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Ask Dr Bragg

Dear Dr. Bragg:

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

Curious, 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.

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