Why Does Cheap Botox and Filler Put You and Your Health at Risk? And How You Can Protect Yourself.

As a board-certified physician practicing aesthetic medicine in Southern California, I'm seeing something alarming: a surge in people sharing images on social media platforms of "fillers" and "Botox" that don't exist in the United States or at pricing that would not be possible if the products were sourced from legitimate United States medical suppliers. I have seen people who are not healthcare providers (a realtor in one example) post on social media that they have “taught” themselves how to inject their own neurotoxins in order to save money.

I'm not just concerned. I'm scared for these consumers. Aesthetic medicine is medicine, injectables are medical treatments with real life-threatening consequences if not injected properly. 

Here's what's happening:

In 2024 alone, the CDC and FDA documented 15 people across 9 states (including 2 in California) who were hospitalized after receiving counterfeit Botox injections. 11 people required hospitalization, and 6 needed botulism antitoxin—a life-saving intervention for what is essentially poisoning. (UC Davis Health, May 2024)



This isn't a "one-off" problem. Between March 2021 and March 2024, federal agents seized shipments of counterfeit Botox, Juvéderm, Sculptra, and Restylane from China, labeled in foreign languages, being sold through Alibaba and distributed in salons, homes, and unlicensed "med spas" across California. One provider in Massachusetts alone generated $933,414 in revenue from counterfeit products before being arrested in 2024. (ELLE Magazine investigation, August 2025)

The California Reality

Southern California—particularly Los Angeles, Orange County, and San Diego—has become a hotspot for illegal injectable distribution. With Botox prices ranging from $15-25/unit legitimately, and counterfeit products available online for a fraction of that cost, unscrupulous individuals are exploiting people's desire for affordable aesthetics.

But here's what that "bargain" can cost you:

The Documented Risks of Counterfeit Injectables

Recent systematic reviews published in Medicina (December 2024) analyzed 38 studies involving 3,967 participants and documented 8,795 complications from dermal fillers—and that's just from legitimate products when improperly administered. With counterfeit products, the risks multiply exponentially:

• Botulism poisoning: Blurred vision, difficulty swallowing or breathing, muscle weakness, incontinence, paralysis
• Severe infections and abscesses: Requiring IV antibiotics, surgical drainage, or hospitalization
• Tissue necrosis: Death of skin and underlying tissue, leading to permanent scarring or disfigurement
• Granulomas and inflammatory nodules: Disfiguring lumps that can appear months or years after injection
• Vascular occlusion: Blocked blood vessels leading to blindness, stroke, or tissue death
• Unknown toxic substances: There is no way to verify what's actually in those vials—silicone, industrial-grade substances, bacteria, or worse
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A 2024 FDA report documented 1,478 adverse event reports in 2023 alone related to dermal fillers, with vascular complications, abscesses, nodules, and granulomas being most common. (FDA Medical Device Report Database, November 2024)

The Red Flags I Need You to Know:

🚩 Products labeled in languages other than English (California Department of Public Health warning, 2024)

🚩 Prices that seem "too good to be true" (legitimate Botox sourced in the United States will not be sold at $5/unit, the product costs more than that for a provider to purchase it without considering the cost of needles, the injector’s time and expertise, etc… ask yourself how that's possible)

🚩 Providers who won't show you the vial or package before injection

🚩 Websites selling injectable products directly to consumers (illegal under federal law—these are prescription-only medications)

🚩 Providers who can't produce a medical license or won't let you verify their credentials on the California Medical Board website

🚩 Social media accounts promoting "imported" or "international" versions of Botox/fillers

What the Law Actually Says:

In California (and all U.S. states), neurotoxins and dermal fillers:



• Are prescription-only medications that can only be obtained from FDA-approved manufacturers (Allergan, Galderma, Merz, Evolus)
• Must be administered by a licensed physician, PA, NP, or RN under physician supervision
• Require informed consent, medical evaluation, and proper sterile technique
• Must be stored and transported according to strict temperature and handling requirements

Anything else is illegal, dangerous, and puts your health—and potentially your life—at risk.

My Plea to You

If you've been considering "cheaper" options for injectables:

• Please don't. The savings aren't worth blindness, disfigurement, or worse.
• If it sounds too good to be true, it is.
• If you can't verify your provider's credentials on the Medical Board website, don't let them touch your face.

If You've Already Been Injected with Suspected Counterfeit Products:

Seek medical attention immediately if you experience:

• Difficulty swallowing, breathing, or speaking
• Vision changes or drooping eyelids
• Severe pain, redness, or swelling
• Lumps, nodules, or skin discoloration
• Fever or signs of infection

Report suspected counterfeit products:

• FDA MedWatch: 1-800-FDA-1088 or www.fda.gov/medwatch
• California Medical Board: 1-800-633-2322
• Local health department

To My Fellow Aesthetic Providers:

We have a responsibility to educate our patients and our communities. When we see illegal activity, we need to report it. When we see patients harmed by counterfeit products, we need to help them—and make noise about it.

This isn't about protecting our business. It's about protecting people.

The Bottom Line:

Aesthetic medicine, when performed correctly with FDA-approved products by qualified healthcare providers, is safe and transformative. I see it every day in my practice. But the rise of counterfeit injectables is creating a public health crisis. It's not just about vanity or "looking good"—it's about safety, informed consent, and protecting vulnerable people from predators who are literally poisoning them for profit.

If you're considering aesthetic treatments, I beg you: do your research. Verify credentials. Ask to see the product packaging. Choose licensed, qualified providers who source products legally.

Your face—and your health—are worth it.

Dr. Kristin Dean, MD | Board-Certified Family Medicine Physician & Founder of Glomi Wellness Lab | Physician-Led Mobile Aesthetics Serving San Diego County with Safe, FDA-Approved Treatments