As part of our Advanced Practice Providers Guide to Starting a Botox Business training course, Injectables EDU walks injectors through the steps to understand, build, and grow a successful aesthetics business. One question we get a LOT is – how much can you make injecting Botox? Today, we’re asking an expert – Suzanne Jagger – to share their thoughts.
Suzanne Jagger, CRNA, APRN, is the owner, medical director, and aesthetic injector at Aura Aesthetics Med Spa in Portland, OR. She also runs Aura Academy, a neurotoxin and filler training course specifically for APRNS. She is passionate about offering clients an individualized aesthetic service where her client’s needs come first.
This is the first of a four-part “Ask an Expert” series featuring Suzanne where she answers the most common questions about starting a Botox™business. While the answers to these entry-level questions can be incredibly hard to come by, often for the sake of decreasing competition in this field, Suzanne openly and clearly provided SO MUCH insider information that anyone looking to get into the Botox™ business would benefit from.
Injectables EDU Interview with Suzanne
Cassie Lane (Founder and Trainer at Injectables EDU): How much can you make injecting Botox alone (no other fillers)?
Suzanne: What kind of practice are you hoping to achieve? Are you trying to replace your anesthesia income through Botox® or are you looking for extra vacation and shoe money? Most people fall into the extra money category. There are three tiers of a neurotoxin business.
The first tier of Botox businesses is friends and family and/or a Botox party or 2 a month. If you can treat 5 people on a regular basis (30units/person every 3 months), you will break even on your business which includes course, malpractice, everything. If you have your sister-in-law, neighbor, best friend’s husband’s wife, etc., you can start a break-even Botox™ business and, for the most part, get your own product for free. This is a low bar for entry and you will be eligible for business tax deductions from your LLC.
The second tier is expanding clientele, and that’s if you want to go beyond friends and family. Scaling above your direct friends and family costs time and money to grow. If you want to make a couple of thousand dollars a month you need to be seeing about 5 people a week, which actually does take work. It sounds easy but there is something to that.
The last tier would be moving up to share a space, like one room in a spa. I recommend something similar to a hair salon, like where you get your brows done in the back, those are perfect. Or split at a place like SOLA salon two or three ways with another provider. Or come in on the days that the hairdressers aren’t there and use the place. The third tier of Botox business is getting your own lease of your own space.
There are people who are quite successful in doing a neurotoxin-only business without fillers. If you make Botox™ your only business then you need to generate volume. Which means time and marketing.
How much does a vial of Botox and other neurotoxins cost these days (May 2020)?
Great question. In order to know how much money you can make injecting Botox™, you need to know the cost of goods. The minimum amount of purchase for the product is typically 2 vials. There are 4 different providers in the US of FDA-approved neurotoxins. Prices range from the cheapest, Xeomin, at $482 a vial to Jeuveau at $618. Botox™ costs $601, Dysport $532. Some companies have different purchasing programs to bring down the price (Xeomin does not). Galderma and Allergan have a tiering where the more vials you purchase, the more discount you receive. Jeuveau has friendly tiering-buying that dramatically reduces your cost.
You need to have a few things – certain things in a certain order – to even be able to open an account with an FDA-approved supplier. And you only order from there- not from China, not from Canada, you go to the company and pay full freight. You will open an account with each manufacturer and, as I said, only order from there. They ship really fast.
Pharmaceutical companies reward placing large orders of product with discounts. This means it is important to know how long you can keep a vial or syringe on the shelf before popping the lid. What’s the shelf life for unopened vials of Botox and fillers?
The expiration date is dictated by what the pharmaceutical company did during their FDA approval period. For instance, Ravenesse Versa’s shelf life was just extended to 12 months. Originally it was approved for 6-8 months because it was faster to get it through FDA approval with a shorter expiration date. Radiesse has about a 3-year shelf life.
Neurotoxins are typically very shelf-stable- Dysport about 6 months, Botox™ 1-2 years. Also, you need to account for what lot you buy and how long it has been sitting before it gets to you. So there is no guaranteed shelf life from when you receive your order in that respect. If stored properly (normal room temps) none of the products have a problem with degradation or infection. The amount of degradation on neurotoxin and fillers is very minimal according to studies done. Part of the shorter shelf lives is to encourage more purchasing. Although we must always adhere to the expiration dates.
There’s a reason Botox parties are so common – there’s less worry about wasting part of your product by having it unused. How long is a vial of product good for once you pop the lid?
Per FDA approval, all neurotoxins are approved for 4 hrs. There is literature showing its safety and efficacy opened up to six weeks. There has been literature that came out recently that suggests it can be longer than that. It’s supposed to be reconstituted with saline, not necessarily bacteriostatic. There is some debate if using bacteriostatic saline decreases the longevity of the product after reconstitution. It is reported among providers that it does not, and I feel the safety of having bacteriostatic in a multi-dose vial is important for obvious reasons. And it also stinks less! You never ever want to use sterile water-it doesn’t work. It messes up the Botox™ molecule and it will not last as long by about half.
Most aesthetic clinicians would agree fillers are much more of an art than Botox, requiring more practice and obviously additional training. Fillers also have more profound, longer-lasting complications than neurotoxins.
But, the profit margin is way higher on fillers, and you can achieve markedly better results by combining neurotoxin and filler injections.
When I’ve asked a number of people who would like to start aesthetic injections if they plan to incorporate fillers into their practice, many shy away from the idea. Entering into a fillers practice is more intimidating than Botox-only.
What do you think – is it worth it to add dermal fillers to a Botox business?
If you really want to start generating money then you need to start talking about filler. The whole goal of Botox is the conversion into filler where the market really is. Neurotoxin is a gateway drug-it is a bit of a lost leader. Botox gets people in, but it’s really there to drive sales for other services. Here is the caveat, I’m a big believer filler should not be done as a mobile business (unlike neurotoxin alone). Fillers are sterile implant that has dire consequences when it goes bad. You are not equipped to deal with that in someone’s house. It is not considered industry appropriate to do that mobile. I know that people do- and I won’t teach it, I’ve refused to teach people who want to do it at their kitchen table. I can’t live with that.
The importance of a medical assessment is paramount in any specialty. In the medical field, oftentimes half of our work is done before even touching a patient. Could you tell us a little about the importance of being able to do an aesthetic assessment? How do you know how much Botox™ you will need to use by just looking at someone?
It’s just like anything, for example, it took you three years to get good at anesthesia. You’re inexperienced that first year, you don’t know what you don’t know. You are a novice and as you learn you can reflect on how far you have come on the learning curve. It’s the same thing with this. First, do no harm, build on your knowledge, stay in your lane, and build up incrementally and you will improve if you’re thinking about it.
Just like in anesthesia, with experience, you can kind of know just by looking at someone and having a decent idea of how much narcotic or gas they are going to need. It’s the same with this. You just learn how to read their face better, you can eventually just look at someone and know how much one syringe of filler is going to buy you. It takes time. You can’t rush. That being said, just like anesthesia, people will come along and surprise you, and require more or less product than you predicted!
Final thoughts on how much can you make injecting Botox:
I really cannot say enough wonderful things about Suzanne. Learn more about her here. When you’re ready for more expert advice, don’t forget to catch part four of our series with Suzanne. In our last post of this “Ask an Expert” series, we discuss what injectors to follow on social media, how to make the most out of your networking opportunities, and more!
👉Need your specific questions answered by an expert? Schedule a FREE 30-minute mentoring call with me, Cassie! I’ll help answer any questions you’ve got!