An appointment made on the networks, an attractive price, a promise of immediate results… and the temptation to say yes too quickly. Before any aesthetic injection, the practical answer is simple: do not accept anything until the professional, the product, the documents and the risks are clearly identified. Health authorities point out that these actions are not simple beauty treatments: they can lead to complications, sometimes serious.
For Dr. Gérald Kierzek, the objective is not to panic, but to put the medical aspect into a decision that is often trivialized. Here are questions to ask before an injection of hyaluronic acid, botulinum toxin or another filler.
Who injects, and with what qualification?
The first question should be direct: “Who performs the act, and are you authorized to do it?“. The DGCCRF points out that aesthetic medicine is the responsibility of doctors, because it uses more or less invasive techniques. But be careful: for botulinum toxin for aesthetic purposes, Health Insurance specifies that it is not enough to be a doctor “in the broad sense”. The procedure is authorized for qualified qualified doctors: dermatology, aesthetic doctors, ophthalmology, reconstructive and aesthetic plastic surgery, face and neck surgery, maxillofacial surgery.
“Before talking about results, we must first talk about competence: who injects, where, with what qualification and in what medical setting?” explains Dr. Gérald Kierzek.
A serious practitioner must accept these questions without discomfort. You can also check its registration with the Order and be wary of an act proposed in an improvised place, without prior consultation or with pressure to pay quickly. To go further, True Medical details how to check that a practitioner is indeed a doctor before an aesthetic injection.
What product, what documents and what traceability?
Second block of questions: the name of the product, its nature, the area injected, the planned quantity, the expected effects, possible adverse effects and precautions after the act. According to Health Insurance, a prior consultation must make it possible to research your background, explain the procedure, the risks, the alternatives, and provide the necessary documents, in particular a quote, an information sheet and informed consent.
“If the name of the product, its brand or its batch number are not available, you do not get injected. Traceability is part of safety” recalls Dr. Gérald Kierzek.
For hyaluronic acid, the doctor keeps the type, brand and batch number of the injected product. For filler products, the ANSM/Afssaps also recommends tracing the procedures, the products used, the areas of the face targeted, the volumes used, the number of injections, the time between injections, and putting this information in an aesthetic notebook.
The practitioner must also ask you: previous injections, product already used, severe allergies, reaction to a local anesthetic, abnormal bleeding, infection or skin disease in the area, pregnancy or breastfeeding, autoimmune disease, anticoagulant treatment or clotting disorder. An injection of hyaluronic acid into an area that has received permanent filler is contraindicateddue to the risk of granulomas.
“An aesthetic injection should never start with the syringe: it begins with a medical interview and informed consent. And avoid any non-doctor injector!” insists Dr Gérald Kierzek.
What signs should you consult urgently?
After an injection of hyaluronic acid or filler, redness, swelling, blistering or bruising may be transient. But certain signs should not be trivialized. Health Insurance cites immediate allergic reaction, bacterial infection, skin necrosis and visual disturbances among the rare but serious complications to watch out for.
For hyaluronic acid and fillers, significant pain in the injected area followed by whitening and then a purplish appearance should prompt consultation. : ameli describes this picture as suggestive of obstruction of an arteriole which can lead to skin necrosis. Any visual disturbance after this type of injection requires urgent ophthalmological consultation..
For botulinum toxin, illegal injections expose you to other warning signs. Health Insurance reports 8 serious cases of botulism between August and September 2024 after cosmetic injections carried out by unqualified people. Difficulty speaking or swallowing, aspiration, difficulty walking, blurred or double vision, difficulty breathing:
these symptoms require urgent treatment. Also find the warning signs before a botox injection.
“After the injection, we do not minimize an unusual symptom: intense pain, change in skin color, visual disturbance or difficulty breathing should seek medical advice without delay” underlines Dr Gérald Kierzek.
Last reflex before signing: take the time to reread the quote and the information sheet, compare, ask for a reflection period if you are hesitant. A refusal is always possible. To better understand the complications linked to fillers, True Medical reviews the risks of non-medical hyaluronic acid injections.