# 📌 Reconstitution of Botulinum Toxin with Normal Saline ## 1. General Principles - Botulinum toxin type A is supplied as a **lyophilized powder** (commonly 50U or 100U vials). - It must be **reconstituted with preservative-free 0.9% sodium chloride (normal saline)** before injection. - Dilution determines **concentration, diffusion, and spread**. For **Skin Botox (Microbotox)**, we deliberately use a **more dilute solution** than conventional Botox to allow wide intradermal distribution. --- ## 2. Standard Dilution Ratios - **Conventional Botox (muscle use)**: - 100U vial + 2.5 mL saline → 4 U per 0.1 mL - 100U vial + 2.0 mL saline → 5 U per 0.1 mL - **Skin Botox (Microbotox)**: - 100U vial + 5.0 mL saline → 2 U per 0.1 mL - 100U vial + 10.0 mL saline → 1 U per 0.1 mL - Some protocols extend to **100U + 20 mL saline** for ultra-dilute “skin wash” style injection. 👉 Rule of thumb: - **Higher dilution → wider spread, softer effect** (best for pores, oiliness, glow). - **Lower dilution → more focal, stronger effect** (closer to traditional Botox). --- ## 3. Step-by-Step Reconstitution 1. Use a **sterile 5 mL or 10 mL syringe** prefilled with preservative-free normal saline. 2. Insert the needle into the vial and **slowly inject saline down the side wall** (not directly onto the powder, to avoid foaming and denaturation). 3. **Do not shake**. Instead, gently **swirl or roll** the vial until fully dissolved. 4. Withdraw the required volume into insulin syringes or a multi-needle injector for use. 5. Store at **2–8°C**, ideally use within 24 hours (although some studies suggest stability up to 2 weeks if refrigerated). --- ## 4. Example Protocols for Skin Botox - **Face full-field rejuvenation**: - 100U Botox + 5 mL saline → 2U/0.1mL - Inject 0.02 mL per site -> 0.4U per site - 100 points -> total 40U - 인슐린 주사 1개 = 1 mL = 20U = 50 points 가능(0.4U per site) - Inject ~30–50 points at 0.01–0.02 mL per site → total 30–50U - **Oily T-zone**: - 100U + 10 mL saline → 1U/0.1 mL - Microinjections across forehead/nose/cheeks - **Neck lines / Décolleté**: - 100U + 5–6 mL saline - Multiple intradermal blebs along horizontal lines --- ## 5. Advanced Variations - Some dermatologists **mix saline with small amounts of HA (skin booster), PDRN, exosomes** → “Hybrid Microbotox.” - In such cases, dilution ratios are adjusted so that the **toxin concentration remains 0.5–2U per 0.1 mL** while delivering regenerative factors simultaneously. --- ✅ **Key Takeaway**: For Skin Botox, always aim for **ultra-dilute solutions (1–2U per 0.1mL)**, prepared by reconstituting 100U of botulinum toxin with 5–10 mL of preservative-free saline, injected in **tiny aliquots (0.01–0.02 mL)** across the treatment area. ---