To Dr.'s office Marek Wasiluka was reported by a patient with lumps persisting for many weeks after self-performed "mesotherapy" of the neck. A friend encouraged her to undergo the procedure. She bought the preparation online, guided by the attractive description and packaging resembling a professional treatment product.
When I saw the packaging and composition, it turned out that it was not a preparation intended for injection. The patient treated the fact that the product was in an ampoule like medicines as proof of safety: if something looks medical, it can be injected. This is a very dangerous mental shortcut, says an aesthetic medicine doctor.
This case shows that the risk begins before the first injection. The consumer often does not distinguish a product/cosmetics intended for use on the skin from a product intended for a specific medical procedure, including aesthetic medicine. It is also unable to assess sterility, concentration, interactions of ingredients, transport conditions or whether the product is approved for marketing and use in a given indication.
Legal substances used contrary to their intended purpose
A professional-sounding name, a vial, a syringe included in the kit or the declaration "for professionals" create a false impression of certainty. Meanwhile, the form of the packaging does not say anything about whether the substance can be administered under the skin. Also, the CE marking, if a given product has it, is not a consent for any use or a guarantee that the person performing the injection has the appropriate qualifications.
Aesthetic medicine is not an extension of home care. When we pierce the skin, we bypass the body's natural protective barrier. The preparation goes directly into the tissues, so not only its name is important, but also its full composition, purpose, place and depth of administration, dose, patient's health condition and the ability to act if something undesirable happens - explains Dr. Marek Wasiluk - aesthetic medicine doctor, Master of Science in Aesthetic Medicine, expert, founder of the L'experta clinic in Warsaw.
Therefore, there are at least two overlapping phenomena on the market. The first is the open sale of products that may be legal in themselves, but are used contrary to their intended purpose - for example, a cosmetic is injected, although the manufacturer only intended application to the surface of the skin. The second is the actual black market: trade in prescription drugs outside the legal chain, counterfeits of branded preparations, products without marketing authorization and goods imported and stored in unknown conditions.
Botulinum toxin from an illegal source may contain an unknown dose
A special case is botulinum toxin. In Poland, preparations intended for human use are medicinal products subject to prescription. The Office for Registration of Medicinal Products emphasizes that they can only be administered by a doctor or dentist, and products without marketing authorization pose an unacceptable risk to life and health.
This is not a theoretical warning. In a statement from August 2025, the office referred to at least 38 cases of botulism in Great Britain after treatments using unauthorized products. A counterfeit may contain a different amount of substance than declared, impurities or a completely different composition. Even the original drug loses its safety if the required cold chain is broken or the vial is repeatedly used in inappropriate conditions.
If someone offers botulinum toxin cheaper, without a prescription, ordered via messenger or from a closed group, the patient has no real opportunity to check what is in the vial. A low price can mean savings on product source, transportation, storage, sterility and liability. These are not details - this is the entire security system, emphasizes Dr. Marek Wasiluk.
Recommendations from "ordinary people"
According to the expert, one of the drivers of the phenomenon is the "illusion of knowledge". Search engines, social media and tools based on artificial intelligence make the instructions for performing the procedure available in a few seconds. The video can show the angle of injection, the number of points or the volume of the preparation. However, it does not show the entire qualification process and does not teach how to recognize situations in which the procedure cannot be performed at all.
You can learn to repeat professional words and reproduce hand movements, but this does not mean understanding medicine. The Internet shows what someone is looking for. It does not show what a layman does not know and should ask about: contraindications, vascular anatomy, interactions with drugs, differences between preparations, symptoms of ischemia or principles of treatment of complications - says Dr. Wasiluk.
Recommendations from "ordinary people" are also important. An anonymous entry: "I did it and it was fine" can be more convincing for the recipient than a doctor who advises against the procedure. Testimony sounds selfless, while a professional is often portrayed as someone who "scares" or wants to charge a high fee. However, the recipient does not know whether the report is true or sponsored, whether the author was able to recognize a late complication and whether he will provide his data and take responsibility in the event of damage.
In the pseudo-office, qualifications, documentation and a rescue plan disappear
From 2026, the position of the Ministry of Health is clear: aesthetic and restorative medicine procedures are health services and should be performed by authorized doctors in registered entities performing medical activities. The resort lists among them: treatments with botulinum toxin, cross-linked hyaluronic acid, biostimulators, injection mesotherapy, platelet-rich plasma and fibrin, some device procedures and medium-deep and deep medical peels.
As Dr. Marek Wasiluk says: the weekend course certificate does not give a person without the right to practice medicine the right to perform these procedures. It does not replace a medical interview, examination, documentation, asepsis and the ability to implement treatment. In a pseudo-office - an apartment, a rented room, a salon without medical facilities or a mobile office - the patient may not even receive the name and batch number of the preparation used.
Qualifications are not about making someone hold the syringe better. The doctor must assess the indications and contraindications, select the preparation and technique, and, above all, recognize the complication and start treatment. The injection itself may take a minute. Safety is determined by the knowledge used before and in the first minutes after it - he emphasizes.
The mere fact that the procedure takes place in a place called a clinic does not provide a full guarantee. The patient should verify the person performing the procedure and ask about the source of the preparation. People working professionally in treatments may also reach the black market, driven by the price or lack of legal access to the drug.
Dr. Wasiluk: Swelling or worse are not the worst complications
As the specialist explains, after administering an inappropriate, contaminated or improperly used preparation, infections, abscesses, chronic inflammation, nodules, granulomas, necrosis and permanent scars may develop. Some problems take days or weeks to become apparent, making it difficult to link symptoms to the procedure.
In the case of fillers, the most dangerous is unintentional injection of material into the vessel or its compression. Blood flow obstruction, ischemia and skin necrosis may occur. Visual disturbances, permanent blindness and stroke have also been reported. Quick diagnosis is crucial, so the person performing the procedure must know the anatomy, alarm symptoms and emergency procedures.
Botulinum toxin used incorrectly or not approved for sale may cause symptoms of botulism, including drooping eyelids, double vision, problems with speaking and swallowing, generalized muscle weakness, and in severe cases, breathing disorders. This is a condition that requires urgent medical attention.
A patient who performs the injection himself or goes to an unqualified person takes on a risk that he usually cannot even assess. The biggest problem isn't that he doesn't know the answer. The problem is that he doesn't know the questions to ask.
