Debunking the Dilution Myth

There's a lot of chatter on social media about neurotoxin (Botox, etc.) dilution, and how practices are scamming patients by excessively diluting their product but still charging full price. After fielding an accusatory phone call from a prospective client, who questioned our dilution because we were offering a special and she'd "heard" that if tox was discounted it must be because it was "diluted", I decided it was time to speak up and provide some clarity on the subject. 

Spoiler alert: ALL TOX IS DILUTED. 

It literally has to be diluted in order to inject it, because it is packaged as a powder. Now, there are different ways to dilute the product, depending on how one plans to use it, but dilution does not diminish it's efficacy. Units are units, now matter how dilute or concentrated they are. The only thing dilution changes is the VOLUME of fluid injected. 

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For those who appreciate a mathematical explanation, here you go: 

One vial of neurotoxin contains 100 units. As noted above, this arrives as a powder. 

Standard dilution (per the manufacturer), is 2.5:1, meaning that 2.5ml of saline is used to dilute one vial of neurotoxin. This results in 4 units per 0.1ml. 

Diluting 1:1 means that 1ml of diluent is used to dilute one vial, resulting in 10 units per 0.1ml (more concentrated). 

Conversely, diluting with 4ml (4:1), means that 0.1ml contains only 2.5 units (less concentrated). 

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Injectors may select different dilutions (and often do), based on the area they're treating. For more precise placement, a more highly concentrated (less fluid volume) dose may be used, while in an area that we might want the product to spread a little (crows' feet, for example), we might choose a lower concentration due to the increased fluid volume that will allow for more coverage. 

THIS DOES NOT CHANGE THE UNITS. 

The only way your injector makes more money off higher dilution is if they're LYING about the number of units used. Period. Not only is that unethical but it is also illegal. 

As a professional who not only values my license but ethically always seeks to do right by my patients, such an accusation is not only insulting, but potentially damaging to my reputation and that of this business I've worked so hard to grow. I ask you please, the next time you hear someone accusing a professional of "diluting" their product to make more money, please think long and hard about what that accusation implies, and maybe share this article with them. I'm hoping that together we can stop the spread of this potentially damaging misinformation!