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Syringes and Needles: The Art of Neurotoxin Injections

Authors: Julius Few, MDFaculty and Disclosures


Posted: 03/25/2011


In Dr. Few's video lecture, he says he uses a diabetic syringe and needle for neurotoxin injections. Doesn't that needle become dull very quickly?

Response from Julius Few, MD
Director, The Few Institute for Aesthetic Plastic Surgery; Clinical Associate, The University of Chicago, Chicago, Illinois

When injecting neurotoxins, I prefer a standard 30-unit insulin syringe with a 32-gauge needle because of the ease of using the line gradients on the syringe. Each line gradient represents approximately 1 unit of onabotulinumtoxinA (Botox®) and 2 units of abobotulinumtoxinA (Dysport™) when reconstituted with 1 cc or 1.5 cc, respectively, of saline. (Note that on-label reconstitution of Botox calls for 2.5 cc of diluent for a 100-unit vial.) I always use meticulous sterile technique and favor using a bottle-top remover to avoid placing the needle through the rubber stopper. It is important to place all of the product in sterile syringes and to store the syringes in appropriate biological refrigeration. It is also vital to label the syringes. Using this approach, the needles stay sharp and patients report very little discomfort. I often say that this method is almost like delivering the neurotoxin with a mosquito.

Supported by an independent educational grant from Medicis Pharmaceutical Corporation.

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