How to choose your injector

Whether you are a veteran Botox user or a first-time filler patient trying to figure out who should be the lucky person to put those tiny magical needles into your face, we have outlined some fairly good guidelines so you can find a good injector. It’s us BTW, but maybe you don’t live near us, so by all means, read on.

Things you should look for when picking your injector:

1. Results

With the vast reaches of the internet and social media, you should be able to find your injector and their results somewhere online.  Do their results match with what you would like to receive? Every injector has different techniques and there is a certain amount of artistry that goes into each treatment. Remember though, you are usually seeing the “highlight reel”, also ask about their mess-ups, re-do’s, bruises, etc. If they don’t have any they haven’t been injecting long enough or they are probably lying.

2. Background/education 

With the boom of the aesthetic industry, injectors have expanded way past just dermatologists and plastic surgeons over the years – now there are PAs, NPs, nurses, dentists, and even estheticians injecting in certain states! We think it’s important to choose a provider whose primary dedication is to inject for the majority of their week. Botox is a prescription drug and should still be considered a medical treatment. Dermal fillers are more serious as they are classed as implantable devices in gel form, which is a technical procedure that requires advanced anatomy.

We personally believe that only MD’s, NP’s, RN’s and PA’s should be doing injectable aesthetic treatments. So don’t be shy, ask for credentials, a good injector is not going to have any problem providing them and they legally must wear their name and credentials on their uniform anyway. Please do not let a medical assistant, esthetician, or salon professional inject your most prized possession.

3. Training and experience

Usually an injector that has been working consistently for over five years is a safe bet. The field of aesthetics is ever changing, and your injector should be keeping up. Make sure they are staying up to date with the latest products and techniques to not only enhance your results but also keep you safe.  Choosing a board-certified plastic surgeon or dermatologist (these are the core specialties for aesthetics), or a qualified medical professional who works under one is always the best option.

Truth Bomb: You are far more likely to receive better and safer results from someone trained or certified in facial aesthetics under the supervision of a board-certified plastic surgeon than going to a family doctor/dentist/surgeon that just added BOTOX to their practice. Do you want your procedure from someone who has decided to do something as a side gig or do you want a consummate professional who has made aesthetics their passion and focus?

Certification means your injector has submitted themselves for a validated examination and gained certification from a trustworthy organization? It’s best to see CANS (certified aesthetic nurse specialist) or CPSN (certified plastic surgical nurse) behind your injectors name. Our head injector and head trainer Sonya Ellis, MSN, RN, CPSN, CANS is one of only two nurses in the state of Texas who is not only certified in Aesthetics but also Plastic Surgery. Only 37 nurses hold this dual certification in the United States.  

Does your injector attend continuing medical education that is specific to injectables? What journals are they reading? Many injectors continue education solely by following the materials provided by the injectable manufacturers, and although those can be helpful, this is not robust enough in our opinion. Your injector should be seeking knowledge proactively and often.

Advanced injectors should also attend extensive head and neck dissection anatomy courses with cadaver heads, which result in their greater understanding of muscles, ligaments and vessels which in turn, increases efficacy of treatments and safety for you. Injectors should be able to almost have x-ray vision into your anatomy while they are providing treatment in order to provide the safest most results driven outcomes that they can.  

4. Patient relationships

Consultations, in our opinion, are mandatory. The initial conversation with your injector is vital to the process, they need to give you all your options and make sure they are someone you could see having a long-term relationship with. Your injector should spend some time getting to know you and what you want to accomplish. Aesthetic medicine is a process, and it will more than likely take several treatments for you to receive the results you desire. So, you better enjoy their company as you will be seeing them 4-6 times per year on average. Also ask about their follow up/touch-up policy – are they available for questions/concerns after hours, on the weekends or holidays? Are touch ups complimentary or will they nickel and dime you if you need a couple more units of Botox for a wrinkle that is still visible at follow-up.  Don’t be afraid to ask, it’s your FACE!

5. Facility Accreditation.

In our opinion (we realize we have a lot of opinions) injections should occur in a medical setting. The facility should have proper licensing for each state’s regulations and be clean and professional. Non-medical rooms for rent and hair salons are not appropriate places for cosmetic medicine or injectables of any kind. We also detest “Botox parties” located in private residencies or clothing boutiques. Who’s injecting you, do they have credentials, was the product stored properly, are you getting a medical clearance, did you consent for the procedure, what if something doesn’t look good, what if you need a touch up, what if something goes wrong, who’s liable, the person injecting, the person throwing the party, is there a medical director involved? See how things can get sticky real fast, and you are usually saving maybe $100-150 by putting yourself in this position. When you think about what could go wrong, is it really worth it.

6. Safety

First of all, your injector should share with you in full disclosure all of the risks, benefits and alternative treatments before any injections begin. They should also have all the emergency equipment necessary for any complication you could have in their office. They should also make sure they carry malpractice insurance in case you get hurt. Also, having a medical director in a core specialty (plastic surgery or dermatology) is the best case scenario in case things go sideways. Other physicians are going to refer to difficult complications to these two specialties, anyway, so why not start in the right place to begin with. 

7. Reasonable Cost – You often get what you pay for

If an injector is always giving a cheap deal on injections, there is usually a reason why. These practices are either brand new and looking for new patients or have been around and aren’t fully booked, either way, neither option is going to be good for you as clearly neither one of them usually know what they are doing. Choosing an injector solely off a deal can also cause you to overlook important questions such as who is offering the injections, what product is being used, is the provider experienced, and does the treatment match my needs. We suggest you sign up for your injector’s email or text list to get notified when they offer specials. Even the best injectors will give discounts sometimes, every loyal patient deserves a deal once in a while.

8. Mentoring and supporting the future community of injectors – Paying it Forward

Is your injector affiliated with professional organizations, are they mentoring or training the next generation, are they serving on boards, lobbying to keep their patients/practice safe, giving their money/time to support their profession? Being a member of a national or local society or association means that your injector will have significant experience in his/her field, will stay up to date with the latest techniques, and they are keeping in touch and networking with like-minded professionals often.

9. Red. Flags

 Over-confident – if they tell you, you are going to look like a celebrity when they are done or they are willing to give you a certain aesthetic look that doesn’t work with your natural facial structure – RUN. Also, for example, if an injector will work on an super high risk areas like the nose the first 3 years of their career, please walk out, we can almost promise they have not had enough training, anatomy or dissection for these dangerous areas.

They are nervous and can’t answer all your questions

A qualified and quality provider will not hesitate to answer and will gladly show you their before and afters or their credentials. If the injector cannot answer all of your questions, it usually indicates that they are not qualified or inexperienced.

Do you know what’s going in your face?

There are numerous products available between neurotoxin and dermal fillers, and all of these products should come directly from the manufacturer, and you should make sure that an FDA approved product is being used. Ask to see the bottle or your syringe. Don’t be shy, once again, it’s your face. Ask to watch them mix the neurotoxin in front of you, you are the consumer, you have a right to know.

If an injector doesn’t take their time with you

If your potential injector doesn’t take the time to listen to your concerns, create a custom treatment plan, or once again answer all your questions, it’s best to keep looking. 

They’re pushy or overselling you

If you go in for a BOTOX treatment, it’s likely an injector will be advertising or will tell you about other services they offer. That’s fine, we offer all services that would be beneficial to the patient in our first consultation. However, if an injector is being overly pushy about a treatment that you don’t want, they may just be after your money, and it is best to go somewhere with someone you feel more comfortable with. You should never feel pressured to do a treatment, EVER.

10. The Bottom Line

Choosing an injector is never an easy process, but by taking your time and asking the right questions, you can drastically improve your overall experience, safety, and results. Most of all, when you take the time to choose a great injector, you can form a relationship with them. Over time, that will open up another level of treatments. They will know you, your face, your likes, dislikes, your livelihood, social calendar, how you react to different things and whether or not you need to hide a purchase from your hubby……….. and that can be invaluable information for getting the best results long term.

Getting a treatment should be a pleasant experience and you should feel completely comfortable. Be focused on the result rather than cost per unit, what injectable brand they are using or price per syringe. Remember, you are there to get results and maybe a great patient/injector relationship that last years.

A great injector makes you feel comfortable, understands your concerns, and answers all questions that you have and doesn’t get their feelings hurt if you choose not to get the treatment that day.

All in all, your injector should be an investment, just like your face!

Sonya Ellis, MSN, CANS, CPSN

the L.A.B. med spa

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