While the Botox product must be diluted before injection, some providers over-dilute the solution to get more mileage out of their inventory.
The recommended dilution is 100 Units/4 mL with preservative-free 0.9% Sodium Chloride Injection, USP (see Table 1). Using a sterile 30 gauge needle, 50 Units of BOTOX (2 mL) is injected intradermally in 0.1 to 0.2 mL aliquots to each axilla evenly distributed in multiple sites (10-15) approximately 1-2 cm apart.
Mixing the toxin with too much saline increases the risk of complications because a dilute solution is more likely to migrate into other muscle areas, he says, causing problems like a droopy eyelid, double vision or a droopy lip. And a watered-down injection isn't as likely to hold up.
Improving Dosing Accuracy
A dilution for a 100 unit vial with 2.5ml saline means each site would be injected with 0.1ml reconstituted saline, rather than 0.04ml with a 1.0ml dilution. The 0.1ml volume makes it simpler for the practitioner to read measurements and control each injection dose across the required area.
what about botex or dysport?? Yes …..pretty much any and all of these can be “watered down.” The company recommended and standard dilution for a Botox vial is 2.5 cc.
While the Botox product must be diluted before injection, some providers over-dilute the solution to get more mileage out of their inventory.
Answer: Botox dilution
Typically, botox is diluted with 1 to 3 cc's of saline, depending on the injector's preference and the areas being treated. The more concentrated the solution, the more exact the treatment and the less the diffusion or spread.
Too much Botox in the forehead muscles can cause the eyebrows to droop, making the upper eyelids look very heavy and hooded. The face may look angry or sad all the time. Too much Botox around the eyes can dramatically affect facial expression. The face is simply frozen.
25 Units Of Botox On Average
On average 25 units of Botox will give your skin by your glabellar a full correction and will remove the 11 lines. The '11 lines' are the glabellar lines in between your eyes and eyebrows.
"Facial exercise speeds Botox's wrinkle-reducing effects: Simple facial exercises shortly after injection get quicker results by one day." ScienceDaily.
Even if the masseter muscle is reached, failure to inject deeply enough can leave the lower parts of the muscle moving as normal while the top part is relaxed, creating a 'chipmunk' appearance. Practitioners should aim to inject at the site where the muscle meets the bone, using a longer ½” needle for best results.
Botox must be injected into the superficial layers of the skin in some areas, while in others, it needs to be injected deeply. One example is the masseter muscle near the mouth. If a practitioner doesn't inject this muscle deeply enough, patients can end up with an uneven or unbalanced smile.
Using an appropriate-sized needle and syringe, draw up 1.25 mL or 2.5 mL of 0.9% nonpreserved sterile saline (see dilution table). Disconnect the syringe from the needle, then gently mix BOTOX® Cosmetic with the saline by rotating the vial. Record the date and time of reconstitution in the space on the label.
Botox is measured in “units.” There are 100 units in one syringe of Botox.
Here are what the average units of Botox for the different areas of the face are, so you have a baseline of what to expect when doing your first treatment: Chin: 2-6 units. Corners of the mouth: 3-6 units. Crow's feet (outer canthal lines): 5-15 units.
An average Botox procedure uses about 50 units at a time, with the maximum safe amount being 100 units. Typically, you can expect more Botox units if you want to target more dynamic wrinkles like frown lines, forehead lines, or smile lines.
The only person you never need to tip is a doctor, even for aesthetic treatments like Botox (another reason to only get injections from a dermatologist or plastic surgeon). At the end of the day, all of these stylists, aestheticians, and technicians live off their tips, so be sure to help them after they've helped you.
You should NEVER leave a tip for your PA/NP or nurse injector. Injectables are medications, just like a blood pressure pill or a thyroid medication. You would not tip your primary care provider for doing an EKG on you so no need to tip on our medical services either.
For horizontal forehead lines, practitioners can inject up to 15–30 units of Botox. For “11” lines between the eyes (or glabellar lines), up to 40 units are indicated, with higher doses needed in male patients .
While there is a common perception that Botox® can be “watered” down, this is highly unlikely. More likely is that you did not receive enough units to tackle your areas of concern, or the Botox® was placed in less than ideal areas.
Botox paralyzes the frontalis, preventing it from moving, and thus preventing those horizontal wrinkles. But the frontalis muscle is responsible for raising the eyebrows. So it makes sense that paralyzing this muscles gives you heavy brows.
When Botox is applied to problem areas around the eyebrows, the muscles relax and the skin on top of them becomes smoother. The muscles around the eyebrows are pulled upwards, elevating the eyebrows and making a patient's eyes appear more open.
Why does Botox eventually stop working? Your body makes new neurotransmitters all the time, so the “blocking” effect of Botox gradually wears off as these chemicals start circulating in your body again. The muscles are no longer inhibited.
The manufacturer recommends that Botox be reconstituted in unpreserved saline and used within 5 hours of dilution, after which it should be disposed of.
Up till now, there is no known antidote for Botox! Which means that there is no fast way to dissolve Botox of reverse its symptoms. Time is the only thing that is going to help Botox go away.