When deciding the best approach to Botulax reconstitution, there are varying opinions about the ideal amount of saline required to prepare the product for the desired results. In this article, we have provided a helpful guide on how to reconstitute Botulax and addressed the importance of employing the right way to prepare Botulax and catering to patient concerns in this regard.
Botulax Reconstitution? Why does the right technique matters?
It goes without saying that revolutionary Botulinum Toxin has transformed the medical aesthetic industry in the past few decades. This quick and relatively painless intervention, when injected into the face, offers a safe and quick way to improve the appearance of frown or laugh lines, crow’s feet, and improve facial contours among other forms of effects.
Botulinum, when employed for cosmetic purposes, involves far lower doses than other forms of medical procedures where the toxin usage is indicated. If you are a medical professional and want to provide your patient with the smallest possible dose that is also effective and accurate, you must take care in preparing the solution and administering it to achieve effective yet safe outcomes.
Many practitioners chose to increase the amount of saline used to reconstitute Botulax as the larger volume of the prepared solution makes it easier to calculate the number of units that are delivered to each target part of the skin.
Nevertheless, aesthetic medical professionals and patients alike have questioned whether it is an effective and safe way to administer Botulax or any other neurotoxin treatment where it is required. It is why there is a standard prescribed for the reconstitution and administration of a neurotoxin treatment like Botulinum. The practitioners can use this benchmark and their expertise to employ the right technique and achieve the desired outcome.
Let’s have a look at the standard method of Botulax reconstitution.
How to Reconstitute Botulax?
As you know, Botulax is supplied in the form of single-use vials in different units including 50, 100, and 200 units. The product is present in the form of a freeze-dried off-white powder in a vacuumed vial, which must be reconstituted before the injection.
To achieve the desired results, provide a high level of patient care and avoid negative side effects, the powder is mixed with 0.9% non-preserved sterile saline which contains 9mg/ml sodium chloride.
The sterile sodium chloride is added to the Botulax vial for the ideal constitution and results. When diluted with saline the product becomes a colorless, transparent liquid. This liquid is then ready to be used for injecting into the problematic skin areas where you want to remove wrinkles or fine facial lines.
To reconstitute a vial of Botulax, here are the supplies you will need
- A reconstitution syringe
- Non-preserved sterile saline
- Vial of Botulax 50, 100, or 200 units
Read on as we discuss the mixing ratio of saline and Botulax and the process in the next sections.
Botulax Mixing Ratio
As mentioned earlier, there is a standard guideline for using the diluent to prepare the Botulax injection for application. Depending on the amount of saline used, the prepared solution amount will also vary.
For Botulax 100 and 200 units, here is how many solutions can be prepared in units/0.1ml, with respect to the varying amounts of sodium chloride when added to the dried powder.
| Sodium chloride | Botulax 100 units | Botulax 200 units |
| 1 ml sodium chloride | 10U | 20U |
| 2ml sodium chloride | 5U | 10U |
| 4ml sodium chloride | 2.5U | 5U |
| 8ml sodium chloride | 1.25U | 2.5U |
The dilutions in the table are determined for an injection volume of 0.1ml. An increase or decrease in the Botulax dose can be achieved by using a larger or smaller volume of the injection. The 0.1ml volume makes it easier for the practitioner to read the measurements and regulate every injection dose applied across the requisite area.
It implies that less of the active Botulax dose is lost to the small obsolete space in the needle hub, which is significant if we consider the small volume of Botulinum toxin used in cosmetic medical treatments.
For preparing the solution, the higher the concentration in comparison to the standard instructions provided for using the diluent, the more long-lasting the Botulax treatment is expected to be while minimizing the side effects. Let’s understand this aspect in more detail.
When a more concentrated reconstituted Botulax is injected into the target area, it has a more profound impact on the specifically targeted muscles. It is easy to manage and calculate and the resultant swelling will also be less. Physicians who use a more concentrated form of the product claim that it leads to a more precise effect and also has a longer duration with fewer complications.
As suggested in the earlier section, there are varying opinions about the ideal amount of diluent that must be mixed with Botulax powder. Some of the standard amounts for dilution for Botulax as mentioned in the table include 1ml, 2ml, 4ml, and 8ml.
Many cosmetic medicine practitioners use a higher amount of the diluent as a more dilute Botulax reconstitution will lead to more product dispersion, and will result in a softer appearance.
However, there is also the risk of complications as with higher dispersion, there is the risk of negative effects such as lid drooping, etc. It is because a diluted liquid will result in more diffusion of the product to the contiguous muscle groups.
Therefore, it is always recommended to seek the opinion of an experienced practitioner who is skilled at the technique of applying Botulax the right way. When you have the necessary insight about what areas of your face must be the main target areas for the treatment, and how different concentrations of the reconstituted Botulinum toxin will affect you, you can draw your own conclusions from the consultations and make an informed choice.
How to Mix Botulax? Step-by-Step Guide
To mix Botulax for reconstituting the lyophilized Botulax powder, here is what needs to be done:
- Draw up the required amount of sterile non-preserved saline in an appropriate-size syringe and insert this syringe gently into the vial.
- The integrity of the drug can be affected by any form of agitation such as bubbling etc. so it is important to take care while handling the vial.
- You must carefully observe the vial when the saline solution syringe is inserted into it. There is a vacuum in the Botulax vial that reflects that the vial’s sterility is intact. If a vacuum does not pull the diluent into the vial, it indicates a problem and you may need to discard the vial.
- Now disconnect the syringe from the needle and mix the Botulax powder with saline by rotating the vial gently.
- Once the solution is ready, it should be transparent, clear, and devoid of particulate matter. Prepared drug products must be inspected visually for particulate matter or discoloration before administration.
- Once the Botulax vial is reconstituted, you will need to record the date and time of the preparation process on the vial label for reference.
Ideally, the prepared solution must be used within 24 hours for the desired efficacy. It is also required to store the prepared solution in a refrigerator at 2 to 8°C until it is ready for use.
Reconstituted Botulax is injected in the facial areas where fine muscles have caused the skin to wrinkle and get fine lines over time. In most cases, the canthal lines, i.e. the areas around the side of the eyes, and glabellar lines, i.e. the area between the brows, are the parts most affected. The injectable can also help reduce wrinkles around the chin and nose.
For the administration of the injection, your practitioner can guide you about the initial recommended dosage. For applying Botulax, air bubbles from the syringe barrel are expelled before the syringe is attached to an appropriate-sized injection needle. A new and sterile syringe and needle must be used to enter the vial on each occasion when drawing out the Botulax solution from the vial.
The Botulinum toxin can be used in your forehead, between the brows, and the nose bridge. It can help correct the wrinkles around the eyes, chin area, nasolabial folds and corners of the mouth. It can also help correct facial contours by restoring their lost shape and tightening the skin.
You may experience slight pain when the needle is inserted. The process may also result in slight discoloration and bruising. However, there is nothing to worry about and no intervention is required, as these bruises only remain for some time and go away on their own.
Final word
The cosmetic effect of Botulax can be observed within three to seven days. However, the full impact can be observed in ten to fourteen days after the treatment. For Botulax reconstitution, the right technique entails using the correct amount of saline for preparing the injection and employing the right way to mix the diluent into the powder, so as to keep the toxin’s integrity intact.
At the same time, it is important to ensure that you seek guidance and treatment from an expert aesthetic medicine practitioner, who will prepare the vial accurately and administer the right dose of the injection in the target areas and deliver the expected results.
