Do you like to read Dr. Alex’s blog? If so, then you’ll love to watch Dr. Alex’s video blog.
What is Dr. Alex’s blog?
Dr. Alex created a blog where he posts new information every week. Sometimes it’s information about a new product or treatment we offer at A E Skin. Sometimes it’s information about the latest devices. Sometimes it’s about exciting results of a treatment. And sometimes it’s about an event such as a conference or training event. The blogs are posted every Sunday so you can read and learn something new every week.
What is Dr. Alex’s video blog?
Dr. Alex’s video blog is similar to Dr. Alex’s blog. While it does have some of the same content, there is new content not available on the web blog and it’s all in video format. Click below to see Dr. Alex's video blog.
Here is a recent video with the transcript below.
Botox Preparation Video
Botox comes prepared as a freeze-dried powder in 100- or 50-unit vials on dry ice or in cold containers. Once received by the manufacturer (Allergan) it is to be refrigerated upon arrival. However, there have been reports that if the product is left at room temperature upon arrival for as long as 72 hours before refrigeration, there is no change in efficacy. Per the manufacturer’s guidelines the product is to be reconstituted with 2.5 mL of sterile saline for a 100-unit vial or 1.25 mL of sterile saline for a 50-unit vial. This provides a concentration of 40 units/mL or 4 units per 0.1 mL (a common increment used in a syringe). This is injected usually using a 3-mL syringe and the vial contains a vacuum which sucks the liquid into the vial without requiring pressure on the plunger of the syringe. After the saline is added, the vial is gently stirred for approximately one minute and the product is ready for use. The manufacturer recommends that the vials be single use only; that is one vial should be used for one patient and vials should not be shared between patients. The guideline is also that the product be used within four hours of reconstitution. More commonly bacteriostatic saline is used to reconstitute the product. This contains benzyl alcohol which has the advantage of providing greater comfort when the product is injected. It also allows for the product to be stored in a refrigerator for up to 6 weeks without a change in the effects of the product. Since this is different from the manufacturer’s guidelines it is called off-label use. The term off-label has a negative connotation although doctors routinely use medications in an off-label manner and it is very safe.
Additionally, most vials are used for multiple patients although different needles are used for each patient (another off-label use). For example, a small amount such as 20 units is withdrawn using a sterile needle. When the product is used later, a new sterile needle is used to withdraw the Botox so that there is no contamination of the product. The product is refrigerated after use prior to the next use. The product is usually withdrawn in 1 cc or 0.3 cc syringes and injected using small needles (28-32 Gauge).