Before anyone injects your face: the questions to ask about Botox and fillers

The answer in brief

Before Botox or fillers, ask who will inject you and what their license is, which exact product they will use and where it was purchased, what they recommend for your face and why, and what they will do if something goes wrong. A careful provider answers all four without hesitation. If any answer is vague, especially about the product's source or who is holding the syringe, keep looking.

I am Jennifer Simon, BSN, RN, RFNP, Chief Operating Officer of ReGen & Aesthetics Concierge of Texas, where neurotoxins and dermal fillers are delivered by advanced practice providers. I want people in Dallas to walk into any aesthetic appointment, ours or anyone else's, knowing what to ask. What follows is general information, not medical advice for your face.

Why these questions matter more than the price per unit

The U.S. Food and Drug Administration describes dermal fillers as medical device implants and says filler injection should be considered a medical procedure, not a cosmetic treatment. The FDA calls unintended injection into a blood vessel the most concerning risk of fillers, because it can cause vision problems including blindness, tissue damage and stroke. That is not said to frighten anyone. It is the reason anatomy training and the ability to respond quickly matter so much.

Neurotoxins carry their own risks when the product is not genuine. In 2024 the FDA warned that counterfeit Botox had been found in multiple states and given to people for cosmetic purposes, and the Centers for Disease Control and Prevention investigated harmful reactions linked to counterfeit or mishandled botulinum toxin injections. The CDC says some of those products were bought through large online marketplaces instead of authorized suppliers. A low price per unit means nothing if you cannot be sure what is in the vial.

Questions about the person holding the syringe

Ask for the full name and credentials of the person who will inject you, not only the name of the business. In our practice, injections are given by advanced practice providers, and the clinic states its providers have master's or doctorate-level medical education and are board-certified nurse practitioners. Whatever the setting, you should know the license before you sit in the chair.

In Texas, you can look up a nurse's license, including registered nurses and advanced practice registered nurses, on the Texas Board of Nursing's license verification portal. The CDC also suggests checking whether a provider is licensed and notes that the facility may need its own license. It takes two minutes and is worth doing.

• What is your license, and can I verify it?
• How long have you been injecting, and how often do you treat my area of concern?
• Will the same person do my consultation and my treatment?
• Who supervises or collaborates on your care, if that applies to your license?
• Can I see photos of your own work on faces like mine?

Questions about the product in the vial or syringe

Ask for the brand by name. For neurotoxins, we use Botox, Xeomin and Daxxify, which share the same type of active ingredient, botulinum toxin type A, but differ in formulation, and those differences can affect how quickly they work and how long they last. For fillers, ask which product line and which specific product, because hyaluronic acid fillers come in different thicknesses meant for different areas such as lips, folds or cheeks.

Ask where the product was purchased. The CDC's advice is to ask whether a product is approved by the FDA and obtained from a reliable source, and the FDA tells consumers directly not to buy dermal filler products online. A legitimate practice buys from the manufacturer or an authorized distributor and will tell you so. You are also entitled to ask how many units or syringes are planned and why.

• Which brand and exact product will you use?
• Was it bought from the manufacturer or an authorized distributor?
• How many units or syringes do you plan, and what is the total cost?
• If it is a hyaluronic acid filler, can it be dissolved if needed?

Questions about the plan for your face

A good consultation starts with your concern in your words, then an assessment of what is causing it. Lines that appear when you frown or squint are usually treated differently from lines that are present at rest, and hollowing from volume loss is treated differently again. If you are not sure which category you are in, my guide comparing Botox, filler and Sculptra for an aging face explains what each one does.

Ask what the provider would not do, and why. Restraint is a skill. A provider who tells you that one area does not need treatment, or that a smaller amount is enough for a first visit, is usually a provider worth trusting with the areas that do.

• What do you think is causing what I see?
• What do you recommend first, and what would you leave alone?
• What results are realistic for me, and how long do they usually last?
• What will this cost now, and what will maintaining it cost over a year?

Questions about safety and what happens if something goes wrong

Every injector should be ready to answer this calmly. Ask how they review your medical history and medications before treatment, what side effects are common, which ones are urgent, and how you reach them after hours. For hyaluronic acid fillers, ask whether hyaluronidase, the enzyme used to dissolve them, is on hand; it can correct overfilling or complications. Other filler types may not be reversible, so ask about that too.

Know the warning signs. The CDC lists blurry or double vision, drooping eyelids, difficulty swallowing, difficulty breathing and muscle weakness as symptoms after a neurotoxin injection that need immediate care from a healthcare provider or emergency room. After filler, severe pain, skin color changes or any change in vision should be reported right away.

Questions about where the treatment happens

Location matters less than standards, but it changes what you should ask. In a clinic, look around: the room should be clean and private, products should come out of sealed packaging, and the provider should clean your skin before injecting. Ask what emergency supplies are kept on site, including hyaluronidase if you are having a hyaluronic acid filler.

Our practice also offers concierge treatment at a client's home or chosen location. If you choose any in-home service, ours included, ask how the product is stored and transported, how the provider keeps equipment and the treatment area clean, and what they bring in case of a reaction. Our providers disinfect equipment and use aseptic technique wherever they treat, and you should expect the same from anyone.

The setting to avoid is the one with no medical structure at all: a party, a pop-up, or a friend of a friend with a vial in a bag. The CDC's own advice is blunt on this point: if in doubt, do not get the injection.

• How is the product stored and transported to my appointment?
• What emergency supplies do you keep with you?
• How do you clean the skin and equipment before treatment?
• Who do I call if I have a concern that night?

Red flags that should end the appointment

Most problems I hear about started with a warning sign that was easy to ignore in the moment. If you notice any of these, it is fine to leave before treatment. A professional will not be offended.

• Nobody can tell you who will inject you or what their license is
• The product brand is vague, or the box is not shown to you
• Prices far below what licensed practices charge, with no explanation
• Pressure to buy a package or add areas on the first visit
• No medical history review before treatment
• Treatment offered at a party or event with no medical setup
• Promises of permanent or guaranteed results

What the first visit looks like when it is done right

In our practice, you start with a consultation, in person at our office next to Hilton Park Cities, or at your home through our concierge service. Your provider reviews your history, asks about your goals, examines your face at rest and in motion, and explains which treatments fit. You hear the product names, the planned amount and the price before anything happens.

If you go ahead, treatment is usually quick. Most people return to normal activities right away, with advice to skip intense exercise and avoid rubbing the treated area for a short time. Temporary redness, swelling or bruising at injection sites can happen. You leave with written aftercare instructions and a way to reach the team with questions.

Plan for follow-up. Neurotoxins wear off and fillers are absorbed over time, so you will be deciding about maintenance within months. I explain typical timing in my guide on how often to repeat Botox, filler and skin treatments.

When aesthetics are not the whole story

Sometimes a person comes in for lines or tired-looking skin and, as we talk, it becomes clear that energy, sleep, weight and mood have all shifted too. Injectables can change how a face looks, but they do not address why someone feels run down. If that sounds like you, my guide on what a medical consult looks at when you feel unlike yourself is a better place to start.

Whatever you decide, take your time. Ask every question on this page, write down the answers, and choose the provider whose answers made you feel informed rather than sold to. We see clients from across Dallas and the Park Cities, and we would rather you arrive with a list of questions than with none.

Questions people ask me