- Botox and filler injections have grown in popularity over the years.
- Not all who offer them are qualified or follow safety protocols.
- An esthetician and a dermatologist shared the red flags to look out for.
Botox and filler injections have grown in popularity over the years, at least in part because they are less invasive than plastic surgery. However, it is not without risk.
In April, the CDC issued a warning about fake botox after 19 women got sick. On a smaller scale, spoiled Botox or excess filler can lead to unpleasant side effects that last for months, from a frozen facial expression to a puffy “pillow face.”
Dr. Morgan Robachdermatologist and Dr. Vivian Chinesthetician, both administer Botox and filler treatments. They shared some of the biggest red flags to look for when going on your first date, from “deals” to unhealthy working conditions.
Your injector does not have the correct credentials
Treatments from unlicensed or unauthorized injectors are always dangerous, whether you’re getting Botox or “vampire facials,” because they may neglect basic safety protocols.
Chin said your injector should be a doctor, registered nurse, nurse practitioner, physician assistant or doctor of osteopathic medicine.
“Botox is a medical procedure, so an esthetician or a doctor cannot inject Botox,” he told BI, even though he hears clients being injected by estheticians all the time. “They shouldn’t have done that.”
You found a “deal” for treatment
One of the biggest red flags is a “very, very cheap price,” Rabach said, because neuromodulators like Botox are expensive to inject.
THE average cost of botox in the U.S. it hovers around $500 per session, so if you’re looking at a coupon for $150, you’re either sacrificing experience or safety, such as an injector using an illegal or expired product, Rabach said.
Flat fees aren’t necessarily red flags, but they can be a waste of money. For example, if you go to a pop-up clinic that offers Botox for $450, you’re getting a set amount that isn’t necessarily enough to see results, Rabach said. “It incentivizes the place to use less because then their margin is bigger.”
Chin said she’s had clients come to her for extra Botox injections after going to flat-rate clinics because the injectors wanted to “cheat and save money.” He recommended getting a consultation and personalized quote from an injector to save time and money.
Your injector is inexperienced
When it comes to injections, you get what you pay for — including experience.
“Even the same units placed by an experienced provider can look different,” Rabach said, adding that a doctor with knowledge of facial anatomy “will have a different level of experience than someone who takes a weekend class and starts to injects.”
The place is not clean and comfortable
The office should always be clean and well lit. Other safety protocols include having the injector wear gloves and clean your face before injecting, Rabach and Chin said.
A good office should also be prepared for emergencies. If you are getting filler, the office should be stocked with hyaluronidase, an enzyme that breaks down the filler, in case a blockage of the filler occurs.
To prepare for possible fainting at a Botox appointment, Rabach said reliable offices usually have tight balls, juice boxes or smelling salts for when clients seem nervous or pale.
You are skeptical about the high dose
Even if you’re new to botox or fillers, it’s good to know roughly how many units work for you. As a rule of thumb, Rabach said the average amount per area is 20 units, but that can vary by age. A person in their 20s getting preventative Botox may need 10 units or less on their forehead.
It could be a red flag “if you feel like you’re being oversold or being pushed for more units” — a sign that the injector just wants to raise costs, Rabach said.
The place does not take “before” pictures.
Rabach and Chin said you should always take pictures before you’re injected. Besides helping you see your progress, it’s also a sign that the place is following best practices.
“My malpractice insurance requires pre-photographs of every patient,” Chin said.
You don’t like the style of your injector
If your own injectable Botox and filler seem too dramatic, it pays to be cautious, according to Rabach. Everyone has a different style of injecting — Los Angeles is very different from New York, for example — and an injector’s personal appearance reflects what they think is good.
You can get an idea about it beforehand by reading reviews. “I tend to be a conservative injector,” Chin said. “All the reviews tell me that.”
Arguably, the best way to find a solid injector is through a referral, he said. That way, you know the place is legit and the results will align with your goals.