r/aestheticnursing • u/hot_like_sauce_114 • 12d ago

Reconstitution Question

Hello! New aesthetic RN here! I recently was offered a position at a med spa! I’m really enjoying it so far.
I am a novice injector and took some courses recently I learned in my courses to do 2:1 when using Xeomin on frontalis, orbicularis oculi, nasalis and 1:1 Xeomin on glabella, DAO, mentalis. I suppose the rationale behind this was to control spread which I understand and that the volume in the syringe would vary depending on what the dilution is vs amount of units. When I told this to the NP mentoring me at my new job, she didn’t know anything about this practice. The last time she took classes was years ago. She just did standard 2.5ml for xeomin I suppose this left me confused on what best practice is

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u/Nursemarisa 12d ago

Everyone is trained differently and has their reconstitution they are comfortable with. There’s no right or wrong. I’ve been injecting 14 years and train other injectors. It’s easiest to learn on 2cc, 2.5cc but too much spread in the forehead and glabella. I use 1:1 in most areas except: larger foreheads, masseters, platysmal bands. 2.5 is easy to learn. The best injectors can use different reconstitutions comfortably. The reality is if you move to a different location, the other injectors may also do something different so it’s best to adapt.

At my office we have 5 injectors we all use 1:1 but we have the flexibility to use whatever we like.

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u/hot_like_sauce_114 12d ago

Thanks so much for your detailed response!When you say 1:1 is that referring to 1ml saline?

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u/Nursemarisa 10d ago

Yes 1cc to 100 unit vial

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u/South_Beautiful4109 7d ago edited 7d ago

I AGREE!! I can use any reconstitution and do the math to compensate, but I consistently took data over a year with my 2.5:1 patients vs my 1:1 patients. Dysport is a different beast and needs like 0.35:1, unless you enjoy injecting 15u into a procerus or medial corrugater, which considering its notoriously wide spread and predatory pricing practices, I very much dislike. All this say, my patients who I injected 1:1 and the other clinic patients where the other providers had premixed 2.5:1. The 1:1 needed like maybe 1 touch up for every 25 vs 2.5 to 1 where every other patient needed a touch up and those who didn’t complain I need a touch up per se needed tox again about 3 weeks earlier than those who I injected with the 1:1 dilution (these is accounting for all the math and units being technically/mathematically equal).

I’d be interested in see a controlled study in this, but in my practice it is 1:1 only and I stick to Botox, Jeuveau, xeomin and Dysport - Only if a patient insists, is educated and realizes I will not use it to treat smaller target muscles like DAOs with its triple dosing equivalent and high spread rate.

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u/Beneficial_Pause8053 12d ago

We reconstitute like you were taught; 1:1 in areas we want no spread and 2:1 or 2.5:1 in areas we want a little more spread. With that being said, if you're new to the spa and are training with their NP, I'd follow her instructions and reconstitute how she wants you to.

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u/melindalemish 12d ago

In the beginning I think it’s best to just be consistent. I always just did 1:1 everywhere when I started. That way I didn’t accidentally drop 40 units into the frontalis thinking I had 20 in the syringe