An exchange on Medical Spas Online's "physician-to-physician" message board reflects the unregulated aspect of the industry when it comes to the source of the raw materials used in one kind of procedure.

In one conversation, a Florida medical spa owner calling herself "aestheticRN" asks other med spa operators whether they'd had any luck buying the cosmetic filler Restylane overseas. "I recently spoke to some folks who purchase their Restylane from Bulgaria for almost half the price as it is in the U.S. They say it's the same as we use here, same packaging, etc. I know Botox can only be purchased from Allergan but what about Restylane? Anyone else import it?"

User "MD" responds a couple of months later to report buying Restylane from a distributor in Colombia at a third the cost and "never had any problems with it."

The Food and Drug Administration cautions against buying medical products abroad, noting that they may not meet U.S. requirements. Medicis Aesthetics, based in Arizona, holds all marketing rights to Restylane sales in the U.S. and says it has had a problem with counterfeits from abroad. The company includes a hologram on the product's packaging to ensure authenticity.

? Cost of Beauty Restylane is a cosmetic dermal filler made of hyaluronic acid that is injected into the skin to add volume and fullness to make wrinkles less noticeable. The wholesale cost for a 1-ml syringe runs about $240. The typical med spa charges consumers anywhere from $375 to $575 for the same syringe.