Key takeaways
- Injectables are a medical procedure. The FDA advises treating filler injection as a medical procedure, not a cosmetic one.
- Ask who prescribes, who injects, their training, the product name and source, and the amount.
- A careful doctor explains risks, aftercare and what happens if you are unhappy or have a complication.
- Red flags include paying before a consultation, group or party treatments, voucher deals and treatments at home or in hotels.
- You should never feel rushed. A cooling-off period after a consultation is normal.
Why does the choice of doctor matter so much?
People sometimes say, "Doctor, it's just a small injection, anyone can do it." Here's the truth. The needle is small, but the face is not simple.
See, what happens is, the face has blood vessels and nerves in places that vary from person to person. The FDA describes accidental injection of filler into a blood vessel as the most serious risk. It is uncommon, but it can cause tissue death, vision problems including blindness, and stroke. With anti-wrinkle injections, a poorly placed dose can cause a droopy eyelid or brow, or a crooked smile, usually temporary but distressing. DermNet notes weakness in nearby muscles happens in under 10% of treatments and can last up to 12 weeks.
That is very important to understand. The skill is in knowing where not to inject, how much is enough, and what to do quickly if something goes wrong.
What should I ask before booking?
The NHS suggests asking these questions at the consultation. I agree with every one of them. - How many of these procedures have you done? - What are your qualifications and training? - What are the most common complications? - What aftercare should I expect, and who looks after me? - What happens if something goes wrong, or I'm unhappy with the result? - What is the total cost, including any further treatment?
For anti-wrinkle injections, which are prescription medicines, the NHS also advises finding out who the prescriber is and who will give the injections. For fillers, ask for the product name and where it came from.
I'd add a few of my own: - Will you write down the product and dose? It makes future treatment safer and more predictable. - What would you not do on my face? A good doctor has opinions about what you don't need. - When is my review? A follow-up visit to check the result should be part of the plan.
What should a good consultation include?
| A careful consultation | A worrying one |
|---|---|
| Asks about your health, medicines, allergies and past treatments | Skips medical history |
| Looks at your face at rest and in movement | Goes straight to "how many syringes?" |
| Explains what the treatment can and cannot do | Promises a dramatic or guaranteed result |
| Names the product and amount | Can't or won't tell you the product |
| Discusses risks and what happens if something goes wrong | Says there are no risks |
| Gives you time to decide | Pushes a same-day deal or a package |
| Fixes a review date | No follow-up |
The FDA advises discussing allergies, active skin infections and bleeding problems before filler treatment, and asking for the product's patient information. DermNet notes that blood thinners such as aspirin increase bruising risk, so your doctor should ask what you take.
What are the red flags?
The NHS lists several, and I see the same patterns: - Paying before a consultation. The NHS says do not pay for a procedure until you've had a consultation to check it's right for you. - Group treatments or events with alcohol. - Vouchers from group discount sites. - Mobile services in homes or hotels. - Practitioners who only advertise on social media. - Only a short training course in the procedure.
I'd add: anyone who sells you fillers online or suggests injecting yourself. The FDA advises never to buy fillers online, because they may be fake or unapproved, and never to inject yourself. It also notes it has not approved any needle-free "pen" devices for injecting fillers.
Should I choose by price or by before-and-after photos?
Basically, neither on its own. Price tells you very little unless you know the product, the amount and who is injecting. My article on what anti-ageing treatment costs explains how to compare.
Photos can be selected and edited, and they show someone else's face, not yours. At Dr Tvacha we don't publish before-and-after photographs. I'd rather you judge a doctor by how carefully they assess you, how clearly they explain, and whether they tell you when you don't need something.
What if I've had a bad experience before?
It happens, and it's not your fault. Bring whatever details you have: when you had treatment, which area, the product name if you know it. If anything was written down, bring that too. A careful doctor will look at what's there now, explain what can be done, and won't rush to add more on top.
If you have unusual pain, changes in your vision, or skin turning white, grey or blue near a filler, the FDA advises seeking care immediately. Don't wait for a routine appointment.
How I approach injectables at Dr Tvacha
I am an Aesthetic Physician (MBBS, Dip. Dermatology (UK), Reg. No. 2001/02/1124), and I have been practising in Thane since 2005. At a face assessment, I take your history, look at your face at rest and moving, tell you what I would and would not do, and write the product, dose and fee down before treatment. You can take time to decide. Review dates are fixed on day one. You can read about the Long Game Anti-ageing Plan, filler safety, anti-wrinkle injection safety, or find our centres in Thane and Mumbai.
Frequently asked questions
Who should give anti-wrinkle injections and fillers?
A registered doctor trained in facial injectables, who assesses you before treatment and can manage complications. The FDA advises choosing a licensed provider with specific training and experience in filler injection. Anti-wrinkle injections are prescription medicines, so ask who prescribes and who injects. You can ask for the doctor's registration number and qualifications.
What questions should I ask before fillers?
Ask which product will be used and where it came from, how much, who will inject and their training, what the common and serious risks are, what aftercare is needed, who looks after you if something goes wrong, and the total cost including any top-up. A careful doctor will answer all of this clearly and write down the product and amount.
Is it safe to get fillers at a salon or a party?
I don't recommend it. The NHS lists group treatments, events with alcohol, and mobile services at homes or hotels among the red flags. Fillers carry an uncommon but serious risk of blocking a blood vessel, which needs quick recognition and treatment. That is far harder outside a proper medical setting with a trained doctor who can act straight away.
How do I know if the product is genuine?
Ask for the product name and source before treatment, and ask to see the packaging or patient information. The FDA advises against buying fillers online, as they may be counterfeit or unapproved. A doctor who writes down the product and amount in your notes, and gives you a copy, is being transparent about what goes into your face.
What should I do if something feels wrong after fillers?
Contact the doctor who treated you straight away. The FDA advises seeking immediate care for unusual pain, vision changes, skin turning white, grey or blue near the injection site, or signs of stroke. These are rare, but they need urgent attention. Mild bruising, swelling and tenderness for a few days are common and usually settle on their own.
Written by
Dr Amit KarkhanisAesthetic Physician · MBBS, Dip. Dermatology (UK) · Reg. No. 2001/02/1124Founder of Dr Tvacha, practising in Thane since 2005. Leads the weight loss and hair programmes.
Sources
- Choosing who will do your cosmetic procedure, NHS
- Dermal Fillers (Soft Tissue Fillers), US Food and Drug Administration
- Botulinum toxin, DermNet
- Before you have a cosmetic procedure, NHS
This article is for general education and does not replace a consultation. Medicines and treatments are prescribed only after a doctor's assessment. Last reviewed 25 October 2026.