1 & 2: Who's actually injecting — and who's medically directing

Who administers your treatment matters. In New York, injectables can legally be administered by physicians, nurse practitioners, physician assistants, and registered nurses (under physician supervision). Each has different training depth, and within each category, experience volume varies enormously. A nurse practitioner with 5,000 injection visits is far more qualified than a physician who's done 50.

The question to ask: "Who will be performing my treatment, and what is their specific training and experience with this procedure?" A legitimate provider answers clearly.

Medical direction is separate from who injects. "Under physician supervision" can mean a physician who is present and actively involved, or it can mean a physician whose name is on file and who the clinic will call if something goes wrong. These are very different. Ask specifically: "Is a physician on-site during treatments, or is the medical director a remote collaborator?" Neither is automatically disqualifying, but you should know what you're in.

3 & 4: Published pricing and written quotes

Published pricing is a green flag. Clinics that publish per-unit Botox pricing, per-syringe filler pricing, and package pricing for laser on their website have made a decision to be transparent before you've even called them. Clinics that require a consultation to get pricing are often structuring that consultation as a sales environment.

Published pricing isn't just convenient — it signals that the clinic knows its numbers, has standardized its protocols, and isn't pricing by what they think you'll pay.

Written quotes before treatment are non-negotiable. Before any treatment, you should receive a written quote showing what you're getting, how many units or syringes, the product name, and the total cost. "We'll figure out what you need when you're in the chair" is not appropriate informed consent. If a clinic doesn't provide written quotes, don't proceed.

5 & 6: Red flags that show up in almost every bad outcome

Pressure to add treatments. A consultation that ends with a provider recommending significantly more treatments than you asked about, framed with urgency ("if we start now…" or "your skin really needs…"), is a sales environment, not a clinical one. You should leave any consultation with a clear, bounded recommendation for what you specifically need — not a menu of additions.

Deep discounts on injectable packages. "Buy 10 Botox sessions, get 5 free" or "50-unit Botox package for $200" are pricing structures that require either volume you don't need, diluted product, or non-FDA-approved sourcing to work mathematically. Botox doesn't have a legitimate "bulk discount" at the consumer level — providers pay per unit wholesale.

The clinics that have treated us best were the ones that told us we needed less, not more. The ones that kept adding to our treatment plan were the ones we regretted.

7 & 8: Questions worth asking before you book

These aren't trick questions — they're basic clinical due diligence that any legitimate provider answers without hesitation:

  • "What specific product are you using, and who manufactures it?" (FDA-approved branded products, not "pharmaceutical grade" or "our own formulation")
  • "Can I see your provider's credentials?" (License type, state license number, years of experience in this specific procedure)
  • "Will I receive a written treatment plan and quote before you start?" (Yes, always)
  • "What is your protocol if I have a complication or am unhappy with my result?" (A real answer, not a deflection)
  • "Who is your medical director and are they on-site during treatments?"
  • "Do you have a two-week follow-up included for injectables?" (Standard of care; included in any legitimate practice)

The goal of these questions isn't to catch anyone out — it's to confirm you're in an environment where clinical standards matter. A provider who answers all of them directly is a provider you can trust with your face.

Frequently asked questions

What credentials should my Botox injector have?+
In New York, Botox can be administered by physicians, nurse practitioners, physician assistants, and registered nurses under physician supervision. Credential matters less than experience volume and the quality of medical oversight behind the practice. Ask specifically about their experience with your specific treatment.
How do I know if a med spa is legitimate?+
Published pricing, written quotes before treatment, clear provider credentials, a named medical director who is genuinely involved in clinical oversight, and a two-week follow-up policy for injectables are the clearest green flags. Pressure to add treatments, deep package discounts, and evasion on credential questions are red flags.
Is it safe to get Botox at a med spa vs a dermatologist's office?+
Med spas and dermatology offices operate under similar legal requirements for injectable administration. What matters is the specific provider's training, experience volume, and the quality of medical oversight — not the practice type. Many excellent injectors practice in med spas; some poor injectors practice in medical offices.
What should a Botox consultation include?+
A proper consultation includes: an assessment of your specific concerns and goals, a recommendation for which areas to treat (and why not to treat others), a written quote with unit count and product name, discussion of realistic outcomes and timeline, and screening for contraindications. If the consultation skips any of these, that's informative.