Let’s talk about a hot topic we get asked all the time:
“How long can I store my Botox after reconstitution?”
And not just Botox—Dysport, Xeomin, Jeuveau, and now Letybo—because they all come with their own quirks. What happens if it sits in the fridge for too long? Or worse—if you leave it on the counter overnight?
Let’s break it down—science meets real-world aesthetics.
I’ll cover:
✅ Storage rules by brand
✅ The difference between preserved vs. non-preserved saline
✅ What the studies actually say
✅ My personal take after treating 10,000+ patients
FIRST—WHAT WE’RE WORKING WITH
There are 5 FDA-approved botulinum toxins for glabellar lines:
- Botox® (OnabotulinumtoxinA)
- Dysport® (AbobotulinumtoxinA)
- Xeomin® (IncobotulinumtoxinA)
- Jeuveau® (PrabotulinumtoxinA)
- Letybo® (LetibotulinumtoxinA)
Each comes lyophilized (freeze-dried) and must be reconstituted with sterile saline before injection.
Here’s the twist—the type of saline you use and how you store it matters. A lot.
PRESERVED vs. NON-PRESERVED SALINE
This is where things get interesting.
Most manufacturers recommend 0.9% preservative-free saline. But in real-world practices, many injectors use preserved saline (with 0.9% benzyl alcohol)—especially when they want to reduce pain during injection or extend vial usability.
So what’s the difference?
| Feature | Non-Preserved Saline | Preserved Saline |
|---|---|---|
| Manufacturer recommended? | ✅ Yes | ❌ Off-label |
| Antimicrobial? | ❌ No | ✅ Yes |
| Comfort on injection | Neutral | ✅ Less sting |
| Storage time? | Shorter | ✅ Longer (off-label) |
WHAT THE STUDIES SAY
Let’s get into the evidence. Here’s what peer-reviewed literature tells us:
1. Stability with Preserved Saline
A 2013 study published in Dermatologic Surgery (Ghalamkarpour et al.) tested Botox reconstituted with preserved saline and stored at 4°C (refrigerator temp).
✅ Result: The Botox retained full efficacy for up to 6 weeks after reconstitution.
✅ Conclusion: No significant difference in clinical effect versus freshly reconstituted toxin.
2. Non-Preserved Saline Stability
According to Botulinum Toxin: Procedures in Cosmetic Dermatology (Alster et al., NCBI), non-preserved Botox shows decreased potency after 24 hours, especially if kept at room temp.
📉 Result: Loss of activity observed after 24–48 hours when not refrigerated.
3. What if I left it out?
A 2014 study in Actas Dermo-Sifiliográficas looked at accidental room temp exposure.
🚫 Result: Toxin reconstituted and left out for >12–24 hrs at room temp lost measurable potency.
So—if you left your vial out overnight, even once—toss it. It’s done. Injecting degraded toxin won’t give you results—and may erode trust with your patients.
STORAGE TIME BY BRAND
Let’s compare the big players based on manufacturer instructions + real-world clinical use.
| Brand | Manufacturer Storage Recommendation | Real-World Practice w/ Preserved Saline |
|---|---|---|
| Botox | Use within 24 hrs (non-preserved); 4°C | 4–6 weeks (preserved), if refrigerated |
| Dysport | Use within 24 hrs | 1–4 weeks, depending on storage |
| Xeomin | Stable up to 24 hrs (room temp OK before reconstitution) | 2–4 weeks after reconstitution, refrigerated |
| Jeuveau | Use within 24 hrs | Up to 3 weeks refrigerated (off-label) |
| Letybo | Use immediately after reconstitution | No long-term data yet (stay conservative) |
MY REAL-WORLD STORAGE PROTOCOL
Here’s what I personally do in my practice:
- Reconstitute with preserved saline
- Store in the refrigerator at 4°C in sterile vials
- Label all vials with date/time of reconstitution
- Use within 3–4 weeks for optimal efficacy
- Never freeze. Never leave out.
“If it’s not cold, it’s not gold.”
QUICK FAQ
Q: Does preserved saline reduce efficacy?
A: No significant evidence says so. In fact, it may improve injection comfort and extend use.
Q: Can I use toxin after 2 weeks in the fridge?
A: Yes—with preserved saline and sterile handling, most clinicians report no loss of effect up to 4 weeks.
Q: Can I draw up and save for the next day?
A: Yes—but only if kept cold and sterile. Use unit-dose sterile vials to minimize contamination risk.
FINAL THOUGHTS
In the aesthetic world, results are everything. That means your neurotoxin needs to work every single time—and how you store it matters.
If you’re using preserved saline, keeping it cold and sterile, and tossing any vial left at room temp, you’re playing it safe—and smart.
And remember: Storage technique is just as important as injection technique.
Ready to Upgrade Your Injection Practice?
If you’re a doctor, nurse, PA, or dentist looking to master neurotoxin and dermal filler injections, my friends at Botox Medical Training offer botox certification programs that go beyond the basics—so you can open or scale your aesthetic practice confidently.
