Groupons for Botox: Legit or Lethal?
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Botox and other anti-wrinkle injectables ain’t cheap, so when you see a deal from daily coupon sites such as Groupon and Living Social for 75 percent off, you may be tempted to click. But hold that finger for a sec.

There’s good reason to be skeptical of these coupons, says Matthew Schulman, M.D., a New York City-based plastic surgeon who used to offer such discounts but has since stopped because of concerns for consumers’ health and ethical issues.

Since the physician is offering an extremely low price yet has to give a percentage of sales to the coupon site, they don’t profit as much. Some doctors may therefore overdilute the toxin to shave costs, which results in poor results for the consumer, he says.

“Doctors may also acquire the product from a cheaper source such as overseas or off the so-called ‘grey market,’ which sets up the potential for inferior, harmful products,” Dr. Schulman adds. (The list of possible side effects of Restylane, for example, include problems swallowing, speaking, or breathing and may be life-threatening.)

Several organizations, including the New York Regional Society of Plastic Surgeons and the American Society of Plastic Surgeons, have advised members not to participate with daily deal sites, in part due to the legal implications of fee-splitting with the coupon site and because of the ethical concerns of giving a time-sensitive offer on a medical procedure that carries risks and potential complications.

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Groupon, however, says consumers shouldn’t be wary about the docs on their site. “We are especially thorough with Botox deals and have a working relationship with Allergan, the company that manufactures Botox and is the sole licensed distributor of the product in the U.S.,” says Julie Mossler, the site’s director of communications.

Groupon requires doctors to submit a form signed by Allergan affirming they have a valid account with the company and are purchasing Botox from them. Professionals also must provide evidence of a current license that demonstrates they are certified to administer the procedure. Mossler said that Groupon has “equally thorough vetting” for deals on other substances such as Dysport and Restylane.

If you're tempted by an offer, carefully examine how many units you'll get at what price, and keep in mind that the average cost of Botox is around $400 and the FDA-approved unit dosing is 20 units to treat lines between your brows.

You also should research the physician’s credentials, says Ellen Marmur, M.D., a board-certified dermatologist and dermatologic surgeon, because although some gynecologists, cardiologists, internists, radiologists, and even dentists offer the procedures, many do so only because they see dollar signs. She recommends checking manufacturer and medical association websites such as the American Academy of Dermatologists (aad.org).

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When you visit the office for the procedure, don’t be shy. “Ask questions about the medical professional who will perform the injection such as how long they have been practicing, if they have had the appropriate training, and how much experience they have with the specific product,” Dr. Marmur says.

And request the product by brand name, to be sure you're treated with the real thing, she adds.

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