Botox
Posted by associatedplasticsurgeons on November 25, 2008
Many people have asked me “why is there such a variation in pricing on Botox”. It seems like everyone is injecting Botox Cosmetic these days. Botox is sold by Allergan in the United S
tates to all physicians, physician assistants and nurse practitioners independent of their level of training.
Allergan, an extremely reputable company doesn’t differentiate between a plastic surgeon and other practitioners. In fact, most “injectors of Botox” in the US aren’t even physicians – they’re nurses who might have taken a one-day course in Botox technique. Botox is a fee-for-service procedure, and therefore it become lucrative for practitioners to inject. At Associated Plastic Surgeons, only Board Certified Plastic Surgeons are injecting Botox.
Many “practitioners” are purchasing botox from Canada at a reduced cost. The FDA frowns at “imported medications.” At Associated Plastic Surgeons, Botox is purchased directly from Allergan in the United States.
Botox has a shelf life of 10 days after which potency decreases rapidly. Many practitioners, try to stretch the shelf life to several weeks, if not months. At Associated Plastic Surgeons, Botox is discarded after 7 days so you’re assured of receiving fresh, non-contaminated injections of equal potency each time.
Because Botox is so expensive, many practitioners try to maximize the number of patients they can treat from one bottle to increase their profits. They do this in several ways – as previously mentioned, they increase shelf life, but more importantly, they dilute the botox. Allergan recommends that Botox be reconstituted in either of two ways: by addign 2.5 cc or 4.0 cc of normal saline making the concentration 4U/0.1cc or 2.5U/0.1cc. Many practitioners are increase the dilution by adding 5cc or 8 cc, thereby diluting the botox, decreasing the effective period and increasing the number of patients treated/bottle, thereby increasing their profits. At Associated Plastic Surgeons, we follow the manufacturers recommendations of either a 2.5 cc or 4.0cc reconstituting, assuring our patients of fresh, potent and effective botox.
I trust this answers many of the questions about pricing variations of Botox.
Elliot B. Duboys, MD, FACS
