In today’s fast-moving, information-overload world, it’s alarming that people are still falling victim to fake injectables and unlicensed providers. This isn’t a hypothetical risk: In one widely publicized 2025 New York case, an aesthetician was allegedly injecting clients with counterfeit neurotoxin imported from China. Patients reported severe side effects, including double vision and difficulty swallowing, after receiving treatments from someone who wasn’t licensed to inject.
And it’s not just happening behind closed doors. Earlier this year, NewBeauty reported on the rise of “Backyard Botox,” a TikTok trend in which users appeared to inject themselves with what they claimed were Botox or Botox-like neurotoxins, often framing it as a money-saving hack.
That kind of online normalization is exactly why experts say patients need to be extra cautious. As medspas continue to expand across the country and aesthetic treatments become more mainstream on social media, many people are still booking appointments based on viral videos, pricing or Instagram aesthetics rather than medical credentials and safety standards.
So, how do you protect yourself? Choosing the right medspa and injector is more important than ever—not just for aesthetic results, but for safety. Before booking an appointment, here’s what top plastic surgeons say you need to know about vetting your provider, spotting red flags and making sure what’s going into your face is actually FDA-approved.
Featured Experts
- Dr. Philippe A. Capraro is a board-certified plastic surgeon in Denver
- Dr. Alan Durkin is a board-certified plastic surgeon in Vero Beach, FL
- Dr. M. Bradley Calobrace is a board-certified plastic surgeon in Louisville, KY
Check Who’s Performing—and Overseeing—the Treatment
One of the first steps in medspa safety is confirming who is performing the treatment and who is medically overseeing the practice. According to Denver plastic surgeon Philippe A. Capraro, MD, the spa’s medical director should be a board-certified aesthetic specialist. “I always recommend that patients research the medical director associated with the medical spa they are considering,” he says. “If they are not a board-certified plastic surgeon or dermatologist, it may not be the best place for injectables and treatments.”
“If something goes wrong, the medical director is responsible for addressing it. You need to be confident that they are in the appropriate area of expertise.” The same scrutiny should apply to the person performing the treatment. “Spend time looking into your injector as well,” adds Dr. Capraro. “Are they knowledgeable? Do they have a good reputation? If not, that’s a red flag.”
Ask How the Medspa Is Run
Medspas operate under different business models, and not all are run by board-certified plastic surgeons or dermatologists. While there are reputable medspas outside of these specialties, the risk can be higher when there is no direct oversight from an experienced aesthetic physician.
“As there is little oversight in the medspa arena, this is very difficult for patients to evaluate,” says Vero Beach, FL plastic surgeon Alan Durkin, MD. “In a global sense, patients who attend medspas that are owned and operated by plastic surgeons and dermatologists on-site at the spa will have a markedly safer experience with much broader options available to the patient, especially in the realm of regenerative aesthetics.”
“Having said that, there are many examples of successful medspas outside of the ‘core aesthetic specialties.’ Best practices are to ask the providers to show proof of direct-from-manufacturer purchase. This can be done by simply showing the box to the patient or the labeling on the injectable.”
Choose an Established Medspa
Beyond credentials, Dr. Durkin says limited hours can be a red flag. “If a medical facility cannot support itself during business hours, it’s what we call a ‘pop-up’ medspa,” he explains. “It’s an investment vehicle for an investor rather than a medical facility focused on patient outcomes.”
Louisville, KY plastic surgeon Bradley Calobrace, MD, says another mistake patients make is trusting social media over professional referrals. “People see marketing and photos instead of focusing on credentials,” he explains. “You need to know who has tested the provider and their experience.” He also advises asking how often a doctor is in the clinic overseeing treatments. If the medical director is rarely present, that’s a red flag.
Don’t Confuse Social Media With Medical Expertise
Plastic surgeons say social media has made aesthetic treatments more accessible, but it has also made it harder for patients to distinguish between experienced medical providers and skilled marketers. “A large following doesn’t automatically equal expertise,” says Dr. Calobrace.
Experts warn patients to be cautious of heavily filtered before-and-after photos, “Botox parties,” extremely discounted treatments and providers who appear to prioritize content creation over patient education and safety.
Don’t Choose a Medspa on Price Alone
Price can be an indicator of quality. “You get what you pay for,” says Dr. Capraro. If a deal seems too good to be true, it probably is. Extremely low prices may mean diluted or non-FDA-approved products, an inexperienced injector or both. “At the end of the day, you want to give your body the best, which will not be the cheapest.”
That’s why it’s fair to ask where the product came from. “Legitimate providers will gladly show patients the packaging and confirm the product came directly from the manufacturer,” adds Dr. Durkin.
Ask Questions
A good consultation should never feel rushed. Before any injectable or laser treatment, ask:
- Who will be performing my treatment?
- Are they licensed in this state?
- Is there a physician on-site or supervising the practice?
- What brand or product is being used?
- Can I see the box or packaging before treatment?
- What is your protocol if there’s a complication?
- How often do you perform this procedure?
Know What to Do If Something Goes Wrong
Even with careful research, complications can still happen. If a patient suspects they received an unverified product or had a poor outcome, the first step is obtaining medical records. “Notify the medical board and Better Business Bureau,” advises Dr. Calobrace. “If the injector was a nurse, notify the nursing board as well.” If a provider used an unapproved product or lacked proper certification, it should be reported to the state medical board.
Experts also recommend seeking medical attention immediately if symptoms like vision changes, severe swelling, skin discoloration, difficulty swallowing or unusual pain occur after treatment.
