Many times people who are new to having procedures done are not familiar with terminology used.  I many times hear people ask for Botox to be placed in the nasolabial folds “Laugh Lines”.  An easy way to remember the difference is that fillers like Juvederm “Fill In” low spots or wrinkles.  Botox works on the muscle to help it not move.  Botox does not paralyze the muscle, but rather weakens it so that it does not temporarily not move.  Botox typically comes in units whereas Juvederm and fillers come in a pre-filled syringe.  Juvederm is a gel like substance, and Botox is a fine powder until mixed with sodium chloride to reconstitute it.  Can you “water down” juvederm or fillers?  Absolutely not.  I have read about people thinking they are getting scammed on juvederm by someone watering it down…impossible.  Can Botox be over diluted and “watered down”…yes!  In my own personal opinion I don’t feel it is morally right to cheat someone out of something if they paid for it, but other shady med spas have no problem doing it.  How do you know if it is watered down?  It is extremely difficult to determine if Botox is over diluted, unless your the one doing it.  This is why it is so important to deal with a reputable office.  A few times I have treated people and they said it didn’t work completely, so I re-treat them at no charge.  Do your homework and find a great place to go, and more importantly people you trust.  I always recommend Yelp for honest reviews or Google+.