Bad BTX*? or bad injector?
Ever puzzled by variable results in effect and duration of your Botulinum Toxin (BTX) injections? Read on.
BTX is fussy, needs refridgeration before and after reconstitution. BTX injectors have varied training and experience.
A few years ago a patient of mine returned from Palm Springs and reported that every other shopfront offered BTX.
Well, the same now seems true in BC, many Dermatologists, Physicians, Dentists, Nurses-all offering BTX.
Excellent, and poor injectors, come from all fields.
So how to choose your injector?
1. Ask how long they have injected BTX
2. Ask where they were trained-one day, two day-two hours peeking over a friends shoulder?
3. Have they had regular refresher
4. The critical question is how many people they inject a week-
Practice makes perfect, and BTX has a limited shelf life once reconstituted-usually w bacteriostaic saline.
So, if your injector only injects one person a week-if you are week four from that vial, the BTX may not be very active.
5. Look at your injectors Clinic-is it tidy, well organised?
If chaotic, messy-perhaps BTX left out in the sun for the afternoon?
If you have good consistent results from your injector, stick with them-and recommend them to your friends.
Occasional blips can occur-perhaps an unseen weekend powercut nixed all the BTX in the fridge?
A good injector will note a group of patients reporting poor results and figure it out. And compensate accordingly.
Occasionally you hear rumours of injectors over diluting BTX, or using expired product-even Top End Clinics-
It probably happens, but the injectors are dicing with their reputation-and the higher up the ladder they are, the more they have to lose.
The Bottom Line?
If you do not get the results you have had from BTX before, go back and tell your injector.
If no explanation, correction occurs-go elsewhere-but ask your friends, and use the guide above.
Dr Julian Hancock FRCP(C) is a Vancouver Island Dermatologist with over twenty years experience in BTX.