The Beauty Standard with Dr. Roy Kim

The Hidden Dangers of Baby Botox: Patient Safety, Counterfeit Injectables, and Med Spa Risks Exposed

• Dr. Roy Kim

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The Hidden Dangers of Med Spas and Baby Botox | The Beauty Standard with Dr. Roy Kim

In this episode of The Beauty Standard with Dr. Roy Kim, we delve into the alarming rise of counterfeit injection products and the myths surrounding baby Botox. Dr. Kim explores the rapid growth of med spas and the risks associated with poorly regulated practices. The episode highlights the story of Rebecca Elli, who ran a fraudulent med spa operation, and discusses the long-term implications of starting Botox treatments too young. Additionally, Dr. Kim provides essential tips on how to ensure your cosmetic procedures are safe and performed by qualified professionals. Tune in to learn why patient safety should always be the top priority.

00:00 Introduction: The Beauty Standard with Dr. Roy Kim
00:57 The Counterfeit Injection Crisis
03:11 The Baby Botox Phenomenon
04:35 Med Spa Safety Concerns
06:26 Red Flags in Cosmetic Surgery
07:20 UK's New Regulations on Cosmetic Procedures
08:14 The Importance of Breast Implant Registries
09:30 FAQs on Cosmetic Procedures
10:27 Conclusion: Prioritizing Patient Safety

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Speaker 1:

Welcome to the Beauty Standard with Dr Roy Kim. Oh no, you're looking in the mirror and that little line between your eyebrows look deeper underneath your ring light. Your 25-year-old colleague mentions that she's been getting baby Botox since college. Your mom suggests that you do something about it before it gets worse. Sound familiar? You are not alone, but here's what's happening behind the scenes that nobody wants to talk about. Hi, this is Dr Roy Kim and I am doing an audio podcast episode of the Beauty Standard with Dr Roy Kim.

Speaker 1:

Today, we're going to be diving into the counterfeit injection crisis, the baby Botox myth and why getting procedures for the wrong reasons could actually cost you more money. Before we get started, remember that this audio podcast is for educational purposes only and does not constitute medical advice. You need to actually establish a relationship with a board-certified, qualified plastic surgeon or doctor for any of your cosmetic concerns and, as always, individual results vary and all procedures carry risks. Now let's get real about the numbers. Med spots have exploded from 1,700 locations in 2010 to over 10,400 locations today, in 2025. So that's a pretty big increase. The average baby Botox sessions costs $462, with patients starting treatments every four months from their mid-20s. And here's the kicker Complications at med spas happen 77% of the time, compared to virtually 0% in doctors' offices for skin tightening procedures. Meanwhile, counterfeit Botox cases have hit multiple states, sending people to hospitals with botulinum symptoms. The FDA is tracking fake injections from China, selling for $50 instead of the legitimate $600 to $650 per box. Now this is the counterfeit crisis that nobody saw coming.

Speaker 1:

Let me tell you about Rebecca Fadinelli. She's a gorgeous Instagram presence with a white Range Rover lab coat, photos and more. She ran two luxury med spas in Massachusetts called Skin Beauté. Clients all thought that they were getting premium treatments in a high-end facility. Unfortunately, ms Fadinelli wasn't even a nurse, like she claimed. She was an esthetician with $600 of training, buying counterfeit Botox from China through Alibaba for about $50 per box. Her Chinese supplier would text her warnings like this batch Botox is strong. Add three milliliters saline for try. Please do not add too less saline. It will be injection too much. Think about that. Her supplier knew that the potency was off. Her clients started complaining about droopy eyelids, lumps forming in their lips, eyes sinking into their faces and more. One woman had tingling in her forehead and bumps in her lips after Fadinelli injected filler between her eyebrows without permission. The FBI caught her carrying a Silverbreed case and a lunchbox full of counterfeit products. Between March of 2021 and March of 2024, she made $933,000 from these fake injections. She unfortunately now faces 20 years in prison. This isn't some back alley operation. These med spas look legitimate Velvet chairs, chandeliers, professional websites and the scary part A study found that 41% of dermatologists have encountered counterfeit injectables and nearly 40% have treated patients who suffered complications from fakes.

Speaker 1:

Next up is the baby botox phenomenon. This term makes it sound harmless, doesn't it Like baby carrots or baby shampoo? It is not. We're talking about injecting botulinum toxin, the same bacteria that causes botulism, into 20-somethings who barely have any lines. I read about Sydney Brown, whose mother noticed a frown line during a video call when Sydney was 23. Her mom, who happens to be a plastic surgeon, started giving her regular Botox injections. Sydney says she and her friends will do whatever it takes to look their best, but here's what the marketing doesn't tell you.

Speaker 1:

Dr Duran, a Miami plastic surgeon and a friend of mine, warns that starting Botox too young may cause muscle atrophy. Over time. As we age, we naturally lose facial volume, so when you compound that with muscle wasting from years of Botox, you may get a hollow or hollowish appearance. The BBC also found a 26-year-old business manager named Ven who spent thousands in preventive treatments. He gets injected every few months and calls it an investment in confidence. But sociologist Dana Berkowitz, who literally wrote the book Botox Nation, points out something crucial Once you get people in their 20s, you do have a lifelong customer. That can be the business model for some injectors Get them young and keep them coming back. Berkowitz herself, the author, admits she needs treatments more frequently now because she's built up a tolerance. So make sure that what you get started in terms of wrinkles and wrinkle treatment stays. Remember. Whatever you started as a prevention should stay as a prevention Now.

Speaker 1:

Next up is the area of med spa safety. The American Society for Dermatologic Surgery found that supervising physicians are only present during injection treatments 38% of the time at med spas. Only 46% even notify a doctor when complications happen. Let me give you a perspective of what we're dealing with. In July of 2023, ms Jennifer Cleveland, a 47-year-old mother of four in Texas, died after getting an IV vitamin treatment at a med spa. The unlicensed practitioner gave her a hospital-grade solution that unfortunately caused an overdose. She couldn't breathe properly and died. In New Mexico, maria de Lourdes Ramos de Ruiz was running an unlicensed spa doing vampire facials. Four clients actually contracted HIV because she was reusing needles and throwing blood next to food in the refrigerator. When investigators looked at her place, they found unwrapped needles and unlabeled tubes of blood on kitchen counters. These are not isolated incidents. The FDA has issued alerts about counterfeit products, cleanliness and so on, causing blurred vision, shortness of breath, incontinence and hospitalization across multiple states.

Speaker 1:

So remember to always get surgery for the right reason, not the wrong one. Julia Fox recently opened up about her cosmetic surgery regrets she's had liposuction, a nose job, veneers, botox and fillers, but her honest take is this one Quote I was so hung up on this idea that I needed to be attracted to men so that I could survive. She wishes she could go back to being someone who's never done anything. Fox started getting injections at 21, driven by external validation rather than personal choice. This hits on something very important that I tell all my patients and that you should know as well. When you're getting procedures to meet someone else's beauty standards, you're setting yourself up for disappointment. You should do it for you. Social media trends shift, the male gaze changes, but surgical and non-surgical decisions are permanent and injectable habits may become lifelong commitments.

Speaker 1:

Next up are seven red flags that a group of board-certified plastic surgeons say you should never ignore. First of all, if your surgeon isn't board-certified in plastic surgery specifically, maybe you should walk away. Some doctors call themselves cosmetic surgeons, but they're trained in pediatrics or other medical specialties, and that is not the same thing. Second, they may not specialize in your procedure. Third, no before and after photos. If they don't have pages of examples, they probably don't do many of these procedures. Fourth, prices that seem too good to be true. You get what you paid for, and revision surgery may cost more than doing it right the first time. Fifth, you feel pressured. Good surgeons do not use scare tactics or rush you into decisions. Sixth, they can see you tomorrow. Usually busy and qualified surgeons are booked weeks, days or even months in advance. Seventh, they actively upsell you. If you feel that your consultation is a sales pitch for procedures that you didn't even ask about, maybe you should leave.

Speaker 1:

Meanwhile, the United Kingdom is finally clamping down on regulation and some chaos. New regulations mean only qualified healthcare professionals will perform certain high-risk procedures like Brazilian butt lifts and injectables. Cosmetic surgery clinics and aesthetic clinics will need proper licensure and treatments for under 18-year-olds will be restricted. Right now, christine Hall, a doctor from the UK, explains the current problem. She states that, quote you can go online, purchase dermal filler within minutes and have it injected by someone with no medical training. I've seen patients in emergency departments after doing exactly this, with complications ranging from infection to tissue death. Unquote. Yes, the cost for UK patients may go up, but patients will have an actual, qualified professional performing and doing their treatments. It's a win-win for both the industry as well as consumers.

Speaker 1:

Speaking of patient safety, let's talk next about breast implant registries. The National Breast Implant Registry launched in 2012 to track devices and improve safety. With nearly 150,000 cases entered, researchers now have a lot of data to look at. This registry helped identify the link between textured implants and ALCL, a rare type of lymphoma. When recalls needed to happen, patients can be notified quickly instead of relying on paper. One doctor points out that quote without that large amount of data, you're not going to pick up correlations like that. Unquote. The breast implant registry allows swift responses to safety issues and raising industry standards. Some patients do worry about privacy, but fortunately, this is much better than the old system of paper charts. The National Breast Implant Registry is a huge step forward for patient safety, as well as anonymizing data.

Speaker 1:

Not everyone believes early intervention is the answer. Some experts argue that prevention should focus on proven methods rather than injectable. So this may include comprehensive skin care with retinoids, daily sunscreen, antioxidant serums and professional treatments like chemical peels or microneedling. These address skin quality and texture without muscle paralysis. Dermatologists may recommend facial massage, led light therapy and other things which may improve circulation and collagen production naturally. Next up are the FAQs. First question is preventive Botox worth it? Long-term studies have not been done yet. However, they do seem to help in some patients. An easier fix is probably to focus on proven prevention, sunscreen, retinoids and good skincare.

Speaker 1:

How do you spot a fake practitioner? Well, you can ask for product packaging, check their credentials on local databases or even national databases. What's a safe age to start cosmetic procedures? To be honest, there's no magic number. Some people believe in their 40s, other people think in their 20s or 30s. I would definitely focus on realistic expectations and qualified practitioners. Are med spas safe? Yes, if they have the proper physician supervision as well as a licensed staff, at least in the United States. The qualifications and credentials actually vary slightly from state to state. So just make sure that the one that you're seeing is qualified.

Speaker 1:

Should you get surgery to please someone else? I think this is a pretty easy answer. The answer is never, so you should do it for yourself. So, to wrap up, here's your bottom line your safety matters more than trends. The baby Botox craze, med spa proliferation and counterfeit injectables all point to the same problem when profit drives decisions instead of patient welfare, people will get hurt.

Speaker 1:

Before you book anything, you have to ask yourself am I doing this for me or for others? Can I afford the long-term commitment? Is the person that's seeing me actually qualified? You have that choice right now. So here's my question for you to consider Is it worth it to get the lowest price or get the latest treatment, or is patient safety the highest concern To me as a plastic surgeon? What's interesting to me as a plastic surgeon is not just that the aesthetic result's important. What's very important, obviously, is patient safety. As always, stay informed, stay safe, and we're going to see you next week. If you have any questions about this podcast, please let me know. I put all the credits and the newspaper article links into the text caption. If you have any topics you want to discuss, please fire away and let me know. And, as always, have a wonderful week. Thank you for listening to the Beauty Standard with Dr Roy Kim. Make sure to follow for future topics and episodes.