• Ask Dr Bragg

  • Dear Dr. Bragg:

    What should I know about the manufacturing, packaging, and mixing of Botox Cosmetic®?

    Winter Park, Florida

    Dear Curious, When it comes to treating wrinkles, not all products are created equal. That’s why it’s important to make sure your physician purchases Botox Cosmetic® from the FDA’s only approved U.S. manufacturer—Allergan, Inc., in Irvine, California. Botox Cosmetic® arrives on dry ice and contain 100 units of Botox Cosmetic® per bottle. Botox Cosmetic® must stay refrigerated until used and will have a thin white film at the bottom of the bottle. Because there is no liquid in Botox Cosmetic®, salt water must be added before it can be injected. Some doctors add 1cc or 1ml to the film. Others add as much as 5cc or 5ml. Regardless how much water is added, the total units of Botox Cosmetic® do not change. Therefore, it is very important to ask how many units you are receiving, not how many cc’s or how much liquid. For example, the upper face is usually treated with around 50 units, or half of a bottle. Therefore, the 50 units could be in only 0.5cc or as much as 2.5cc. Salt water does not decrease the effectiveness of Botox Cosmetic® and, when added with a preservative, extends the shelf life of “mixed” Botox Cosmetic® for up to 30 days.

    Note: For maximum effectiveness, Florida Vein Care and Cosmetic Center will not inject any client with Botox Cosmetic® that has been mixed for more than seven days.

    Dear Dr. Bragg:

    I have very ugly varicose veins in my legs, and they are painful. My mother had them and she had to have them stripped. I would really like to be able to wear shorts. Will my insurance pay for my treatment?

    Ocala, Florida

    Dear Concerned: Varicose veins can be painful and there are several contributing reasons why you have them. Most insurance companies will pay for the treatment, especially a new procedure: Endo Venous Laser treatment, which is performed right here in our office. This is an alternative to the ligation and stripping your mother had—and with much less pain, recovery, and down time. Your insurance will generally pay for your initial consultation (if you have an HMO, you will need a referral from your Primary Care provider). After you have had an evaluation and an ultrasound of your legs, our office manager will meet with you to begin the insurance process. We will contact the insurance company and provide all the necessary information. Insurance companies do have some guidelines, and will frequently request a review of your medical notes. They may ask questions about your symptoms, and how they interfere with your lifestyle. After the review is complete, your insurance company will notify you in writing of its decision regarding coverage.

    Do you have questions about a health issue or cosmetic procedure? If so, contact us!