Medical Mythbusters – Myth- “All Botox Is Created Equal” or Botox Buyer Beware!


This is the second article in a series about combating the aging process and turning back the hands of time. The “I’m Just Going to Age Gracefully- Part Two” article will eventually follow. Those that know me are aware of the fact that I can be sidetracked easily. This article is a response to a question posed by several readers.

The Medical Mythbusters articles are designed to be interactive, so if you have a question that falls within my purview, don’t hesitate to email. My particular areas of training are encompassed by the 5 A’s- anesthesia, analgesia (pain medicine), aesthetic medicine, aviation and aviation medicine, and ambulance medicine (pre-hospital care). I do not consider myself an expert on Women’s Health, but I am intimately associated with an OB/Gyn. If your question falls outside those subjects, I’ll either phone a friend or tell you I don’t know!

Back to the myth this article addresses- “All Botox Is Created Equal”- right? Not really… Botox, produced by the Clostridium botulinum bacterium, has been around since the dawn of man (possibly a reason for the extinction of dinosaurs-our wrinkles don’t come close to theirs) but didn’t enter the therapeutic arena until the 60’s and 70’s. It was used initially to treat eye disorders such as blepharospasm and strabismus but gradually worked into other areas of medicine (Gastroenterology, Orthopedics, Pain Medicine) before entering aesthetic medicine. Onabotulinumtoxin A (Allergan trade name Botox) is FDA approved for the treatment of chronic migraines and sweating as well as the commonly known frown-lines or Angry-Elevens between the eyes. It temporarily blocks the signaling pathway between the nerve ending and target muscle, thus providing an average of 3-4 months relief from the target muscle group’s action.

Allergan has marketed Botox in the United States since 1989. Recently, it has become available on the black and grey markets. When patients tell me that they tried Botox and it didn’t work I always ask if they were sure it was the real thing. Allergan has a Botox physician locator ( that can be used to verify that the Botox is genuine. If your doctor’s name or medical practice isn’t listed when you type in the zip code, the Botox can’t be verified as coming from Allergan.

Why is it important to ensure that the product is real? Allergan stands behind its products and will reimburse the practice and patient if there is a problem. Allergan will not guarantee Botox obtained from second or third parties. Botox that comes directly from Allergan is shipped on dry ice to ensure potency. The potency of black market and grey market “Botox” is often a problem as poor shipping and repackaging affects product longevity.

Botox is an excellent product with a long history of safety in aesthetic medicine. My wife says it has improved our relationship as we both find it difficult to scowl at each other. Confirming the Botox you use comes from Allergan will ensure it achieves the desired effect!

Disclaimer: Dr Stephen Rath is the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He doesn’t offer non-Botox relationship advice but he will be happy to help you with your “aesthetic emergencies”! His email address is