By Nate Trookman, MD
A recent cosmetic patient came into my office with a coupon flyer from a local Botox nurse injector, asking me if I would price-match the competitor. The price per unit offered by the registered nurse, who injects from a small office, located in a strip mall seemed very low. I explained to the patient that the price offered, was about the price that I pay to Allergan, for my authorized, authentic, U.S. distributed Botox.
The patient left unhappy. I’ve never heard from her, but I hope that if she did proceed with her discount injections, that she won’t be harmed from either fake product, or poor injection technique.
The FDA has recently unleashed a crackdown on the market of imported, counterfeit injectables. “Bootleg Botox” can be purchased from Canadian pharmacies and other international distributors for lower prices than US-imported authorized Botox. A recent study by Allergan found that 9% of fillers and Botox imported from Canada, was spoiled, fake, improperly handled and stored, and not safe for human consumption.
Allergan reported their findings to the FDA, and at least 150 physicians nationwide, including some in the Colorado Springs area, received a warning letter about purchasing products outside the U.S.
Botox and Fillers, such as Juvederm and Restylane, are very sensitive to temperature, and any mishandling can make the product degrade, and be unfit for human use. So, the product imported from Istanbul, may be FDA approved, but it also may have sat on a dock for weeks, until imported to the United States. That is not the product that I would be injecting into patients.
In 2004, a Florida physician, injected fake Botox into 4 patients, including his girlfriend and himself, and created the largest subset of Botulinum toxicity the U.S. has seen in over 50 years. The patients became paralyzed, and stopped breathing when their lungs stopped working. Over 2 months in the hospital on a breathing machine, prompted the FDA to crackdown on this industry, and many unscrupulous physicians were assessed jail time for their actions.
So, how is a patient to know if their physician or nurse injector is using authorized products. One option is to check the Allergan or Galderma websites for authorized injectors, who purchase U.S. products. You can also ask the injector if their product was purchased in Canada or another outside source, or ‘Group Buying.’ Unfortunately, the bottle, the label, and the Hologram can be official looking, but that doesn’t mean the product was temperature controlled and handled according to U.S. standards.
Our suggestion, is only to have Botox and Fillers performed in a Dermatologist or Plastic Surgeons office. That assures patients that the products and techniques will be of the highest standards.
So, before you attend the next ‘Botox Party,’ or are lured by the nurse injector that performs injections without any physician present in the office, think about your health when receiving a medical procedure that is at a discounted cost that is too good to be true.