Headings
Pre-treatment assessment · Product and lot number · Dilution · Injection sites and units · Total units · Photographs · Aftercare given · Follow-up
When to use it
Use this each time you inject a neurotoxin for lines or muscle relaxation. It is built around units, sites and dilution, which is what you need to repeat a good result or explain a poor one. Filler, which is measured in volume and technique, has its own template.
Example
Fictional example
Pre-treatment assessment
J.T., 38F, returning client. Strong glabellar lines and crow’s feet on animation. No new medications. No infection at sites.
Product and lot number
OnabotulinumtoxinA, 100-unit vial, lot 000-TEST, expiry checked.
Dilution
Reconstituted with 2.5 mL preservative-free saline. 4 units per 0.1 mL.
Injection sites and units
Glabella: 20 units across 5 points. Lateral canthal lines: 12 units each side across 3 points.
Total units
44 units.
Photographs
Frontal and oblique, at rest and on animation, taken before treatment.
Aftercare given
Stay upright for 4 hours. No rubbing, facials or hard exercise today. Written sheet provided.
Follow-up
Review in 2 weeks for result and any touch-up.