11 Under the Skin of Society: The Botox Market
-by Allie Campbell
Society has created its own version of beauty. The majority of the public possesses an undying desire of owning flawless, smooth skin. In the U.S. economy, the beauty industry uses this desire to sell millions of beauty products and services nationwide, including the drug known as Botox to smooth expression lines called wrinkles. Owning wrinkle-free, flawless skin is now as simple as spending money. Not everyone who desires to improve his or her beauty, however, can afford or receive access to this service, which pushes some to organized crime to achieve society’s version of beauty. As Botox continues to grow in popularity throughout the United States, acknowledging the harmful counterfeits found within the Botox black market and understanding the reason behind the use of unregulated drugs for the sake of beauty can prevent unnecessary damage to one’s life.
Botox Continues to Grow in Popularity
Throughout the years, Botox has claimed the position of the #1 aesthetic procedure in the world. Botox consists of a purified protein derived from an inactive, toxic botulinum bacterium. Receiving Botox entails a nonsurgical procedure where small, healthy amounts of this protein are injected into a muscle to temporarily intercept nerve endings and relax the muscle from contracting completely[ii]. Most commonly, people turn to this product to prevent or reduce facial wrinkles such as frown lines, crow’s feet and horizontal forehead lines[iii]. Botox injections typically last 3-4 months with an average price of about $300-$425[iv].
Society’s valuing of smooth skin and youthful appearance fuels the demand for Botox. Within the licit economy, patients range from as young as 18 years old to as old as 80 years old[v]. This large age range for those desiring Botox explains why companies like Allergan succeed. Allergan remains a global pharmaceutical company that sold 2.3 billion U.S. dollars of Botox within the United States in 2016 alone[vi]. Year after year, the Botox industry continues to increase its sales. Injecting the product calls for a quick 10-minute procedure with minimal discomfort. It has a 94% satisfaction rating[vii]. Allergan recorded 7,230,967 Botulinum Toxin type A procedures in 2017. The industry has experienced an 819% increase in procedures since the year 2000[viii]. Currently, companies like Allergan continue to expand the applications of Botox to go beyond preventing or removing wrinkles. Researchers have discovered ways to use Botox all over the body for many medical conditions. Some potential uses include treatments for teeth grinding, facial twitching, irritable bowel syndrome, dark circles under the eye, cardiac muscle disorders, back pain, and countless other disorders that currently await patents[ix]. Products producing these kinds of results to such a diverse population just fuel the desire for the black market to exist.
Due to the high demand and a hefty price tag for this product, the Botox black market emerged. Money creates the main drive behind this underground market. Consumers who want the beauty benefits of Botox but do not want to empty their wallets often resort to the black market to acquire it cheaply. Businesses unwilling to purchase Botox at premium pricing legally can turn to this illicit economy as well. Those who sell this illicit Botox often consist of people willing to ignore their moral obligation if it means they can make a huge profit. This deceiving practice puts greed and deception above the common good of mankind, creating a real dilemma for society. This immense Botox market will continue to grow, and the Botox black market is right behind it.
It can Happen to Anyone, Even Professionals
Many people think counterfeit Botox products are simply made up horror stories, but in reality, they exist all over the U.S. and consumers need to be aware. In many instances, clients and even doctors were deceived into purchasing counterfeit Botox. In 2012, 350 medical practices in 43 states throughout the country were notified by the Food and Drug Administration (FDA) that they could have potentially purchased counterfeit Botox without even realizing it [x].
Illicit companies constantly trick consumers or professionally certified cosmetic doctors into buying their counterfeit Botox. In 2015, a 38-year-old woman named Racula Crisan was paralyzed in her face for eight months after receiving a Botox injection. The plastic surgeon claimed he ordered the Botox from a Chinese supplier and was unaware of exactly what substance was in the vial due to the Chinese label. For eight months Crisan could not use any facial muscles, including muscles used to cry or laugh. Upon further investigation, the illicit Botox was found to actually be viper venom. In some cultures, snake venom is diluted and used as a non-injectable cream to reduce wrinkles. After two years and many intensive medical treatments later, Crisan only has control of 70 percent of her facial muscles[xi].
Another example occurred around Thanksgiving in 2010, when two couples got Botox injections at an area clinic in Fort Lauderdale called Advanced Integrated Medical Center. Several hours later, the four of them fell gravely ill with the condition that results from Botox overdosing, known as botulism. After becoming ill, investigators found fliers at the clinic that advertised a botulinum-based injectable for only $199, compared to regular $300-$425 for real Botox, from a company in Arizona[iv]. Turns out, the doctor actually purchased the counterfeit Botox from a Northern California company that contained a concentration of botulinum bacterium that was “100,000 times” the regulated amount[xii]. This total disregard for patient safety continues today without having any effect on the black market.
Propaganda also plays a huge role in spinning the truth within these Botox black markets. Throughout the article “Propaganda” by Edward Bernays, Bernays discusses the way people can use propaganda to influence others. Propagandists fluctuate their circumstances in order to modify their product and appeal to their consumers. Businessmen who want money from the Botox industry, but do not have certification to administer the product, can use beauty propaganda to create a situation that convinces their customers their practice is legitimate. More dangerously, propagandists can also subconsciously influence the leaders of a market, thus causing those beneath the leaders to also be influenced[xiii]. Botox black markets showcase this when certified professionals are tricked into buying counterfeit Botox. Then, these doctors would easily convince their customers with honest intentions. Through this kind of propaganda, counterfeit Botox reaches deeper than most people realize. This demonstrates how easily anyone can be deceived, even from trusting and honest circumstances.
As crucial as it is to be aware of how often consumers and Botox providers in the industry can be deceived, it is also important to understand how not to be deceived. Within “The Dangers of a Black Market,” the Concierge Medical Practice known as WIFH, discussed tips for a consumer to ensure the receipt of legitimate Botox. Customers can recognize true Botox if the Allergan Company delivers it sealed, on dry ice with an Allergan hologram image on each vial. This vial comes in a form of powder and once mixed with sterile water, develops into a liquid. Since some facilities kept real Botox around in case they were ever investigated, WIFH suggests the consumer request to see the vial previously drawn and previously injected[ii]. Once the public is more educated and aware of counterfeit Botox, everyone can be safer and consider all outcomes before engaging within this market.
Is This Beauty Worth Dying For?
Two main concerns arise with Botox from a black market – not all providers contain correct certification to provide treatments and the counterfeit Botox rarely go through any sort of regulation. These safety issues are simply not worth the risk.
In many cases, treatments given by illicit facilities consist of untrained, non-professionals trying to capitalize on the Botox industry. In contrast, certified doctors go through training for a reason. Their education and skill level was tested and approved for everyone’s safety. Often within the black market, situations occur like in the case of Fort Lauderdale with the Advanced Integrated Medical Center. The center was only licensed as a “therapeutic massage establishment”[iv]. It portrayed itself as a certified, trustworthy company to reel in money with no concern for the consumer’s health and well-being. Practices like these damage the honest physician providers who have the greater good in mind.
Throughout black markets in American and throughout the world, the illicit Botox is never regulated appropriately. No one can be certain where exactly the Botox is originating from, as well as how it was manipulated before it reached its destination. The Advanced Integrated Medical Center received Botox containing a concentration of neurotoxin that was 100,000 times higher than the standardized dosage, which was totally unbeknown to the injector[xii]. This lack of regulation proves that receiving products from the black market is a huge safety gamble with a great deal left to mystery. In some cases, the counterfeit is not even Botox, it is just a concoction sold as real Botox, like the snake venom mix-up. This deception can happen anywhere to anyone.
Many people believe that turning to cheap Botox alternatives is worth a little risk in order to feel beautiful and have smooth, flawless skin at a low price. They trust their providers as experts in the industry assuming that they have their best interest in mind. However, many do not realize people actually die from injecting counterfeit Botox. In May of 2006, a beautician in California by the name of Martha Mata Vasquez was charged for murder due to practicing medicine without a license. Vasquez’s client died from an embolism after being injected with corn oil. The client, along with many others that needed medical care, believed that the products being injected were FDA-approved. Vasquez was sentenced to 15 years in prison after pleading guilty in November of 2006[x]. The client lost her life from turning to the unreliable underground market to unnecessarily change something that society inflicted on them.
The Food and Drug Administration (FDA) is the reason that companies like Allergan remain trusted worldwide. The FDA originated in order to protect animals and people of the United States from receiving harm due to products on the market. The administration confirms that companies must obtain complete transparency with their product’s ingredients and honest about the product’s results. This process assures that businesses cannot make unproven claims with intentions to gain profit. Cosmetic-based treatments, like Botox, can take years of research, a series of clinical testing, and evaluation by trusted medical professionals to prove the safety and effectiveness of their claims before approval[iii]. The rigorous and lengthy approval process is necessary for everyone’s safety. Since the underground market bypasses basic regulations, counterfeit Botox is not regulated by the FDA. There is no guarantee what a vial of counterfeit Botox contains and no way to tell the degree of harm it could cause.
The Botox industry is far from declining. The demand for perfect skin will continue to prevail as our society still values this definition of beauty. As research validates, new uses for Botox and the number of providers and consumers is increasing. The consumer should expect the Botox black market will continue to be stronger than before. Since the black market remains unauthorized, it attracts people who are willing to forget their morals and take advantage of others. The companies within the black market will never value human’s well-being above money, and they will do anything in their power to convince their consumers otherwise. These corrupt motivations increase the driving power behind the black market. This powerful market will always exist as a dangerous alternative to conventional medicine and should not be taken lightly. Do you really want to die from the process of fixing your natural beauty? Smooth skin is simply not worth dying for.
[i] James Delli Gatti, Botox + Dysport: Does Beauty Come With a Cost?, (Girlfriend Is Better, 28 July 2017)
[ii] The Dangers of Black Market Botox, (WIFH, 30 Nov. 2016)
[iii] Terence Myckatyn, What Does an FDA Approval Mean for Cosmetic Treatments and Devices?, (American Society of Plastic Surgeons, American Society of Plastic Surgeons, 27 Feb. 2018)
[iv] Michelle Green, Black-Market Botox?, (PEOPLE.com, Time Inc, 20 Dec. 2004)
[v] 2016 Cosmetic Surgery National Data Bank Statistics. (The American Society for Aesthetic Plastic Surgery, 2016)
[vi] Botox Global Regional Revenues 2015-2017, (Statistic. Statista, Allergan, Feb. 2018)
[vii] Black Market Botox, (RealSelf.com, 28 Mar. 2017)
[viii] 2017 Cosmetic Plastic Surgery Statistics, (American Society of Plastic Surgeons, 2018)
[ix] Botox: A Drug With Many (Potential) Uses, (The New York Times, 13 June 2014)
[x] Black Market Cosmetic Injectables in the U.S., (Physicians Coalition for Injectable Safety (PCIS), May 2014)
[xi] Woman Gets Snake Venom Injection Instead of Botox, (Fox News, FOX News Network, 28 Oct. 2015)
[xii] Daniel J DeNoon, Bogus Botox Fells 4 in Florida, (WebMD, WebMD, 8 Dec. 2004)
[xiii] Edward Bernays, Propaganda, (History Is a Weapon)
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Botox Global Regional Revenues 2015-2017 | Statistic. Statista, Allergan, Feb. 2018, www.statista.com/statistics/737487/global-revenue-of-allergan-botox-by-region/.
Black Market Botox. RealSelf.com, 28 Mar. 2017, www.realself.com/article/black-market-botox.
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Woman Gets Snake Venom Injection Instead of Botox. Fox News, FOX News Network, 28 Oct. 2015, www.foxnews.com/health/woman-gets-snake-venom-injection-instead-of-botox.
DeNoon, Daniel J. “Bogus Botox Fells 4 in Florida.” WebMD, WebMD, 8 Dec. 2004, www.webmd.com/beauty/news/20041208/bogus-botox-fells-4-in-florida#2.
Bernays, Edward. “Propaganda.” History Is a Weapon, www.historyisaweapon.com/defcon1/bernprop.html