Unfortunately, Botox received from one cosmetic procedure provider may not be exactly what you get at another. Even though Botox (botulinum toxin type A) is supplied to all doctors and facilities in a manufacturer's vial containing 100 units of vacuum-dried neurotoxin complex, in order to be able to inject these active units of Botox, a physician must add a saline solution to get it in "liquid form."



There are 100 units of Botox in every vial, and the more saline that is added to the vial, the less active units that will be present in each syringe. You should be aware that some may refer to this as the dilution process, but it is actually called "reconstitution." So while each healthcare professional gets the same Botox product from the manufacturer, when it's reconstituted for injection, strength and efficacy will differ depending on the amount of saline added. This brings to mind a number of questions for you to ask yourself before deciding on Botox injections.

With this in mind, you should be cautious when you see Botox offered at bargain prices. Everyone pays the same price to the vendor (Allergan) - so how can prices to patients vary so much? It doesn't seem reasonable, does it? That's because it isn't, if manufacturer's recommended reconstitution guidelines are followed. Botox at a "bargain" price almost always means it has been diluted far beyond what's recommended (or effective).

A patient may assume that he or she is getting a "good dose" of Botox because the physician is injecting a large amount - but don't confuse units of saline with units of actual Botox. Physicians who add more saline to the Botox vial than is suggested by the manufacturer, or by the American Society of Plastic Surgeons (ASPS), are administering a less effective injection of Botox - so you should always ask, "What is your reconstitution ratio?"

Also, some facilities quote a price based on the area of injection. You need to look further into this vague statement. As well as asking about the reconstitution ratio, you also need to ask a second important question, "how many units do you inject in that area?"

And, that begs the next question -- what is their definition of an "area". For instance, a provider may advertise "$99 per area", but if the crow's feet area is broken up into two areas, when in most practices it is considered one area, you're not getting any bargain. Look, instead, for a dermatologist or plastic surgeon that charges for Botox "by the unit" so you only pay for the exact number of units you receive. Be sure that he or she follows ASPS guidelines on reconstitution, as well.

If you're considering Botox, you want to be as educated as possible and do plenty of research before going ahead with the injections. Being the well-informed consumer of these products means being aware of exactly what is being used in your cosmetic treatment, whether the person administering your cosmetic treatment is qualified, and last, but not least, if you are even a candidate for Botox injectables.