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According to the Centers for Disease Control and Prevention (CDC), “As of April 12, 2024, a total of 19 people from 9 states have reported harmful reactions after receiving botulinum toxin injections from unlicensed or untrained individuals or in non-healthcare settings, such as homes and spas. States reporting these reactions include Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee, and Washington.” The investigation remains open, and the source of the Counterfeit Botox has yet to be determined.

2024 Botox Packaging

This is what the authentic Allergan BOTOX Cosmetic box and vial look like. It comes packaged as either 50 or 100 units per vial.

As of last week, nineteen women have become ill from counterfeit botox. Nine required hospitalization. Four were treated with Botulism Antitoxin because it was suspected that the toxin had spread from the treatment area. Five were tested for botulism, and all were negative. This means the toxin was injected and not from an infection.

Symptoms of Botulinum Poisoning

All people reported receiving these injections from unlicensed or untrained individuals or in non-healthcare settings, including homes and spas. This is a red flag.

Women reported multiple symptoms including:

All reports came from women, ranging in age from 25 to 59 years, with a median age of 39 years. Eighteen (95%) people reported receiving botulinum toxin injections for cosmetic purposes. None of these cases are linked to FDA approved botulinum toxins including Botox and Botox Cosmetic, the authentic FDA approved Onabotulinum Toxin A which the counterfeit product mimicked in its packaging.

What Does Fake Botox Look Like?

Authentic BOTOX boxes and vials are shown at the top of this post. Counterfeit boxes and vials look similar to the old Allergen packaging and some are labeled as 150 units per vial, an amount not produced by the company.

Fake 2024 Botox Packaging

This is how the 2024 Fake BOTOX was packaged. (Click on photo to see some of the errors.)

The counterfeit product, meanwhile, includes telltale information that can be found on the outer carton and vial. Counterfeit product may be identified by one or more of the following. The outer carton or vial have:

How to Spot Counterfeit Botox

Plastic surgery as a specialty requires extensive training, experience and expertise to perform procedures safely and effectively. Counterfeit products are often quoted at a significantly lower price. Prices from clinic to clinic can vary, but if a price seems too good to be true, it should raise concerns. The American Society of Plastic Surgeons (ASPS) emphasizes the importance of receiving Botox and other injectables exclusively from licensed professionals who adhere to strict safety standards in clinical settings.

How to Avoid Counterfeit Botox

Patients can best protect themselves and significantly reduce the risks associated with all cosmetic procedures by consulting a Board Certified Plastic Surgeon who is a member of ASPS. Botox treatments are given by Plastic Surgeons, Dermatologists, Ophthalmologists, Otolaryngologists and other specialties, but each specialty has a certifying board, and you want to select a physician who is board certified in their chosen profession. In the San Francisco Bay Area call (925) 943-6353 to schedule a private consultation appointment today.

At a minimum, ask to see the packaging and compare it to the current Allergan packaging as shown at the top of this post. Consumers should report suspected counterfeit Botox products to FDA at 800-551-3989, or through

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