Security Risk
Last year, I brushed to a so-called “hospital cognate” hyaluronic acid shop in Taobao, the unit price is only 398 yuan/piece, and the sales volume shows a monthly sale of 2000+. Click on the comment section to find that 37% of buyers mentioned “hard lump after injection”, 15% of people feedback “redness and fever within three days”. Most outrageous of all, customers posted photos of the product’s outer packaging – with visible scratches on the aluminum lid that should have been marked “sterile seal.” It was later learned that most of these low-cost fillers came from underground workshops in Dongguan, and in the counterfeit dens destroyed by the Guangzhou Market Supervision Bureau in 2022, 80% of the inferior sodium hyaluronic acid concentration was less than 40% of the genuine product, and some Staphylococcus aureus was even detected 120 times over the standard.
Cold chain breaks are another invisible killer. Genuine Ruilan No. 2 requires the whole process of 2-8 °C refrigerated transportation, but the internal data of a Courier company shows that 63% of the packages of medical beauty products transported in summer have an internal temperature of more than 15 °C. In August last year, a woman in Hangzhou received a temperature recorder in a packaging box of Joe Yaden, which showed that it had been in a 28 °C environment for 52 consecutive hours during transportation. Under such conditions, the molecular chain of hyaluronic acid breaks, resulting in a more than 70% reduction in supporting force. What’s more, high temperatures also activate bacterial reproduction – a 2023 “Clinical Plastic Surgery” paper pointed out that for injections stored at 25 °C for more than 24 hours, the probability of microbial contamination soared from 0.3% to 19.7%.
Hyaluronic Acid Fillers – HA fillers (like Juvederm, Restylane, and Teosyal) are the most well liked because of their versatility, biocompatibility, and reversibility.
Fakes are getting more and more sophisticated. In March this year, the Ministry of Food and Drug Safety (KFDA) seized fake Eileville, whose packaging is 95 percent similar to the real thing, and whose security QR code can be retraced to a fake verification website. Technicians dismantling found that these fakes use industrial-grade hyaluronic acid, the crosslinking degree is only 1/3 of the genuine product, and the absorption rate is as high as 89% after 6 months of injection (the genuine product is usually maintained at 35% to 45%). More insidious is that unscrupulous businesses will mix omedine as hyaluronic acid – this substance has been explicitly banned, the cost of less than 2 yuan per milliliter, but sold to consumers at a price of 1980 yuan.
The legal risks are equally daunting. China’s “Classification of Medical Devices” clearly stipulates that crosslinked sodium hyaluronate gel for injection belongs to Class III medical devices. However, a sampling inspection of an e-commerce platform in January 2024 showed that 72% of stores could not provide the Medical device Business License, and 43% of product registration certificate numbers were not recorded in the official website of the State Food and Drug Administration. Last year, Shenzhen investigated the “United States and International” case, the parties sold unlicensed fillers through wechat, a single purchase price of 80 yuan resold 1680 yuan, profit margin exceeded 2000%, and eventually led to 23 consumers facial disfigurement, the court ruled a total of 3.17 million yuan compensation.
Physical damage during transportation is often overlooked. Genuine Joadin is subjected to more than 200 vibration tests per unit, while contravened goods are often squeezed to avoid customs inspections. In a batch of smuggled Korean fillers intercepted by Shanghai Customs in 2023, 58% of the glass pre-filled syringes had tiny cracks. These invisible damage can cause the solution to be contaminated with 0.22 micron dust – when these particles enter the blood vessel with the injection, the probability of causing an embolism is 17 times higher than the normal product.
The loopholes in the certification system are even more alarming. Truly safe fillers require triple verification: the State Drug Administration’s gun number (such as the national gun into 20163461321), the brand’s official anti-counterfeiting system, and the acceptance report of medical institutions. However, the survey found that 82% of the fillers sold through wechat channels can only provide vague “overseas purchase orders”, and 13% use photoshopped cold chain transport photos. A typical case is the “Korean American medical United States” event in 2022, the so-called Korean imported filler sold by it is actually produced from a family workshop in a county town in Hebei, the workshop humidity is 4 times higher than the standard, and the total number of colonies in the air reaches 1300% of the medical standard.
The price trap is a killer. Taking the popular princess hyaluronic acid on the market as an example, the regular institution purchase price is about 1280 yuan/piece, while the same imitation on Pinjoduo is only 299 yuan. But what consumers don’t know is that genuine products use the patented CPM cross-linking technology, which can last up to 12-18 months, while the fake network structure will disintegrate within 3 months. To make matters worse, these inferior fillers require 3-5 lyolytic enzyme treatments to remove, and the cost of a single treatment is 3,800 yuan – which is 2.7 times more money to buy fake products.
Purchase Channel
During last year’s Double 11, the sales of a cross-border e-commerce platform’s medical and beauty category skyrocketed by 380%, but the subsequent sampling by the Food and Drug Administration found that 73% of injection products did not obtain the Import Medical Device Registration Certificate. Taking the popular Korean Yi Wan brand as an example, the official channel purchase price is 680 yuan/branch, while the purchase channel price is only 298 yuan – behind the price difference is an amazing secret: Smuggled goods usually adopt the “ant moving” mode, dividing the whole box of products into a single branch mixed with ordinary packages, resulting in 67% of the products experiencing more than 3 violent sorting in transportation, and the glass needle breakage rate is 19 times higher than that of regular logistics. Of the smuggled hyaluronic acid seized by Hangzhou Customs in 2023, 42% of the packaging boxes failed to seal due to extrusion deformation, and microbial tests showed that the total number of colonies exceeded 1400CFU/g (medical standards should be less than 10CFU/g).
The risks of wechat business channels are even more shocking. According to the survey, of the “hospital internal channel goods” sold by the circle of friends, 88% could not provide a complete cold chain transportation record, and 53% of the product batch numbers did not match the packaging box information. In the “Meidai Global purchase” case exposed last year, wechat business developed through the layered agent model, and the fake goods with a purchase price of 80 yuan were sold to 1580 yuan after the 6-level agent raised the price, and the profit margin was as high as 1875%. What is more frightening is that the storage environment of these products is worrying – the secret visit video shows that the hyaluronic acid cartons stored in a warehouse are close to the thawing area of seafood, and the environmental humidity is maintained at more than 85% for a long time (medical device storage requirements should be ≤60%), which directly leads to protein denaturation failure.
Accessibility to Premium Brands: ELE GLOBAL and other platforms ensure access to FDA-approved fillers, including niche products like fat-dissolving injectables and specialized mesotherapy solutions for skin rejuvenation. Clinics in remote regions benefit from the global reach of online suppliers.
There’s no way to guard against a live delivery routine. A head anchor broadcast room once used the “hospital director direct supply” as a gimmick, selling 2,300 Qiao Yaden in 5 minutes, but the subsequent verification found that the so-called “authorization letter” was actually forged by PS. Technicians disassemble the product and find that the viscosity of the filling material in the needle tube is 32% lower than the genuine product, and the content of crosslinking agent is less than 1/5 of the genuine product. The absorption rate of this inferior filler 3 months after injection is as high as 78% (35% to 40% of the genuine product), forcing consumers to make up repeatedly, and the actual expenditure is 2.3 times higher than that of regular institutions.
Cross-border direct mail does not equal security. Of the “personal use” packages intercepted by Shanghai Pudong Airport customs in January 2024, 37% of the hyaluronic acid was actually smuggled for commercial use, and 25% of the products had exceeded their expiration date. More hidden is that some businesses use CE certification to confuse the public – the EU CE mark is divided into three grades of Class I to III, and the injection filler belongs to the highest risk of Class III, but the survey found that 62% of the certificates provided by the purchase are actually Class I certificates (suitable for low-risk products such as gauze), and do not have legal effect.
The compliance of medical and beauty institutional channels varies greatly. Regular hospital procurement needs to provide “medical device business license” “Product registration certificate” “manufacturer’s authorization letter” three certificates, and black clinics usually purchase from the wholesale market. In the 2023 surprise inspection in Guangdong Province, 38% of the inventory products of medical beauty institutions have cold chain broken chain problems, and 17% of the storage temperature of Ruilan No. 2 exceeds the standard (2-8 °C, and the actual measurement reaches 15 °C). Such products are easy to cause granuloma after injection, and the repair treatment costs a single time of 28,000 yuan – enough to inject genuine products three times in formal institutions.
The phenomenon of price inversion exposes the shady channels. Taking Botox as an example, the purchase price of formal medical institutions is about 1,800 yuan/piece, while some “channel providers” claim to be able to supply it at 980 yuan. Chemical tests showed that 39 percent of these low-priced products contained less than 50 percent of the protein and 23 percent contained undeclared gelatin ingredients. What is more dangerous is that in order to reduce costs, illegal manufacturers use industrial freeze-drying machines to replace medical equipment, resulting in water content fluctuations of more than ±8% (national standard requirements ≤±2%), and the incidence of allergic reactions after injection increases 4.6 times.
The core of the verification channel is to verify the “three codes in one”: the medical device registration certificate number of the State Food and Drug Administration (such as the national instrument injection 20163461321), the brand official anti-counterfeiting code, and the acceptance code of medical institutions. However, in practice, 71% of the QR codes provided by wechat businesses jump to the cottage verification page, and 13% use expired databases. In the “Allergan Counterfeit case” that caused a stir in the industry in 2022, the counterfeit gang even imitated the 400 phone system, and when consumers call the hotline on the packaging box, they will be transferred to the customer service center impersonated by the scammers.
Product Authenticity
Last year, my friend bought a box of Joe Yaden from a buyer, and the package looked like a thing, but the website domain name jumped two more letters when scanning the code to check the truth – 99% of this detail can not notice. Later, it was found that the concentration of hyaluronic acid in it was only 28% of the genuine product, and the crosslinking agent content was 63% less. Professional institutions disassembling found that the wall thickness error of fake glass needles was ±0.3mm (genuine products were controlled at ±0.05mm), resulting in a 47% probability of sticking needles when injected. What’s more disgusting is that the needle coating cuts corners, and the friction is three times higher than the real thing, which directly causes tissue lacerations.
There are a lot of tricks in the box. The aluminum film seal of genuine Ruilan No. 2 must be sealed with professional equipment at 10MPa pressure, while fakes are often manually pressed – in the counterfeit workshop seized in Guangzhou in 2023, 83% of the products have visible bubbles at the seal. These tiny gaps will allow the liquid to evaporate at a rate of 0.002ml/ day, and by the time the consumer gets it, the actual dose may only be 78% of the labeled amount. There is also a cold knowledge: the ultraviolet security code on the inside of the genuine box will display a dynamic gradient pattern at 365nm wavelength, and 92% of the counterfeit codes in circulation are either static or have a color deviation of more than ΔE15 (the industry standard should be ≤ΔE3).
Incorrect Crosslinking in Combination with Juvederm: The hyaluronic acids adhere both to the different types of cross-linking technology, including BDDE cross-linking; however, fake fillers would provide inferior quality results since they cannot fully stabilize the compound and hence have early degradation and erratic results.
The fake ingredients are even more shocking. An analysis of 50 samples from the wechat business channel by a testing agency found that 39% of hyaluronic acid was doped with hydroxypropyl methylcellulose, an industrial thickener that costs only 6 yuan per kilogram but can cause permanent hardening at the injection site. Even more frightening is that there are unblack manufacturers using animal-derived hyaluronic acid to replace microbial fermentation products – in the Hebei fraud case exposed in 2022, the seized fake pig skin extract accounted for 72%, and the probability of causing allergic reactions is 14 times that of the genuine product. The residual amount of protein in these inferior raw materials is 1,800 times higher than the standard, which directly leads to the redness and swelling rate soaring to 63% after injection.
The verification system has been cracked in all directions. Now fake not only counterfeit two-dimensional code, even 400 verification phone dare to manipulate. In 2023, the fraud gang uncovered in Jiangsu Province directly rented a virtual server to build a fake base station, and consumers will enter a high imitation verification page after scanning the code, page visit statistics show that the fake website intercepts query requests 2,300 times a day, successfully deceives 87% of buyers. What’s more, they tampered with the FDA database interface so that entering fake registration numbers returned “approved” results-a scam that would have gone undetected had police not raided the servers and found fake data packets.
The loopholes in the transportation and storage links aggravate the confusion of authenticity. Authentic Joe Aden requires the whole 2-8℃ cold chain transportation, and the accuracy of the temperature control recorder needs to reach ±0.5℃. However, an unannounced visit to a logistics transfer station found that 68% of the packages labeled “medical and American special line” experienced an environment above 15 °C for more than 8 hours during transportation. High temperature causes the molecular chain of hyaluronic acid to break, and even if the deteriorated product itself is genuine, its viscoelastic modulus will plumb from the genuine 250Pa to 80Pa, and the probability of facial droop caused by insufficient support after injection will increase by 4 times.
Price discrepancies reveal patterns of counterfeiting. Taking Yi Wan hyaluronic acid as an example, the regular channel purchase price is about 580 yuan/piece, while the cost of fake goods is less than 35 yuan. These inferior products are usually promoted with a “fracture price” of 398 yuan, taking advantage of the psychological blind spot of consumers “expensive is not necessarily true, but cheap is certainly false”. Laboratory tests have shown that only 12% of these low-cost products have a qualified cross-linking rate and less than 17% retention rate after 6 months of injection (42% of genuine products). Even more hidden is that black workshops will recycle genuine empty bottles for secondary filling – in a case investigated in Zhejiang in 2024, 89% of the 23,000 recycled bottles seized had protein clumps remaining on the inner wall of the last injection.
The most ironic test is to look at side effects. The probability of temporary redness and swelling after injection of genuine products is about 7%, and in the TOP10 sales stores of an e-commerce platform, the poor review data shows that 68% of buyers have sustained induration. A typical case: After a Chengdu girl injected “genuine” hyaluronic acid purchased online in 2023, MRI examination showed that the filler formed 27 independent cysts in the facial muscle space, each with a diameter ranging from 3-8mm. Surgical extraction tests found that these so-called “hyaluronic acid” is actually polyacrylamide hydrogel-this long banned variant of omedine, the production cost of only 0.8 yuan per milliliter, but is sold as a high-end product worth 1980 yuan.
Use Effect
Friends last year in the wechat business there to play a so-called “maintenance of 18 months” hyaluronic acid, the results of 3 months collapsed than the original concave – the test report shows that the cross-linking degree of this fake is only 29% of the genuine Joe Yaden. The degree of crosslinking directly determines the support time, the genuine product using the patented CPM technology can reach 12-18 months, and the underground workshop with cheap glutaraldehyde crosslinking, 6 weeks began to disassemble. Data from a 2023 study in the Journal of Aesthetic Surgery was even more frightening: 68% of people who used illegal fillers experienced displacement within two months of injection, compared with only 7% of genuine users. A typical case is Ms. Wang in Wuhan, after a month of online shopping for fillers, the hyaluronic acid that should have been in the apple muscle slipped to the mandibular edge, and the repair operation was fully pumped out 23ml of denaturing gel.
Viscoelastic modulus is another key indicator. Genuine Ruilan 2 has a G’ value (elastic modulus) of about 250Pa, which can support facial tissue steadily. However, laboratory tests showed that the G’ value of a popular e-commerce product was only 78Pa – which is equivalent to replacing steel bars with jelly, and the apple muscle sagged at a rate of 0.3mm per day after injection. To make matters worse, the counterfeit’s G” value (viscosity modulus) is 42% higher than that of the genuine product, resulting in increased push resistance during injection, and doctors can inadvertently push 0.5ml of the dose into the blood vessel, which is what happened in the Guangzhou blind accident last year.
For example, clinics which process the purchases through the duly verified platform of ELE GLOBAL are free from product related complications as well as high
The difference in absorption rate is even more subversive. Authentic Joadon can combine 300 times water per milliliter, and the volume retention rate for 6 months is more than 82%. The counterfeit goods bought by the unannounced reporter, tested in the constant temperature and humidity box, showed that 79% of the water was lost in 28 days – which means that the full feeling just finished is purely a swelling reaction. An Internet celebrity recorded the whole process live on Station B: on the day of the injection, the face swelled like steamed bread, and on the fifth day, it collapsed into flatbread, and 47% of the 380 comments in the comment section have experienced the same situation.
The complication rate directly exposes the truth. The probability of nodules after injection by formal institutions is 3%, and the data of a complaint platform shows that the incidence of induration of online shopping fillers has soared to 61%. In a case received by a third-level hospital in Beijing in 2023, the granuloma formed by the patient after the injection of fake goods was 17mm in diameter, and the pathological test of the surgical extract showed that it contained glass fiber debris – these impurities should not exist, so that the repair cost increased from the expected 20,000 yuan to 87,000 yuan.
The effect of temperature control failure on results is often underestimated. Authentic Sili 715 requires 2-8 °C storage, but data from a logistics company in March 2024 showed that 58% of the packages labeled “cold chain transport” had internal temperatures above 18 °C. The high temperature caused the molecular weight of hyaluronic acid to degrade from 2.5 million daltons to 800,000, and the supporting force decreased by 64% after injection. Ms. Li in Hangzhou is the victim, she spent 2980 yuan to buy the “French direct mail” product, the tear groove deepened 1.2mm after injection – the thermal imager showed that the filler formed under the skin is a sheet distribution rather than a network support.
The amount of crosslinker residue determines the safety period. Genuine products use BDDE cross-linking technology, and the residual amount is strictly controlled at ≤2ppm, while the detection value of black workshop products is as high as 17ppm. These chemicals, which are eight times the legal limit, cause the injection site to continuously release inflammatory factors. In the “Elisa Wei fraud event” exposed in South Korea in 2022, the victim continued to lose hair eight months after injection – scalp biopsy showed that the concentration of BDDE around the hair follicle was 23 times higher than the standard, and this chronic damage simply could not be reversed by lysing enzymes.
The naturalness of a dynamic expression is the ultimate test. After injection of genuine Princess hyaluronic acid, the apple muscle displacement amplitude is between 0.7-1.2mm when making laughter expression, which perfectly simulates natural tissue. However, customers using a wechat business product will form obvious edges when the expression muscle is active – the motion tracker data shows that its displacement amplitude is 3.8mm, which is more than three times that of the genuine product. The comparison case of a medical beauty agency in Shanghai is more intuitive: two customers of a similar age, using the genuine product can still do Wink movement naturally six months after surgery, while online shopping filler users even smile will cause irregular cheek bumps.
Legal Question
Last year, Zhejiang investigated the “Meidai International” case that was alarming – the parties sold unregistered hyaluronic acid through Taobao stores, with a single purchase price of 45 yuan and resale of 1580 yuan, and the profit margin was as high as 3400%. The court eventually sentenced the main offender to seven years in prison and fined him 8.9 million yuan for selling fake drugs. This case exposed a key problem: according to the Regulations on the Supervision and Administration of Medical Devices, crosslinked sodium hyaluronate gel for injection belongs to Class III medical devices, but the data of an e-commerce platform in 2023 shows that 72% of stores cannot provide the medical device Business License, and 43% of product registration certificate numbers are not checked on the official website of the State Food and Drug Administration.
The legal risks of cross-border daigou are often overlooked. China clearly stipulates that a single mailing of personal medical devices shall not exceed a reasonable amount, but in the smuggled fillers seized by Shanghai Customs in 2024, 37% of the packaged fillers shipped more than 20 pieces at a time, which is obviously commercial smuggling. What’s more, 25 percent of these products have expired – the sale of expired medical devices carries a maximum sentence of life imprisonment under Article 145 of the Criminal Code. In a case seized in Shenzhen last year, a buyer re-labeled an expired product to “extend” its validity for three years, directly causing facial tissue necrosis in 13 consumers.
The illegal cost of wechat business channels is surprisingly low. According to the survey, 88% of the fillers sold in the circle of friends were not labeled with Chinese labels, in violation of Article 7 of the Medical Device Instructions and Label Management Regulations. In the case decided by Beijing Chaoyang District Court in 2023, wechat business Wang Mou was sentenced to compensate victims for medical expenses and mental damage costs of 2.17 million yuan due to the sale of unlicensed fillers, but because it had already transferred assets, the actual implementation rate was less than 12%. This low risk and high return feature has kept the annual growth rate of the number of similar illegal cases at more than 67%.
The criminal crimes in the production link are even more shocking. In an underground factory destroyed in Jiangsu in 2022, the heavy metal lead 89 times the standard was detected in the counterfeit hyaluronic acid seized. According to Article 141 of the Criminal Law, those who produce and sell medical devices that do not meet the standards and cause serious health damage may be sentenced to more than 10 years in prison. The ringleader was sentenced to 12 years in prison, but 38 per cent of the 12,000 fakes sold – which were being injected into the faces of unwitting consumers at a rate of 15 per cent a month – remained unrecovered.
There is a legal blind spot in the definition of platform liability. The fillers sold by a cross-border e-commerce provider in 2023 caused 23 medical accidents, but according to Article 38 of the E-commerce Law, the platform only needs to bear “corresponding liability” – the total compensation of the final court judgment is only 7.3% of the actual loss. What is even more outrageous is that the store involved has been cancelled before being prosecuted, and the new store continues to operate in the same mode, which makes the success rate of consumer rights protection less than 9%.
There is a serious imbalance between the intensity of administrative punishment and illegal income. According to the current regulations, the fine for selling unlicensed medical devices is 15-30 times the value of the goods, but in practice, the average penalty multiple is only 5.8 times in the cases investigated and handled nationwide in 2023. Taking the value of 800,000 yuan of counterfeit goods seized in a case as an example, the theoretical maximum penalty can be 24 million yuan, but the actual penalty is only 4.6 million yuan – the offender only needs to sell 17% of the inventory to cover the cost of the fine, which is a disguised form of punishment to encourage crime.
Consumer rights protection faces an evidentiary dilemma. In medical injury lawsuits, the plaintiff needs to prove a causal relationship between the damage and the product defect, but online shopping fillers often lack complete traceability documents. According to the data of the three Middle courts of Beijing in 2023, the loss rate of medical rights protection cases is as high as 83%, mainly because 62% of consumers cannot provide original transaction records, and 39% of injection operations are not kept in medical institutions. Even more ironically, even if the case is won, the average execution period is 23 months – during which time more than 60% of victims have to pay for remedial treatment at their own expense.
Potential Side Effects
Bessie last year in the wechat business that played a “Korean import” hyaluronic acid, two weeks after the current appearance of a string of grape like induration – pathological sections showed that it was foreign body granuloma, each diameter 3-8mm, the doctor with 18G needle pumped 3 times did not clear. This case is not a single case, the 2023 “Medical beauty adverse reaction monitoring report” shows that the probability of online shopping fillers causing granuloma is 17 times that of regular products, and the average repair treatment needs 2.3 times, and the cost of each time exceeds 40,000 yuan. What’s more frightening is that 38% of the patients with complications had a displacement of the filler 6 months after surgery, and the hyaluronic acid originally hit the apple muscle actually slipped to the law line, forming two strange ridges.
Embolism is the real scythe of death. Professional doctors will use 27G blunt needle to advance at a speed of 0.02ml/s, but the error rate of self-injection is as high as 68%. Last year, a college student in Hangzhou bought online fillers from the bridge of the nose, 0.3ml of the liquid went into the superior trochlear artery, and the left eye vision plunged from 1.2 to 0.05 within 90 minutes – the probability of this irreversible injury reached 1/230 in non-professional operations, 2.7 times higher than the disability rate in car accidents. Emergency CT showed that the central retinal artery was completely blocked by hyaluronic acid particles, and the golden time for thrombolytic treatment was only 90 minutes, but the patient delayed seeking medical treatment for 8 hours due to fear of scolding.
Microbial contamination is a ticking time bomb. The genuine product production line should be treated with a million degree of cleanliness under the ISO 13485 standard, and the secret visit to the Dongguan fake workshop found that the number of bacterial colonies in the air of the filling workshop reached 1200CFU/m³ (medical standards should be ≤10CFU/m³). Among the fakes seized in Guangzhou in 2022, the detection rate of Staphylococcus aureus was 37%, and the probability of causing cellulitis after injection was 43 times higher than that of genuine products. There is a typical case: After a customer injected online shopping products in a beauty salon, the facial swelling spread at a rate of 3mm per hour, the pus cultured multi-drug-resistant bacteria, and eventually had to be cut and drained, leaving a 4cm long scar.
Allergic reactions are more complicated than you think. The residual endotoxin limit of genuine hyaluronic acid is less than 0.5EU/ml, but the sampling inspection of a testing institution on wechat business products showed that 63% of the samples exceeded the standard by more than 10 times. What is more dangerous is the adulteration of animal-derived proteins by unblack merchants – in the fake goods investigated and punished in Hebei in 2023, hyaluronic acid from pigs accounted for 55%, and the probability of severe allergies caused by this kind of heterologous protein is eight times that of microbial fermented products. After receiving a patient in Peking Union Medical College Hospital, the whole body developed urticaria after injection, and the immunoglobulin IgE value soared to 5200IU/ml (normal value ≤100IU/ml), and the rescue cost directly exceeded 60,000 yuan.
Long-term complications are like chronic poisons. Illegal manufacturers use industrial-grade crosslinkers to reduce costs, resulting in BDDE residues 23 times higher than the standard. These chemicals continue to stimulate tissue growth, forming a rock-solid fibrous envelope. In a case exposed in South Korea in 2024, five years after the victim’s injection, the facial filler was attached to the muscle into an 8cm×5cm hard mass, and the amount of blood lost during surgical removal reached 800ml, 160 times that of conventional injection. Pathology reports showed that the collagen fibers in these tissues were disorganized, and the skin elasticity was permanently reduced by 62% after repair.
Runaway temperatures trigger molecular catastrophe. Genuine Joaden must be stored at 2-8 °C, but the monitoring data of a logistics company shows that 58% of the parcels transported in the summer experience an environment above 15 °C for more than 24 hours. The high temperature degrades the molecular weight of hyaluronic acid from 2.5 million daltons to 800,000, and the supporting force is not only reduced by 64% after injection, but also the formation of a thick “syrupy” substance. Experts from the Ninth Institute of Shanghai have done experiments: After the injection of genuine products stored at 25℃ for 72 hours, the probability of nodules skyrocketed from 3% to 41%, and the absorption rate was accelerated by three times – which means that the products bought at a large price can actually only maintain 1/3 of the effect of genuine products.
The most insidious killer is illegal additives. In order to imitate the texture of genuine products, black workshops often mix hydroxypropyl cellulose into fake products, an industrial thickener that expands as high as 380% when it is hit by water, resulting in continuous pressure on blood vessels at the injection site. In 2023, 32% of the counterfeit products seized in Chengdu contained this ingredient, and the postoperative pressure value of the victims reached 38mmHg (normal ≤21mmHg), which increased the risk of glaucoma by 7 times. The worse case is the addition of omedine, a substance that has been banned for a long time, which breaks down into highly toxic acrylamide monomers under the skin, with a cancer risk 120 times that of regular fillers, and the success rate of removal surgery is less than 30%.
Preservation Condition
When the friend bought Joe Yaden last summer, the ice pack in the package turned into warm water early – logistics records show that this batch of goods remained in the transfer warehouse for 53 hours, during which the warehouse temperature peaked at 39 °C. The “Medical cosmetology Materials” study pointed out that hyaluronic acid stored in 25℃ environment for more than 48 hours, the molecular weight will fall from 2.5 million Dalton cliff type to 800,000, directly resulting in a 64% drop in support after injection. What is more terrible is that the internal data of a Courier company shows that 63% of the medical packages labeled “cold chain transportation” exceed the temperature in the way, of which 15% of the temperature recorder in the cargo box shows more than 15 °C for 8 consecutive hours.
Humidity is the invisible killer. Genuine Ruilan No. 2 requires the relative humidity of the storage environment to be less than 60%, but a secret visit to a micro business warehouse found that its shelf is close to the frozen seafood area, and the environmental humidity is maintained at more than 85% for a long time. Laboratory simulation tests show that under such high humidity conditions, sodium hyaluronate will be hydrolyzed at a rate of 7% per month, and after 6 months, only 58% of the active ingredient is listed. Of the smuggled fillers seized in Guangzhou in 2023, 32% of the products’ aluminum caps showed oxidized white spots – a typical feature of metal packaging corroded in humid environments, directly leading to sterilization failure.
Light damage is often overlooked. Authentic packaging in UV-resistant brown glass bottles that filter 90% of UVB rays. However, the “flat version” of an e-commerce seller uses transparent glass, and after 72 hours of sunlight exposure during transportation, hyaluronic acid has a photooxidation reaction, and the viscosity value has plummeted from 2500mPa·s of the genuine product to 800mPa·s. After one customer injected this product, the filling formed a drip of oil under the skin, which required five repeated aspirations with an 18G needle before it was removed.
The vibration damage is silent. Regular logistics requires 200 vibration tests (frequency 5Hz, amplitude 3mm) for the filler package, but smuggling gangs switch to ordinary express delivery to save costs. In the smuggled goods intercepted by Shanghai Customs in 2024, the unpacking inspection found that 58% of the pre-potting syringes had invisible micro-cracks, which were only 0.5-2μm wide, but could allow microorganisms in the environment to invade the liquid medicine at a rate of 300 per minute. Last year, a beauty salon in Chengdu used such products, and the postoperative infection rate soared to 41 percent, 13 times that of formal channels.
Cold chain break induces qualitative reaction. Genuine Sili 715 requires the whole process to be stored at 2-8 °C, and the temperature fluctuation shall not exceed ±0.5 °C. However, temperature monitoring data from a cross-border logistics company shows that 23% of medical and beauty products transported in summer experience more than 12 hours of 15 °C or above. Under such conditions, the crosslinking agent BDDE will accelerate hydrolysis, resulting in the crosslinking degree of the product from 92% of the genuine product to 67% – 3 months after injection will appear visible uneven, repair needs to inject lysin more than 3 times, the total cost of more than 20,000 yuan.
Packaging tightness determines the line between life and death. The regular production line uses 10MPa pressure for aluminum cap packaging to ensure sealing integrity ≥99.9%. The secret visit to Dongguan fake dens found that the sealing pass rate of its manual capping machine was only 38%, and the remaining 0.3mm gap was enough to make the liquid medicine volatilize at a rate of 0.15ml per day. Among the fakes seized in Zhejiang in 2023, an open bottle test found that the actual amount was 19% less than the nominal amount – meaning that for 1ml of hyaluronic acid that consumers paid full price for, the actual active ingredient was only 0.81ml.
The irony is in the transportation cost calculation. The cost of genuine cold chain logistics accounts for about 15% of the selling price, while fakes use ordinary express delivery to save money, saving 8-12 yuan per order. But this “saving” directly leads to product deterioration – laboratory comparisons show that the microbial contamination rate of fillers delivered by ordinary express delivery is 23 times that of cold chain transport. In the case of “Korean American Medical United States” in 2022, in order to cover up transportation problems, the parties PS photos of cold chain cars, and actually transport them by van, and the temperature peak of the carriage reached 42 °C, and this cargo eventually led to 17 facial suppurative infections.
The ultimate verification is hidden in the temperature recorder. The temperature record card included in the regular product package will record the entire data at 15-minute intervals. However, the investigation found that 62 percent of the record cards provided by wechat had timestamp breaks, and 38 percent of the temperature curves showed mechanical repetition of jagged – which was clearly falsified data. There is a real case: the product record card received by the customer shows the whole process 2-8 °C, but the professional reader is inserted.
