title: Botox: shaken, not stirred.
abstract: OBJECTIVE
  To determine whether the effect of botulinum toxin type A is maintained and has the same duration when it is reconstituted vigorously.
  
  
  METHODS
  A prospective, double-blinded, randomized study was performed on 7 consecutive patients who underwent botulinum toxin type A injections to the forehead by one oculoplastic surgeon. Half of each patient's forehead was injected with botulinum toxin type A that had been gently reconstituted according to the package insert and the other half of the forehead was injected with botulinum toxin type A that had been reconstituted vigorously. Eyebrow excursion was measured in millimeters before injection, 1 week after injection, and every month after injection up to a total of 6 months.
  
  
  RESULTS
  Seven consecutive patients with an average age of 39.9 +/- 2.8 years were evaluated. There was no statistically significant difference in eyebrow excursion between the side of the forehead that had been injected with gently reconstituted botulinum toxin type A and the side that had been injected with vigorously reconstituted botulinum toxin type A at every visit.
  
  
  CONCLUSIONS
  The effect of botulinum toxin type A is maintained and has the same duration when it is reconstituted vigorously compared with when it is reconstituted gently.
authors.affiliation: Department of Ophthalmology, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
authors.forename: Nadia A
authors.initials: NA
authors.lastname: Kazim
authors.forename: Evan H
authors.initials: EH
authors.lastname: Black
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002626:Chemistry, Pharmaceutical / Q000379:methods; D004311:Double-Blind Method; D005138:Eyebrows / Q000502:physiology*; D005152:Facial Muscles / Q000187:drug effects*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D011446:Prospective Studies; D015595:Skin Aging / Q000187:drug effects*
chemical_list: D009465:Neuromuscular Agents; D004364:Pharmaceutical Preparations; D019274:Botulinum Toxins, Type A