How to Spot Counterfeit Botox: A Product Safety Guide for Botox and Fillers in Mersin

In Tarsus, a district of Mersin, seven people were reported to have been treated in hospital, some in intensive care, after botulinum toxin (Botox) injections at a beauty centre. According to the reports, the Ministry of Health opened an investigation, the centre was closed and a criminal complaint was filed (Sabah, Halk TV; both in Turkish). Because the investigation is ongoing, claims about the nature of the product used are not an established finding. In this article I am not discussing the incident itself but the question that comes to mind after news like this: how can you be sure that Botox is a licensed, safe product?

The answer is not to look for a single clue but to ask three questions together: who is performing the treatment, where is it being done and which product is being used? Below I have gathered practical ways to check each of these, the warning signs to watch for and the symptoms after treatment that need urgent care.

Why Do the Product and the Practitioner Matter So Much?

Botox is the purified form of botulinum toxin prepared for medical use, and it is a licensed medicine; fillers are registered as medical devices. For licensed products the content, strength and manufacturing conditions are controlled. With an uncontrolled product, nobody knows what is in it or how strong it is. Examples from around the world show that this is not a theoretical risk:

• England, 2025: 25 botulism cases were identified after cosmetic injections; the cases were linked to attending two specific practitioners and receiving an unlicensed product, and the seized product was found to be stronger than its label (370 units per vial against 200 units listed) (Jasperse et al., 2025).
• China, 2014-2024: In a series of 161 cases of cosmetic botulism over ten years, most patients had received injections outside a healthcare facility, from unlicensed practitioners, with products of unknown origin, and symptoms most often began within the first 3 days after injection (Qiu et al., 2025).
• United States, 2024: After injections of presumed counterfeit toxin given outside healthcare settings, seven patients developed drooping eyelids, dry mouth, difficulty swallowing, shortness of breath and weakness; symptoms began a median of 3 days after injection (Thomas et al., 2024).

What these series have in common is that the product or the practitioner fell outside the licensed and supervised framework. The risk comes not from Botox itself but from stepping outside that framework.

1. Who Is Doing It? Ask About the Practitioner's Authorisation

In an information note on counterfeit Botox from a provincial health directorate of the Turkish Ministry of Health, Botox is described as a treatment that must be performed only in healthcare facilities and by authorised physicians; people having the treatment are told to ask whether the physician is authorised in this field and about the originality and origin of the material used (Manisa Provincial Health Directorate, 2023, in Turkish). In practice this means making sure that the person performing the treatment is a medical doctor and that their name and title are clearly known. Vague answers such as "someone I know does it" or "one of our team will do it" are not enough.

2. Where Is It Done? The Setting Should Be a Healthcare Facility

Botox and filler injections are medical procedures; they require sterile equipment, a product stored under suitable conditions and the means to respond if something goes wrong. Treatments done "quickly" in a beauty salon, at home or elsewhere fall outside this framework. In the series from the United States and China, too, the common point was that the injections were given outside healthcare facilities. Before the treatment, it is enough to ask whether the place is a healthcare facility and whether the physician who will perform the treatment actually works there.

3. What Is Being Used? See the Product Together With Its Box

Botox is a licensed medicine. It is entirely normal to ask the physician to show you the box and the vial before treatment and to note the product name, batch number and expiry date; a serious clinic will not find the question strange. You can check the product with these steps:

1. 1Product name and licence: Search for the product name on the box in the Turkish Medicines and Medical Devices Agency's (TİTCK) Summary of Product Characteristics and Patient Leaflet (KÜB/KT) search portal; information on licensed medicines is listed there.
2. 2İTS query: On the medicine box, next to the barcode, there are codes starting with (01) and (21). If you enter these codes, without the leading 01 and 21, on the Medicine Query (İlaç Sorgulama) page of the Medicine Tracking System (İTS), the medicine's name, manufacturer, batch number, expiry date and registration status are displayed.
3. 3Batch number and date: Note the batch number and expiry date; if a problem occurs, this information makes things easier for you and for the healthcare team.
4. 4Box and vial match: Check that the information on the box matches the vial label and that the packaging is intact and unopened.

These checks are a strong filter but not a complete safeguard on their own; even a registered product has to be used by the right person, in the right setting and at the right dose. Consider all three questions together.

How Can You Check the Registration of a Filler?

Hyaluronic acid fillers are medical devices rather than medicines; their registration can be checked on the Ministry of Health's Product Tracking System (ÜTS) public search screen. For fillers, too, you can ask the physician for the product name, the information on the syringe and packaging labels and the CE mark. We explain why the choice and amount of product matter in our guide to value for money in botox and fillers.

Warning Signs to Watch For

If one or more of the following is present, the safest course is to stop and ask, and if necessary to postpone the treatment:

• The product is not shown: The box and vial are not shown, or you hear answers like "we already opened the box" or "we threw the box away".
• No consultation: The treatment starts straight away without discussing your health history, your medicines and a plan.
• The practitioner is unclear: The identity, title or authorisation of the person performing the treatment is not clear.
• The setting is unsuitable: The treatment is done outside a healthcare facility, for example in a salon, at home or at a private event.
• The price is unusually low: Price alone does not mean safe or unsafe; however, official statements note that Botox and filler products are costly and that for this reason counterfeit or smuggled products can be found on the market (Manisa Provincial Health Directorate, 2023). Ask what the difference covers.
• No follow-up: No contact details or check-up plan are offered for after the treatment.

Which Symptoms After Treatment Are an Emergency?

The expected side effects of Botox are mild: redness at the injection points, tenderness, small bruises and a slight headache in the first days. If any of the following symptoms appears, go to an emergency department without waiting and let the place that treated you know:

• Vision: Blurred or double vision, a drooping eyelid.
• Swallowing and speaking: Difficulty swallowing or speaking, marked dry mouth.
• Breathing: Shortness of breath or a feeling of tightness in the chest.
• Weakness: Marked fatigue, weakness in the arms and legs, dizziness.

The World Health Organization describes the early symptoms of botulism as marked fatigue, weakness and dizziness, followed by blurred vision, dry mouth and difficulty swallowing and speaking, and stresses the importance of early diagnosis and treatment (WHO). In the series from the United States, symptoms began a median of 3 days after injection, with a range of 2 to 20 days. These symptoms are very rare but they are an emergency; one should not think "let me wait a little, it will pass". When you go to the emergency department, take the product box or the batch number information with you.

With fillers, unusually severe pain during or after the treatment, whitening or coolness of the skin, a net-like purple-blue discolouration or a change in vision may suggest a blood-vessel complication and is an emergency. In such a case contact the treating physician immediately and go to an emergency department (Hyaluronidase for Dermal Filler Complications, 2024; FDA, 2023).

If You Come Across a Suspicious Situation

For complaints about healthcare facilities and physicians you can contact the Ministry of Health Communication Center SABİM (Alo 184) (sabim.gov.tr). If you come across a product that is not registered in the Medicine Tracking System, report it to the authorities through SABİM or your provincial health directorate.

Our Approach at Dr. Doğan Uysal's Clinic in Mezitli

At our clinic in Mezitli, botox and filler treatments are performed by the medical doctor Dr. Doğan Uysal himself; all medical aesthetic procedures are carried out with products approved by the Turkish Ministry of Health, in a sterile environment and under physician supervision. The name of the filler product to be used is shared at the consultation. It is always natural to ask your questions before the treatment and to ask for information about the product. For details of the services see our botulinum toxin and filler pages, and for appointments our contact page.

Frequently Asked Questions

How can I spot counterfeit Botox?

A counterfeit or unlicensed product usually cannot be recognised by eye, smell or price, so the information on the product box, the İTS and KÜB/KT queries and who performs the treatment, and where, are assessed together. Not being shown the box and vial, an unclear practitioner and treatment outside a healthcare facility are important warning signs.

How do I check that Botox is genuine?

Before the treatment ask the physician for the box and the vial. Search for the product name on the TİTCK KÜB/KT portal and enter the codes starting with (01) and (21) on the box into the Medicine Tracking System's Medicine Query page. Note the batch number and expiry date.

Can Botox be done at a beauty centre?

According to an information note from a provincial health directorate of the Turkish Ministry of Health, Botox is a treatment that must be performed only in healthcare facilities and by authorised physicians. So ask beforehand about the practitioner's authorisation and whether the place is a healthcare facility.

Which symptoms after Botox are an emergency?

Blurred or double vision, a drooping eyelid, difficulty swallowing or speaking, dry mouth, shortness of breath, marked fatigue and weakness are urgent symptoms. Go to an emergency department without waiting, let the place that treated you know and take the product box or batch number information with you.

How do I check that a filler is genuine?

Hyaluronic acid fillers are medical devices; their registration can be checked on the Ministry of Health's ÜTS public search screen. Ask the physician for the product name and the packaging information.

Is very cheap Botox safe?

Price alone does not mean safe or unsafe; however, official statements note that Botox and filler products are costly and that counterfeit or smuggled products can be found on the market for this reason. It is necessary to ask what the price difference covers, to ask for the product box and to ask about the practitioner's authorisation.