A number of women are complaining about getting Botox injections that aren’t doing much for their wrinkles.  Are they building up some kind of immunity?  Or, is the doctor watering down the Botox?   Botox comes in a “freeze dried” form , and it’s left up to the doctor to mix it up properly with saline.   Some places will water down the Botox with more than the recommended normal saline, in order to be able to treat more patients.  But the patients get weaker results.   

“Don’t assume because you’re getting a number of injections that you’re getting a lot of Botox,” says Dr. Andrew Frankel of the Lasky Clinic in Beverly Hills.  “I typically get about four or five areas in a 100 unit vial.  Another doctor may get up to 20 areas with the same vial because he’s watering it down.” 

The only way to know is to go to a reputable doctor and look at the results.  If the Botox doesnt have staying power or it’s not softening the lines you could be getting heavily diluted Botox!  We hear it happens more frequently than you might think.


  1. I am so glad you are reporting on this.    I have been giving Botox injections for the past decade to thousands of patients and have been very frustrated with the lack of standardization in the quantity and the quality of Botox people receive at different offices, not to mention shopping malls.  It is virtually impossible for a consumer to know the number of units being injected into her face.  The only gold standard you may have is the following; THE RESULT HAS TO LAST AT LEAST 3 MONTHS.  ALso most reputable, honest doctors will give a FREE touch up if your Botox is not as effective as you expected.  You can locate the most experience doctor in your area By visiting and type in your zip code in the locate a doctor section.  The list that is generated is arranged in the order of the doctors who perform the highest number of Botox treatments.   

  2. Emily says:

    I am a 40 year old mom who started getting Botox in October 2006. The first treatment I had was great! My forehead was so tight that it wouldn’t move.
    My second round wasn’t until April 2009 in another state. I had 40 units. By the end of the first week, I had to go back because my forehead had way too much movement. I told her my first experience with Botox was much better. I got the excuse that it could be that because it was a couple years earlier that my skin was a bit tighter then so I got a better result.
    I told her my wrinkles were still showing pretty bad. The practitioner looked at my forehead, shrugged her shoulders and said, “Well, it’s not a filler.” She did not offer me a touch up either! So $400 down the drain.
    So fast forward to November 2010. I decided to get some more. I told the practitioner about my history with Botox. She decided on 45 units. She said wait till 2 week mark to see the full results.
    The first week my forehead was very tight. It was great! But then literally, a few days later, I started to notice movement above my right eyebrow that was moving my forehead above it. Day by day, the movement got more and more to where now, when I look up, I have a big section in the middle that crinkles up. So aggravating!!!!
    So now I have to call there and see if she will do a touch up FOR FREE.
    Of course the practitioners will give the excuse that it is most likely you, that you’re just one of those people that it doesn’t work well on, that you need more units, etc, but the truth is, is is more likely them. From watering down the Botox, to using a bottle that is already mixed up. It’s all about money, and it the patients that are getting the raw deal.

  3. P Samara says:

    When I got botox in the past I dont remember them letting the injection squirt out at the injection site. Usually they are way more careful as if they want to ensure that it stays inside the injection site. Well the last time I got it the doctor was dripping it all over my face. If botox is so potent why would the doctor do this and waste it? Could you tell me if it is common for the botox to drip down on all injection sites?

  4. Louise says:

    I have just (for the first time) got my money back on a very bad Botox job. I have had it about 10 times and the difference in strength and Doctors ability is staggering. This last time was with a practicing surgeon, making some money on the side and the frown line between my eyebrows was not affected at all. He did not want to give me a top up but finally agreed and must have put a saline solution in and no Botox at all, although he went out of his way to show me the vial but then spent 5 minutes behind my back fiddling about and yes dribbled some down my face too. There was no difference at all. So I called the salon he was working at, complained and finally spoke to him about it. He denied, lied, blamed my face etc the usual stuff but I stuck to my guns and told him I was not happy and he gave me my hard earned money back. We need to get some regulations in with Botox because it is not fair that it can be watered down and badly administered. It is not rocket science to get the right mix and it costs a lot of money for 10 minutes work.

  5. M. Vixen says:

    My friend, who is a published esthetician, told me salons that offer botox specials through Groupon, Lifebooker, etc are NOTORIOUS for watering down botox.

  6. I am so glad I came across your site. I have been talking to clients and friends whom have suspected this sort of thing. Even from very Reputable dr.s and P.A’s I totally agree there has be more regulations on this. Thanks for sharing.

  7. JBB says:

    I can tell you that I visited a clinic in Lake Oswego, Oregon a few years back for injections. One of the estheticians straight out told me that they had been ‘watering’ down their botox to the point where too many customers were coming back complaining about the results. Those involved had a meeting about it and, after some of the more ‘honest’ staff members insisted that they could not continue to dilute to the degree that they were, the decision-makers agreed to reduce the saline to botox ratio gradually until they had an acceptable amount of unhappy customers. I have since not been back for botox injections anywhere because I feel I cannot trust any clinic to dilute per the manufacturers recommendations. There’s no way to know if they are, and if you ask, just watch the defenses go up. Way back when, my injections used to last 5 – 6 months, and were advertised to last that long. Then, if you’ve noticed, over time the duration was reduced to 4 – 5 months. Now?? Ha. It’s 3 months, even for those who have never used botox before. Wonder why?

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