Anything as popular and expensive as Botox® is bound to have fakes and imitators. We may or may not take umbrage at counterfeit Cartier or ersatz Armani, but we expect the real thing when it comes to medical products. Bogus Botox is fortunately becoming less common in the U.S., but it remains enough of a concern that recently the FDA stepped in, imposing more stringent guidelines. Allergan, the manufacturer of Botox®, now has enhanced packaging with a hologram and traceable serial numbers on each box.
It is important to note that there are other approved brands of Botulinum toxin type A. The generic name for Allergan’s Botox® is onobotulinumtoxinA, Galderma’s Dysport® is abobotulinumtoxinA, and Xeomin® from Merz is incobotulinumtoxinA. Since Botox® is far and away the most familiar, it has the most copycats. It’s worse in other parts of the world; more than half of all aesthetic injectables in China are reported to be fake or smuggled. Even if it is the real thing, conditions such as temperature during shipping and storage can have a significant effect.

The FDA brought criminal charges against a Canada-based importer whose product was said to have sent several patients to the emergency room with complications from what appeared to be legitimate products. So how do you know if your Botox is bona fide? Here are a few tips:

• Beware of bargain Botox.
While I have seen many places offering injectables at what has to be “loss leader” promotional pricing, there is a minimum wholesale cost to the clinic. Even high volume providers only get a certain degree of discounting (I know, because of my affiliation with Skin Spirit,
the nation’s #1 provider of Botox®). All of the products named above have a single licensed distributor in the U.S., so while the consumer can price shop, providers cannot.
• Go to an established clinic with years of experience.
They will have a reputation to protect, and hence little incentive to look to suspect suppliers. Keep in mind also that it isn’t just the product you are paying for, but the skill and expertise of the injector.
• Don’t be afraid to ask!
A good injector will be impressed rather than offended that you want to confirm the authenticity of the products they are using.
Botox might be a household word and a routine beauty ritual for many, but it is a powerful product. Insist on your right to know that what you are getting is legit.