Most doctors charge for Botox and Dysport by the Unit. Why? Why can’t you just pay one price for the 11’s or the forehead? This article will explain dosing of neurotoxins and why one price does not fit all. For this article, I use the terms Botox, Dysport and Toxin interchangeably.
Unfortunately, all the toxins are pricey. In the USA, doctors must purchase toxins from the manufacturers, and they charge a premium. There are no discount shops for injectables. Though the prices are lower in some countries, it is illegal for us to purchase toxins from those countries and import them to the US. Beware of any place that is offering a screaming deal or a groupon– guess what, they might be using black-market or grey-market products. At Glow Medispa, what you get is the real deal.
A unit of Botox is a measure of the amount of toxin in a vial. Each regular vial of Botox has 100 units. The way the unit is measured is different for Dysport. Each vial of Dysport contains 300 units of Dysport– but the units are not the same. Yes, Dysport vials have more toxin than Botox, but by just a small amount, not 3x!
There are 4 toxins that are FDA-approved in the United States. At Glow Medispa, we use both Botox and Dysport. They both are excellent products. Dysport tends to act quicker and last longer than Botox, so most people find they get a little more bang for their buck out of Dysport. As of this writing, we do not carry the other toxins because we have not found them to be better than Botox.
This depends on the size of the area to be treated, the muscle size and strength.
The active portions of all the FDA-approved toxins are identical, and work in the same way. The toxin goes to the neuromuscular junction and stops the signal from making the muscle twitch. This paralyzes the muscle so you can’t make the line or wrinkle. If you have a big thick muscle, it will take more toxin to paralyze it than a small puny muscle. If you have a very high forehead, you’ll need more toxin than someone with a very small forehead. If you are a man with larger, stronger facial muscles, you are going to need more than a woman with slender small muscles.
If you use too little toxin, it will not last very long. You may briefly love the results but feel it just didn’t last. This can be a delicate balance– we always try to use just the right amount– not too much but not too little. Too much and you may feel too frozen. Too little and you may not get rid of the lines at all. But just as important– even if you like the result– it just doesn’t last. If you use too little you may feel like it just wasn’t worth the money. If placed properly, using more toxin will not spread and make you look weird, but it will make the effect last longer. Going light can save money in the short run, but will cost more with more frequent visits.
One of the worst outcomes from toxin is from being undertreated. The forehead is a thin but very big muscle. If you use too little toxin, you can end up with one eyebrow that can be raised up while the other doesn’t move. Or a small area of the forehead that can still wrinkle when the rest is smooth. This is true of any area– you can be left with a small amount of motion that just looks funny when no motion at all would not even be noticeable. So the bottom line is if you use too low a dose, you can look weird.
This is where the art of injections really is an art. Figuring out that balance is where we get to be most creative. Not only do we need to put it in just the right places, we need to use just the right amount. This requires a thorough assessment of the face, size of the area to be treated, size of the muscles there and strength of those muscles. Some people have really strong foreheads. It is like those frontalis muscles could lift up the brows and throw them across the room. Other people barely move their eyebrows when you ask them to raise them. People are so different. Some people have minimal movement and only 5-6 units might be enough for the whole forehead. Others require 25 units (sometimes more!).
Frontalis injections: 8-15 on average, but can be up to 25-30 units for a very high forehead
For the glabella, the average is about 20 units, bu this can range from 16-24 units, depending on how strong those muscles are.
For the crow’s feet, it takes 8-12 units on each side to treat the lines in this location.
Glabella (11’s): 16-25
Crow’s Feet: 16-24 (8-12 each side)
Brow Lift: 4-8 (2-4 each side)
Bunny Lines: 2-4 (1-2 each side)
Smile Lift (DAOs): 2-4 (1-2 each side)
Lip Lines: 2-4 (1-2 each side)
Dimpled Chin: 2-6
Gummy Smile: 2-4
Neck Bands (Plathysmal bands): 15-50
Masseters (for teeth grinding): 30-40 (15-20m each side)
Armpits and Palms (for hyperhydrosis): 100 (50 each side)
Most people don’t fit nicely into an average shoe size, and the dose of toxin is no different. We cater the dose and placement to each person. Though you can expect you might fall into the ranges listed above– you may be an outlier. Just remember, dose = appearance plus duration. If you want to treat wrinkles and look natural, you don’t want to go too low or too high.
I hope it is clear by now that the dose for each person is variable. AND the toxin itself is expensive. If we need to use more toxin, it is simply more expensive to do a treatment. We do endeavor to make sure we are using the least amount possible to achieve the desired outcome. But we also will always advise you that it is best not to treat at all than to undertreat! The cost will thus depend on each person’s facial anatomy and desired outcomes. Pricing by the unit allows us to customize each treatment in this way.