Fillers come pre-filled, and though they can be diluted, if you watch the individual blister pack opened you can avoid that possibility.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Botox and fillers

there are different ways of adjusting the concentration of botox, so that may affect the results.  It is important to find an experienced injector who will discuss the reasons for doing so.  

David A. Lickstein, MD
Palm Beach Gardens Plastic Surgeon
5.0 out of 5 stars 5 reviews


If your "provider" is not a licensed doctor then I would doubt you are getting what you were promised especially on ridiculously cheap specials. If for instance, every reputable doctor in your area is charging $15 / unit of Botox and the salon is charging $10 or has "per area" pricing, its not that the injectable is being "watered down", it is more likely that you are not getting the Botox Units or filler's volume that you expected. Thats how they are able to make money. I would not expect the provider to be truthful about that. You can ask to have the Botox prepared in front of you and ask for the lot number of the vial and how much saline they diluted with. The same goes with the filler. There is a great deal of illegal Botox on the market and it won't have the proper identifiers.

Edwin Ishoo, MD
Winchester Facial Plastic Surgeon
4.4 out of 5 stars 20 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.