Today, we ask a super important question:  Who should inject your Botox?  If you think it should be the gal down at the tanning salon, for the love of your face, please keep reading!

It depends on what state and in what country you may live, but many injectables are given by nurses and doctors.  But even among doctors, there are many different specialties.  While yes, they can technically “do it,” you wouldn’t necessarily expect a dentist or a knee surgeon to be the best choice when it comes to Botox injections.

Basically, you should get an injection from someone you trust, who has a lot of Botox experience and who can also deal with any complications arising from your Botox injection.

In the United States, there are the “Core 4” specialties that have educational, formal training during the post-medical school years.  These specialties are Plastic Surgery, Facial Plastic Surgery, Dermatology, and Oculoplastic Surgery.

Even if these specialists choose not to do aesthetic surgery, they still undergo training as part of their overall medical education to perform cosmetic procedures.  Also, continuing medical education (CME) requirements are still enforced, meaning that continued training, seminars, conferences, and lectures are required to maintain board certification in the “Core 4.”

If you’re a doctor of a different specialty, you won’t get this training in your post-medical school training.  If you want to start injecting Botox, you will be forced to take a weekend course, a week-long course, or some other alternative education, to learn about cosmetic injectables.

In my office, I personally inject ALL Botox patients.  I do this because I’m pretty detail oriented, and I just don’t trust anyone –  yet –  to give it as well as me.  I have developed a combination of special, secret techniques to reduce the pain of injection.  Some of the more difficult injections, such as arching the lateral eyebrow, are fairly straightforward in my hands.  Also, I get very consistent results, which is another thing you want to look for in an injector.  You want to make sure you look the same each time.

Nurses are allowed to perform cosmetic injectables under the supervision of a doctor.  This supervision varies widely, and can mean anything from the doctor being physically present, to the doctor being nearby, to the doctor being available by phone, or whatever the nurse and doctor agree upon.  This would explain why some nurses seem to be able to perform Botox injections with no doctor visible or present during the procedure.

Botox is so widely used and so prevalent that the “medical” factor seems to have been watered down in recent years.  In other words, because a LOT of people are doing it, Botox can seem like a common and easy procedure.  But when it comes to the nuances of pain control or injecting Botox differently for each unique patient to achieve eyebrow arching or some other specific “fix,” those doctors in the “Core 4” will always have a competitive edge.  In addition, these doctors can use Botox to achieve migraine reduction, jaw clenching, and even muscle spasms.

Yes, there’s always the pesky issue of price.  Board certified plastic surgeons and dermatologists will likely charge more than a nurse or non-specialized doctor.  When it comes to Botox, you’re not just paying for the supplies and the cost of the Botox.  You’re paying for expertise and for the knowledge of how to fix things if they’re not quite perfect.

And of course, there’s the old saying –  You Get What You Pay For.  Sayings like this one stick around for a long time for a reason.  I’m just sayin’.

If you have any comments, please feel free to type away below this blog post!

If you’d like more information on Botox, Juvederm, or other cosmetic injectables, please contact Caroline, our Patient Care Coordinator.  She can be reached at or 415 362 1846.


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