These warning signs rest on Texas rules, the Texas Department of Licensing and Regulation, the FDA and the CDC.
A price far below everyone else's
Real products, trained staff and insurance cost money, so a very low price deserves a question about what you are getting. This is not proof of a problem, but ask which product is used and request the packaging or lot information.
The FDA says unapproved versions of Juvederm have been sold in the United States, including online, and says not to use them. In April 2024 the CDC reported 22 people with harmful reactions after botulinum toxin injections given by unlicensed or untrained people or in non-healthcare settings, such as homes or spas. Of the 20 for whom the CDC had information, 11 were hospitalized.
Ask this
Which exact product is this, who supplies it, and may I see the box before you open it?
No named delegating physician
In Texas, a physician must delegate nonsurgical cosmetic procedures, and the practice must post that physician's name and Texas license number in public areas and treatment rooms. If a practice cannot tell you:
- Who the delegating physician is
- How a physician, physician assistant or advanced practice nurse can be reached during your visit
- Who the person treating you is, and their title
...do not book. You can check any physician through the Texas Medical Board's license look-up.
Injections with no real consultation
Texas rules require a practitioner-patient relationship and a medical record before a delegated procedure. A visit that jumps from the door to the needle does not look like that.
A real consultation covers your health history, your medicines and your allergies. Several medicines affect bruising or bleeding, and your provider can only account for them by asking.
Someone treating you outside their license
The Texas Department of Licensing and Regulation says an esthetician or cosmetology operator license does not authorize injecting Botox or fillers, and does not authorize lasers for hair removal. Medium and deep chemical peels count as medical procedures, while estheticians may do superficial ones.
Ask the person treating you for their title and who delegated the procedure. A clear, easy answer is what you want.
- Ask for the treating person's license type
- Look up the delegating physician with the Texas Medical Board
- Check for a posted name and license number
- Skip any practice that cannot explain who is responsible for your care
Pressure to decide today
Cosmetic treatment is elective, so you can take time. If you feel rushed, pushed to prepay for a package or offered a discount that ends before you leave, step back. A provider confident in the care will let you go home and think.
Trust your read
If answers are vague or you feel hurried, leave. You can book somewhere else.