New York law enforcement charged a Manhattan-based aesthetician with wire fraud, smuggling, and other crimes related to misbranded and counterfeit drugs. He was released Wednesday on $100,000 bail.

The Hell’s Kitchen business owner is accused of knowingly importing and injecting counterfeit botox from China without the license required to inject in New York, even after patients complained of strange symptoms and side effects. A client in March 2024 ended up in the hospital with symptoms of botulism and several clients in March and April 2024 informed him that they were experiencing negative side effects. He maintained that the product was genuine and that the symptoms were temporary.

U.S. Customs and Border Patrol seized packages addressed to the med spa, finding that they contained counterfeit drugs. Between March 13, 2024—the date that the hospitalized client contacted the aesthetician—and October 2, 2024—after law enforcement executed a search warrant, the business recorded around 700 appointments for Botox-related services.

Rules for who can inject botulinum toxin vary from state to state. In New York, FDA-approved botulinum toxin products can be injected for cosmetic purposes by registered nurses (RNs), physician assistants (PA), nurse practitioners (NP), and physicians (MD/DO), if certain requirements are met. For New York licensees, current rules and regulations can be summed up as follows:

• RNs can inject with a good faith exam and written order from a physician, PA, or NP, and under appropriate supervision; the RN must have training on the specific device and be competent to perform it.
• NPs must be trained and competent in the procedure, and work in a collaborative relationship or under a written practice agreement with a physician. 
• PAs must be trained and competent in the procedure, and can perform injections when assigned by a supervising physician who is in continuous contact and has the procedure as part of their scope of practice.

As board-certified dermatologist Dr. Whitney Bowe shared on Good Morning America, potential symptoms of counterfeit botox may include blurry or double vision, difficulty swallowing and breathing, slurred speech, and droopy eyelids or a lopsided face. Seek attention from a medical practitioner if you experience any of these symptoms.

When performed correctly by licensed, trained and properly supervised aesthetic practitioners, neurotoxin injection treatments have a high safety profile. For more about injectables safety and what to look for as a patient, find the advice of nurse practitioners and aesthetic trainers Alexa Nicholls Costa, NP, and Alexandra Rogers, NP, of Boston-based LexRx in Injectables Safety: What Patients Should Know About Dermal Filler and Neurotoxin.

Read more about the arrest at United States Attorney’s Office, Southern District of New York >>