Making sure your Botox is legal and safe

FRESNO, Calif.

The most popular wrinkle-reducer is no longer a beauty secret. The leading cosmetic surgeons group says Botox remains the top non-surgical treatment -- with more than four million doses used, last year. Yet, many people still don't know how to get safe and legal Botox.

Susan Andraysen doesn't trust anyone else to erase her facial lines, other than Fresno Doctor, Uma Rao. "I have very deep, deep frown lines here and I don't even know I'm frowning half the time. But people will tell me, are you ok? You look tired, are you angry and I'm not," said Andraysen.

The 58-year-old office manager and grandmother of four, was tired of looking tired, so she gets Botox to soften her face. And she made sure all her health questions were answered, by a board-certified physician. "You should know what to ask. What am I doing? What am I being given? How much? Why are you doing this?"

Dr. Rao starts with consent forms for her clients, to make sure they don't have any health problems that could lead to a bad reaction. She says the "Botox Cosmetic" brand name is the only one approved by the Food and Drug Administration. The generic form can be found on websites from countries like Canada and Mexico, but it's illegal to use foreign versions of Botox, in the U.S.

Botox is different from conventional medicine because it's a live, biological agent and must be FDA approved to control its potency. Other companies can sell the generic version, but the consumer would have no idea about its potency and that could lead to some serious complications.

"I'm sure you've heard horror stories of celebrities who have had other things injected into their face," said Dr. Rao.

Botox must be mixed with a harmless, saline solution to make it injectable, and Dr. Rao shows us how patients can ask for that process to be done in front of them. You can also ask to see the packaging being opened. The Botox bottle should have a hologram label as proof of its authenticity.

Once the Botox is mixed or reconstituted with saline, Dr. Rao says, ask to see the bottle again, to make sure it's not over-diluted. "You can see that it's just minimal. But if you find that there is liquid up to here, you should definitely be concerned."

Concern is what led the FDA to issue a warning letter to 350 medical practices across the country, including two in Fresno. The FDA says the practices received unapproved versions of Botox from a foreign supplier and the medication could be counterfeit, contaminated, and unsafe.

The agency named Dr. Quinta Lopez's office in North Fresno as one of the sites. Action News made several attempts to contact Dr. Lopez at her office and on the phone, but we received no reply. Her office staff did say, she no longer administers Botox.

Palma Del Sol Medical Spa in Central Fresno also received the FDA letter. We found the door, locked, and a sign reading this office is permanently closed and no further treatment will be provided.

Dr. Rao says any Botox provider shouldn't hesitate to show you their process.

Susan has been using Botox for over four years and says she'd never sacrifice safety for a shot of beauty. 'You want results. You want something you know is safe and effective."

Another "red flag" is the price for Botox. If you see it being offered for $5 to $7 a unit, it could be a generic form, from a foreign company or over-diluted. The standard price for brand name, "Botox Cosmetic" is around $9 to $12 per unit. An average treatment is between 18 to 40 units.

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