You Get What You Pay For: The Risk Of Cheap Botox

Let’s face it: cosmetic procedures aren't cheap. According to the American Society for Aesthetic Plastic Surgery, the national average cost (in 2011) for laser skin resurfacing was about $1,200 and a single dose of an injectable dermal filler was close to $600. So when you see advertisements for discounted treatments, it’s understandably tempting. But before you sign up for a so-called bargain, it pays to do a little research.

Why do cosmetic treatments cost so much?

When you get a cosmetic treatment, you're paying for two things: the equipment used (devices like a Fraxel laser and/or materials like Botox or Restylane) and the skill, training, and education of the person performing the treatment. And neither is inexpensive. A cutting-edge laser device can cost tens of thousands of dollars, and a reputable doctor won’t have just one type to offer his or her patients. “Different machines do different things—one for brown spots, one for red spots, one for hair removal, etc.—and work on different skin types, so you need to make sure whoever you’re seeing has a machine that’s appropriate for the goals you want to achieve,” says Dr. Gervaise Gerstner, a board-certified dermatologist in NYC and Assistant Clinical Professor of Dermatology at Mount Sinai. In other words, anyone who claims to have a one-size-fits-all machine is not to be trusted with your skin. Getting a “major deal” on Botox—whether it's from a site like Groupon or a local medi-spa—that slashes prices in half (or even more) is suspect since few, if any, practitioners are willing to lose money on the treatment. “A tiny vial of Botox costs my practice $525, so if someone is offering a cheap treatment, they're either diluting it down or using less, because otherwise they can’t break even,” warns Dr. Gerstner. Diluting it too much can cause it to travel to other places after injection—leading to drooping eyebrows or eyelids, for example. There have also been warnings issued by the FDA about doctors buying unapproved versions of Botox that are potentially counterfeit, contaminated, ineffective, or unsafe.

Is there such a thing as a reasonable discount?

Plenty of reputable medi-spas, and even cosmetic doctor’s offices, will offer package deals for certain procedures. It’s not uncommon, for example, to get a slight reduction in the per-session cost if you book a package of ten laser treatments or glycolic peels. You’re also within your rights to—if not bargain—at least be well-informed about exactly what you’re getting for your money. “Call around to a couple of different offices and ask about prices, about what type of machine they’re using, and how many treatments they think you’ll need,” advises Dr. Gerstner. And if they quote you a price for five treatments (or however many they recommend), don’t be afraid to ask how they handle it if you don’t see results within that time frame. That would be a circumstance in which a discounted treatment may be offered.

Are deals on flash sale websites like Groupon or Life Booker worth considering?

You probably wouldn’t consider scouring Groupon or other local discount sites for a deal on your next mammogram or skin biopsy. And yet most people think nothing of nabbing a deal on treatments such as liposuction, body contouring, Botox injections, laser hair removal, or other cosmetic—but arguably still medical—procedures. All of these carry risks in the wrong hands. “This isn’t like trying out a new restaurant that you got a discount for,” reasons Dr. Doris Day, a board-certified dermatologist and Clinical Assistant Professor of Dermatology at New York University Medical Center. “It’s important to have an evaluation by a trained cosmetic doctor who can create a treatment plan that’s right for your conditions and your goals.” When you buy on a flash sale site, you may be purchasing a treatment from a place that has questionable credentials, or paying for the wrong procedure. “And if you get the wrong treatment, it may not achieve your goals, which means you’ve wasted money—not saved any,” says Dr. Day.  

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