Dec. 4, 2009 -- For millions of Americans, the solution to crow's feet, thin lips, and frown lines is at the end of a syringe, or in a bottle. A quick trip to a medical spa, dermatologist or plastic surgeon for a Botox injection, lip augmentation or chemical peel offers the promise of a youthful look.
But these cosmetic procedures -- and the medical expertise that comes with them -- don't come cheap. For a single treatment of Botox, doctors charge about $380; for lip-plumping injections, over $500; and for a chemical peel, a whopping $700.
These high prices are enough for some consumers to take their business away from medical professionals, and go instead to the Web. They are "doing it themselves," ordering prescription-only products online, and injecting themselves at home.
Laurie D'Alleva, of Mansfield, Texas, is a big fan of "DIY" beauty injections and treatments. She is the face of a DiscountMedSpa.com, a website stocked with what she claims are pharmaceutical-grade cosmetics, similar to Botox, Restylane, and Retin-A.
Self-injecting botulinum toxin might sound dangerous, but D'Alleva, 39, tries to put her customers at ease with informational videos, complete with tips and pointers on how, and where, to inject. "It doesn't hurt... It's easy," D'Alleva claims in one video, as she stands in front of a mirror and injects her face repeatedly.
It might sound easy, but is it safe to self-inject powerful drugs obtained from a Web site?
Absolutely not, according to Dr. Joel Cohen of AboutSkin Dermatology in Denver, Colo. He is one of the leading experts in the treatment of complications related to cosmetic injectables, and has published extensively on the topic.
Every few weeks, Cohen sees a patient who needs his help because of a disfiguring complication from a cosmetic injectable.
"In this economy, people are looking to cut corners," Cohen said. But he adds that DIY cosmetic procedures are a terrible way to save money, and only skilled professionals can administer the injections safely.
Someone ordering a pharmaceutical-grade product from a website like DiscountMedSpa.com has "no idea what they are getting," Dr. Cohen said. Self-injecting is "incredibly dangerous and potentially a disaster."
Disaster isn't what "Alex," a paramedic, had in mind when she visited DiscountMedSpa.com a few months ago. In her 40s and dating, she just wanted to improve her look, and save some money. She asked ABC News not to disclose her identity.
After viewing "every one" of the instructional self-injection videos on D'Alleva's site, Alex was convinced she could do it herself, since using needles was part of her job.
"Why should I pay somebody else that got a few hours of training to do something I think I can do pretty easily?" she said she thought at the time.
Alex paid $450 for a DiscountMedSpa.com products including an injectable facial filler. She says she injected the products under her eyes and alongside her mouth.
But "the next morning, I woke up horrified by what I saw," she said. "Literally, my heart started pounding, and I thought, 'What have I done, what am I going to do?'"
Injections Nearly Caused Blindness in Alex's Case
Alex said the injections caused bags and lumps under her eyes, and a hard, infected pustule on her cheek. Desperate, she turned to Dr. Jerome Potozkin for help.
"I had an 'Oh-my-God' moment," Potozkin said, "when I looked at her and I saw this huge abscess on her cheek. Then she told me it was from a filler that she ordered from an Internet Web site and injected into herself."
Although Alex's condition was serious, it could have been worse. Potozkin told "20/20" that if she had gone just a few millimeters in the wrong direction, she could have "literally punctured an eyeball," or hit a blood vessel -- potentially causing blindness.
The product Alex ordered from DiscountMedSpa.com was labeled "Vitalift," but there is no such product on the list of FDA-approved pharmaceuticals.
Other products for sale included injectables "Restylin" and "Artefil," and a "chemical peel" whose description included a "mystery" ingredient.
Prescription Strength Cosmetics Easily Obtained Online
At ABC News' request, board-certified plastic surgeon Dr. Alan Gold purchased several products from DiscountMedSpa.com and described his experience. "I felt it was important to try to bring this to the public attention," he told "20/20."
Gold shopped from a list of at least 11 different prescription strength medications. The Web site never asked him for a prescription, proof of a medical license, or a medical history to rule out potential negative drug interactions.
"The only thing they wanted was my credit card information," he said.
Two days later, Gold received a package. It contained nine different products with crude labels and mysterious names; no bar codes or authentication holograms that genuine pharmaceuticals would have, he said.
The homemade packaging also concerned Gold: "Getting things in a little plastic baggie is not acceptable to me."
What about the injection how-to videos D'Alleva tells customers to follow? "I hope people who order this don't think it's as easy to inject the product as it was to order it," Gold said. "She doesn't appear to be a very experienced or very skillful injector. It's the blind leading the blind."
Woman Contracts Infection From Chemical Peel at Home
DiscountMedSpa.com isn't the only website selling treatments normally reserved for a doctor's office. Chemical peels are readily obtainable from dozens of Web sites, and like Alex, the people who buy them don't always know what they are getting.
Diana Negron of Florida found a Web site selling high-strength chemical peels. "I thought, you know, why not do it Friday? And I would be beautiful by Monday," she said.
Negron and her sisters, Jesse Mayoral and Jessica Suarez, were convinced that the products were safe. The Web site promised "affordable, non-surgical cosmetic procedures made safe and easy," Mayoral said.
The sisters purchased and self-administered the peels, but instead of erasing wrinkles, each experienced burns. Negron said that as a result, she contracted a bacterial infection.
"My first reaction was, 'Why did I do this? I'm a relatively intelligent woman,'" she said. "I could probably use my photo as the poster woman for what not to do."
Although some kinds of chemical peels are available without a prescription, there are "some things that should only be used in a doctor's office," according to Negron's physician, Dr. Flor Mayoral.
Dr. Mary Lupo, a New Orleans dermatologist, agrees. One young woman she treated who self-administered a chemical peel had a dark complexion, which made her a bad candidate for the product. "A good dermatologist would peel her mildly, if at all," Lupo said.
Lupo said her patient was lucky -- she "could have been permanently scarred if she had not sought out an expert."
Chemical peels "are nothing to play with. It is a lot more complicated than dying one's hair," said Lupo.
Medical professionals may be better qualified to administer injections and peels than the average Jane, but consumers should still seek out doctors with the most experience in such procedures, said Dr. Alberto Gallerani of Miami's Medici Institute of Plastic Surgery.
Gallerani helps patients who are victims of botched plastic surgery, often performed by doctors who are not qualified to perform certain procedures. He stresses the importance of choosing a doctor carefully, educating patients to "never select a surgeon based on price or special."
Gallerani says he often treats patients who have disfiguring lumps and bumps from fillers administered by unqualified injectors. Maryann Boger, the manager of his practice, says the emotional toll of these complications can be severe.
DIY Injectables: 'It's Not Worth It'
That emotional pain continues for "Alex," the paramedic who self-injected after ordering from DiscountMedSpa.com. She is recovering from her wounds, but warns others thinking about DIY injections: if you do it yourself, you have no one to blame but yourself.
"I look back at it and go, I'm a fool and it's my fault. I'm the one who made the mistake. It's not worth it. Don't try it yourself," Alex said.
Gold urges consumers to think of their health before their pocketbooks when it comes to cosmetic procedures.
"One of the things that we're committed to in treating our patients is to assure them of the safety and efficacy of the treatments that we're giving them -- to be sure that no harm is done to them, to whatever degree we can possibly prevent that, and to give them the best result that they can possibly have," he said.
Gold said Web sites like DiscountMedSpa.com are "the antithesis of everything that we try to do." He said he hopes the sites draw "the attention of authorities who have the ability to put a stop to it."
Reached for comment via telephone, D'Alleva told ABC News, "It wasn't a scam. We weren't taking peoples' money and sending them bogus products. They were good products that worked. 99 percent of our customers were thrilled and we were always there if anybody had questions."
D'Alleva refused to appear on camera, saying she "didn't want to have to respond to questions" that she "might not know how to answer."
Last week, the Texas Attorney General's office charged D'Alleva with the illegal sale of prescription drugs, and now DiscountMedSpa.com (and an affiliated website, OntarioMedSpa.com) are offline.
However, in an email sent Tuesday to her customers, D'Alleva promised that the "Medspa will reopen soon."
For information on cosmetic procedure safety, visit the Physicians Coalition for Injectable Safety's Web site.
Statements from Pharmaceutical Companies
As the manufacturer of BOTOX Cosmetic and JUVÉDERM dermal filler, it is our job to produce a quality product for patients who are looking to aesthetically rejuvenate themselves in a responsible and safe fashion, but also to reinforce that these are technique-sensitive procedure and that our products can only be administered by a licensed, aesthetically trained healthcare professional. Our product websites, brochures and advertisements all reinforce that patients need to see a physician if they are considering treatment with a product like BOTOX Cosmetic or JUVÉDERM.
In the United States, the only FDA approved legitimate source of Dysport (aesthetic indication), Restylane and Perlane is Medicis and its distributor McKesson. Any other sale is a violation of law and there is no assurance that product is not counterfeit.
Ipsen places patient safety first, and therefore Dysport is only available through a single government-regulated distributor in the United States. Ipsen does not sell Dysport through any web sites or by any other name in the United States. We strongly discourage anyone from buying any botulinum toxin from a web site. This biologic should only be administered by a trained healthcare professional in an appropriate medical setting.
Dysport, a botulinumtoxin A for injection, is approved by the Food and Drug Administration for two indications. The authorized uses are for the treatment of cervical dystonia to reduce the severity of abnormal head position and neck pain and for the temporary improvement in the appearance of moderate to severe glabellar lines in adults younger than 65 years of age.
Ipsen markets Dysport in the U.S. for cervical dystonia, while Medicis markets Dysport in the U.S. for the aesthetic indication (glabellar lines).