Bogus Botox? Know your injector.
Sometimes smart people make choices they come to regret. That is the case with a patient I have been treating for about the past year and a half, after she received injections of what she was told was Restylane by an esthetician at a local beauty salon. She ended up so disfigured that she has already had to have surgery, and will probably need another operation. In the course of her treatment, we learned that it wasn't actually the wrinkle filler Restylane (which is a very safe and popular product), but some sort of material illegally imported from Asia. Even after laboratory analysis, we still aren't sure what it is. More importantly, the person doing the injections wasn't a licensed medical professional of any sort. Since Restylane (as with anything intended for injection) is a prescription product, it requires a medical license for purchase and use. After a long investigation, federal agents made an arrest this week for practicing medicine without a license, and other charges.
How do things like this happen? I think there are several reasons. One is that the increasing popularity of injectables like Botox and Restylane makes it seem more routine and less "medical." Because they are so safe and predictable, it may not seem as important to really do your homework and check out the provider's credentials. Slick marketing campaigns probably contribute to this perception. The particular salon where my patient had been treated is in a fashionable suburban area, so the business had a façade of being established and upscale. In this context, it just doesn't occur to most people that unlicensed practitioners would be smuggling in counterfeit products and doing medical procedures they were not qualified to do.
So what is an intelligent consumer to do? It may seem difficult at first glance to tell the medispa on the corner offering laser treatments and wrinkle fillers from the salon with bogus Botox, but there are a few simple checklist items that help. First, although nurses and other medical professionals such as Physician Assistants can be very well qualified to do these procedures, there needs to be a supervising physician of record. If you don't see the doctor's name on the door or the printed materials you are given, that should raise a cautionary flag. Some are of the opinion that these procedures should only be done in a doctor's office, though I see this as impractical and no guarantee of better safety or results. In my view it is more important that the supervising doctor be a specialist in cosmetic medicine; some states even require that medispa owners be a dermatologist or plastic surgeon. In any case, no one should be offended if you ask about the doctor's qualifications.
Read more about what to seek out in Healthy Aging's online feature this week.