The popularity of medical spas has soared, with millions seeking Botox, fillers, IV therapy, and skin treatments. In 2023, 9.5 million Americans received neuromodulator injections, according to the American Society of Plastic Surgeons.
Despite booming demand, safety concerns grow. In January 2025, prosecutors charged a New York aesthetician with injecting counterfeit Botox smuggled from China at an unlicensed clinic, leaving patients with double vision, muscle weakness, heart palpitations, and even botulism.
NBC News also reported that a California woman developed a drug-resistant bacterial infection after vitamin and fat-dissolving injections at a med spa. Some patients have suffered lasting scars, long-term antibiotic use, and even death from unsafe, unlicensed providers.
These criminal investigations are clear warnings. With the med spa industry now worth over USD$15 billion, unqualified aestheticians and unlicensed clinics are rushing to cash in, often at the expense of patient safety. The results can be devastating.
So, how can you protect yourself from these fake med spas? Here, we’ve listed down 12 warning signs of a fake med spa so you’ll know exactly what to look for before booking your next treatment.
Not every med spa operates with patient safety in mind. A fake med spa is one that intentionally ignores safety standards, hires unqualified staff, or uses products that aren’t approved for medical use.
Knowing the warning signs of a fake med spa can help you avoid unnecessary risks and protect your health.
Every legitimate med spa must have a licensed medical professional, such as a doctor, nurse practitioner, or physician assistant, overseeing treatments.
State laws require medical oversight for procedures involving injectables or lasers. Without this supervision, you risk being treated by someone who lacks the training to recognize complications or respond in an emergency.
You can verify a provider’s credentials through your state’s medical board. Look for board certifications from organizations like the American Board of Plastic Surgery (ABPS) or the American Academy of Dermatology (AAD).
Licensed nurses and aestheticians should also have their certifications readily available. If a clinic avoids showing credentials or can’t answer questions about its medical staff, that’s a serious red flag.
Botox typically costs $10 to $20 per unit, while dermal fillers range from $500 to $2,000 per syringe. If you see prices drastically below these averages, it’s often because the products are counterfeit, diluted, or not FDA-approved.
Sure, affordability is appealing, but rock-bottom deals usually signal unsafe practices.
Fake med spas may also use “limited-time offers” or pressure tactics with unrealistic discounts to lure patients in. Remember, a reputable provider charges based on the quality of the product, the skill of the injector, and the safety protocols in place.
If a price feels too good to be true, it probably is.
A reputable med spa always begins with a consultation.
This includes reviewing your medical history, talking about your personal goals, and making sure you’re a safe candidate for the treatment. If a med spa provider skips this step and rushes you straight into injections or procedures, they’re putting your health at risk.
Without a proper evaluation, conditions like allergies, medications, or underlying health issues can be overlooked, leading to dangerous complications. A genuine med spa will always prioritize safety over speed.
Legitimate med spas are open about the products and devices they use. They’ll tell you upfront if they’re using Botox®, Juvederm®, Restylane®, or FDA-cleared devices for treatments.
If a provider avoids mentioning brands or uses vague language like “just as good as Botox,” that’s a major warning sign.
Some fake med spas even import unapproved products from overseas to save money. Not only are these illegal, but they can also cause severe and unpredictable side effects. You should always know exactly what’s being injected or applied to your body.
A trustworthy med spa will let you inspect the packaging of the products they’re about to use.
For example, authentic Botox vials are manufactured in specific sizes. FDA-approved Botox comes in 100- and 200-unit vials. If you see a vial labeled “150 units,” it’s counterfeit Botox because Allergan and AbbVie never manufacture Botox in that size.
Another way to spot authenticity is in the labeling. Genuine Botox products always list the active ingredient as “onabotulinumtoxinA” on both the carton and vial. Counterfeit drugs sometimes use the generic term “botulinum toxin type A” instead, which is a red flag.
Real packaging also shows the manufacturer as “Allergan Aesthetics / An AbbVie Company” or simply “AbbVie.”
Why does this matter? The FDA has already confirmed hospitalizations from counterfeit Botox injections purchased from unlicensed sources.
If a provider refuses to show you the label or the packaging looks unusual, you could be dealing with a fake med spa that’s knowingly selling you a fake Botox.
Some of you may think it’s normal for a staff member to say, “I’ll just go to the back room shortly to prepare your injection.”
That’s actually a huge red flag. A reputable med spa will always open new vials or syringes in front of you. When they know they’re not hiding anything, they’ll be transparent and confident in letting you see the products they use because they’re authentic and properly sterilized.
So, if your provider disappears into a back room to “grab” what they need, you’d better cancel your treatment. Imported counterfeit Botox often gets swapped in when unsuspecting patients aren’t watching.
Allergan’s Allē program (formerly Brilliant Distinctions) is the official rewards system for Botox and fillers. Real providers enroll their patients so they can earn points toward future treatments.
Fake med spa services can’t participate because they don’t purchase authentic products directly from Allergan. So, if your prospective med spa doesn’t mention or offer Allē, it could mean they’re not sourcing legitimate Botox.
When a med spa does honest work, they’ll be so proud to showcase their work to their potential clients.
Authentic before-and-after photos will give you a preview of the injector’s skill, consistency, and patient outcomes. Their before-and-after images should look natural, with lighting and angles that match.
However, if a clinic only displays stock images, stolen photos, or “too perfect” results that look unrealistic, take that as a warning.
Fake med spas often hide behind polished but misleading visuals to mask their lack of experience or to distract from the fact that they may be using counterfeit or unsafe products.
No aesthetic treatment can guarantee flawless outcomes because every patient’s skin, anatomy, and healing process are different. But if you’re talking to a med spa that keeps promising miracle results with no risks or instant perfection, that itself is suspicious.
Experienced providers will set realistic expectations, explain possible side effects, and emphasize that results develop gradually and look most natural over time. A med spa that skips this conversation is simply thinking about upping its sales over your safety.
Getting cosmetic treatments is not an easy decision, despite their widespread prevalence. Even when it’s minimally invasive, at the end of the day, you’re still making a medical choice that involves health risks, recovery, and money.
That’s why you should never feel rushed or cornered into agreeing to a procedure. Fake or profit-driven med spas often pressure clients with limited-time deals, scare tactics, or aggressive upselling. They may even try to make you feel insecure so you’ll spend more.
Legitimate clinics, on the other hand, focus on educating clients. They’ll give you space to consider your options, answer your questions honestly, and respect your decision if you choose to walk away.
The condition of the treatment space can speak volumes about the standards of care a med spa has. If you notice cluttered rooms, dirty surfaces, foul smell, or equipment that doesn’t look sterile, it’s a red flag that safety and cleanliness are not being taken seriously.
Another major red flag is when treatments are offered in hotel rooms, private homes, or any setting outside of a licensed medical facility. Cosmetic procedures should only be performed in a clean, clinical environment equipped to handle emergencies if they arise.
A genuine med spa will always provide clear and complete documents, including consent forms, privacy policies, and posttreatment instructions.
These documents exist to protect you and ensure that you fully understand the treatment, possible risks, and your rights as a patient. If a med spa avoids giving you anything in writing or seems vague about policies, that’s a major warning sign.
It’s also important to check what others are saying. In fact, a survey found that 35% of U.S. internet users leave online reviews specifically to inform others about their experience. That means reviews can be one of the most reliable ways to gauge how a med spa actually treats its patients.
If a clinic has no reviews, a weak online presence, or mostly negative feedback, it suggests they may not have the credibility or reputation they claim.
Now that you know the red flags to watch out for, it’s just as important to understand what a safe, trustworthy med spa should look like. Here are a few steps you can take to make sure you’re in good hands under a real, reputable med spa.
Check who will actually perform your treatment. Licensed medical professionals such as board-certified dermatologists, plastic surgeons, nurse practitioners, and registered nurses are the only ones legally qualified to perform injectable procedures.
You can confirm a provider’s licensing status by checking with your state’s medical board.
The injectable drugs and devices used on your face and body should come from trusted, FDA-approved brands. So, before undergoing any procedure or treatment, ask about the products and equipment they’re using.
Better yet, ask to see the packaging of the products they’re about to use on you. A real med spa will not hesitate to show you its products, while a shady one might get defensive.
The consultation is your opportunity to assess whether a med spa is trustworthy and genuinely invested in your well-being. The right med spa will slow down and take their time to understand your health history, your goals, and the results you’re hoping for.
However, if they’re rushing you or pressuring you to go ahead with the procedure without a proper consultation, it’s best to walk away for your safety.
Spotting a fake med spa may not always be easy, especially since most of them have done a great job at blending in with the legitimate ones. But knowing the red flags and warning signs to look out for can help you tell even the tiniest difference.
If you want safe, healthy, and natural-looking results, trust only a med spa in Texas that follows the highest standards of safety and professionalism. Here at InjectCo, our licensed team takes the time to understand your goals, study your health history, and guide you toward treatments that truly fit your needs.
Book a free virtual consultation today and experience the peace of mind that comes from knowing you’re in the right hands.
A legitimate med spa will have licensed medical professionals on staff, use FDA-approved products, and maintain a clean and professional environment. Meanwhile, fake med spas cannot show proper licenses or credentials, use counterfeit injectables, or operate without proper oversight.
Unlicensed injectors may use illegal counterfeit injections or diluted products and lack the training to manage complications. This puts you at risk for infections or even serious conditions like botulism.
No. Cosmetic injections should only be performed in licensed medical facilities with proper sanitation and emergency protocols. Treatments outside a clinical setting are a major red flag for a fake med spa.
Yes. Counterfeit Botox injections can be contaminated or improperly formulated, which may cause harmful side effects or even potentially life-threatening complications. Always confirm that your provider uses authentic, FDA-approved products.
If you experience unusual side effects or suspect you were treated with counterfeit devices and products, seek medical help immediately. Report the provider to your state medical board and the FDA office to help protect others from their unsafe practices.
