‘Possibly Counterfeit’ Botox Has Been Linked to Hospitalizations and Illness in 2 States

And regardless of where you live, there are a handful of smart ways to ensure you’re getting the real deal from a legit injector—and that you don’t live with regret.

Know that credentials come first.

From a medical standpoint, you’ll be safest if your provider is board-certified by the American Board of Dermatology or American Board of Plastic Surgery, David Shafer, MD, FACS, a double board-certified plastic surgeon and founder of Shafer Clinic Fifth Avenue in New York City, tells SELF. (Again, they’ll be trained to deal with complications, should they come up). If you’re set on the non-doctor route, at least make sure your provider checks all the boxes in this guide to finding a qualified Botox injector. And you should also confirm that they’re purchasing authentic botulinum toxin by running a quick background check on the manufacturer’s website. Allergan (the maker of Botox), Galderma (which manufactures Dysport), and Merz (the brand behind Xeomin) all offer directories of official providers.

Also important to note: Just because someone is a dermatologist or plastic surgeon, that doesn’t necessarily mean they’re well-trained in cosmetic injections, so the qualification checklist above applies to doctors, too.

Ask to see the box.

Having your provider open the box in front of you is one of the surest ways to ensure you know what’s going in your body, Dr. Hu says. For Botox, specifically, you can also look for the hologram seal that’s on all legit boxes and vials, Dr. Shafer adds. If you’re getting Dysport, look for the full product name on the front and sides of the box, the Galderma logo in the top left corner, and a barcode on the bottom. Regardless of the brand, the product (if it’s legit) will also have an expiration date, which you can ask to see (don’t be shy; a good injector should appreciate your diligence). “If someone walks into the room with a prefilled syringe, I would be suspicious,” Dr. Shafer says.

Be wary of a bargain.

In this economy? Unfortunately, yep. When it comes to neuromodulators like Botox and Dysport, if a price is too good to be true, it probably is, Dr. Shafer says. A good rule of thumb: “Anything less than $10 per unit is very suspicious,” according to Dr. Hu. “Either they’re diluting the Botox, and it won’t last as long, or they’re not giving you actual U.S. FDA-approved Botox.”

Keep in mind that you’re likely to see per-unit prices much higher than that—around $30 per unit, at practices in major metropolitan areas with experienced, credentialed, and in-demand doctors. At Shafer Clinic, for example, the price per unit is $29, which amounts to an estimated $1,000- $2,000 per session. You may also see Botox priced per area, which Dr. Hu says is popular in Miami—$400 for the glabella (between the brows) or the outer corners of the eyes is common. To see if the price per unit checks out, just ask the practice how many units they typically use for the area you’re getting treated, and divide the total cost by that number. It should still come out to more than $10 per unit, or there’s likely something amiss.

We know, it’s easy to say, and less fun to do—getting injections from a doctor can be budget-bustingly pricey. I, for one, have walked out of an appointment at a Beverly Hills plastic surgeon’s office with a $1,300 bill for a Botox “brow lift” and a squirt or two in my masseter muscles to soften my jaw’s square look. I’ll admit—I looked good a week later, but I wanted to throw up on the spot. In retrospect: Better the severest case of sticker shock than symptoms serious enough to warrant a hospital trip.

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