What Happens at Your First Med Spa Consultation

What happens at a med spa consultation?

A med spa consultation is a medical visit that comes before any treatment. You complete a health history and talk through what bothers you, then the provider examines your face or treatment area, recommends options, explains risks, recovery and cost, takes photos and reviews a consent form with you. Treatment happens only if it fits your health and you agree.

The American Society of Plastic Surgeons' consultation guidance for fillers is a fair template for any injectable visit. It says to be ready to discuss your goals; your medical conditions, drug allergies and treatments; your medications, vitamins, herbal supplements, alcohol, tobacco and drug use; and any past fillers, neurotoxin, laser or facial surgery. The provider may evaluate your general health, examine and measure your face, take photographs and recommend a course of treatment.

At Derm Clinic MD, every treatment starts with an in-person consultation, whether you are interested in a neurotoxin, filler, peel or microneedling. The new patients page covers the practical details. Whatever practice you visit, a little preparation makes the visit far more useful:

• A written list of every medication, vitamin and supplement you take
• Names and approximate dates of past injectables, peels, lasers or facial surgery
• A few photos of yourself from several years ago, if they help show what changed
• Your questions, written down so you do not forget them

What health history will they ask about?

Expect questions about allergies, past reactions to injections, bleeding problems, skin infections or active breakouts, nerve and muscle conditions, breathing or swallowing problems, a tendency to scar, past facial surgery, and pregnancy or breastfeeding. Many of them come straight from FDA labeling and safety guidance, and each answer can change whether, where or when you are treated.

The FDA's patient guidance on dermal fillers asks you to tell your provider if your skin is inflamed or infected, if you have a bleeding disorder, severe allergies or a history of anaphylaxis, or allergies to lidocaine, animal products or bacteria-derived materials, since some fillers contain them. It also says filler safety is unknown during pregnancy, while breastfeeding, and in people prone to keloids or thick scars.

The Botox Cosmetic Medication Guide has its own list. It asks you to tell your doctor about nerve and muscle diseases such as myasthenia gravis, Lambert-Eaton syndrome or ALS, breathing or swallowing problems, bleeding problems, planned surgery, past facial surgery, drooping eyelids, weak forehead muscles, and pregnancy or breastfeeding. The label also says it should not be used where there is an infection at the planned injection site. Answer fully even when something seems unrelated.

Which medications and supplements should you mention?

Mention everything: prescriptions, over-the-counter medicines, vitamins and herbal supplements. The Botox Cosmetic Medication Guide specifically flags any other botulinum toxin in the last four months, recent antibiotic injections, muscle relaxants, allergy or cold medicines, sleep medicines, and aspirin-like anti-platelets or blood thinners. A written list is more reliable than memory.

Some of these change how a neurotoxin works. The label warns that aminoglycoside antibiotics and other drugs that interfere with nerve-to-muscle signaling can strengthen the toxin's effect, and that people taking muscle relaxants should be watched closely. Blood thinners and anti-platelet medicines matter because bruising at the injection site is a listed side effect in both the Botox Cosmetic label and the FDA's filler guidance, and these medicines shape how a provider plans your visit.

Bring the list as it is. If anything on it affects timing, your injector will tell you, and any change to a prescribed medicine is a decision for you and the clinician who prescribed it. Tell the provider exactly which product you received at any past appointment if you know it; the Medication Guide asks for that too, and the label explains that Botox Cosmetic is not equivalent to other botulinum toxin products.

How does the provider assess your face and goals?

The provider asks what bothers you, then looks for the cause: muscle movement, lost volume, skin texture, sun damage or laxity. Expect them to study your face at rest and while you frown, smile and raise your brows, check skin quality and symmetry, and explain which concerns a treatment can help, which it cannot, and what a realistic outcome looks like.

The AAD's guidance says the cosmetic consultation is where you get information on the indications, risks, benefits and alternatives of a procedure so you can make an informed decision. It also encourages you to raise what bothers you and to ask whether the provider sees anything else worth addressing. A line caused by movement and a fold caused by volume loss call for different treatments, and sorting out which is which is the point of the exam.

Realistic expectations belong in this part of the visit. The Botox Cosmetic label describes its approved uses as the temporary improvement in the appearance of specific facial lines and neck bands, and the FDA notes that every dermal filler has a different use and expected duration of effect. The AAD suggests asking to see before-and-after photos of people the provider has treated with the same procedure, especially people with a skin tone and type like yours. Derm Clinic MD's before-and-after gallery is one place to start.

Why do they take photos, and what are you signing?

Photos record your starting point so you and your provider can compare at follow-up visits. The consent form documents that you were told what the treatment involves, its expected benefits, its risks and your alternatives, including no treatment. Read it before you sign, ask about anything unclear, and know that you can take time to decide.

Photos are usually taken in consistent light and from set angles so small changes are visible later, when a mirror and memory are unreliable. They also matter if something unexpected happens. Ask whether your photos stay in your chart. If a practice would like to use them in its marketing, that should be a separate request you are free to decline.

The American Medical Association's Code of Medical Ethics says informed consent should cover the nature and purpose of the recommended treatment and the burdens, risks and expected benefits of all options, including forgoing treatment, and that the conversation should be documented. For fillers, the FDA adds that you should read and discuss the patient labeling for the specific product you will receive. If the form names a product or an area you did not discuss, stop and ask.

Will they talk about cost at the consultation?

Yes, and the numbers should be clear. Cosmetic treatments are usually paid out of pocket, so ask for a written estimate that names the product, the areas, how the price is calculated (per unit, per syringe, per area or per session), how many sessions are likely, and what follow-up visits or touch-ups cost.

The AAD's list of questions includes asking what your procedure will cost and checking whether insurance covers any part of it, while noting that cosmetic procedures are typically not covered. Compare estimates on the same basis: one practice may quote a neurotoxin per unit and another per area, and a filler quote should say how many syringes it assumes. For neurotoxins, our guide to what Botox costs in Atlanta covers published market averages.

Ask about the long run, not only the first session. Neurotoxin effects wear off, and the Botox Cosmetic label notes that dosing more often than every 3 months has not been clinically evaluated, so ask what a year of maintenance would look like. Derm Clinic MD's pricing page is the place to start for its own pricing, and if you expect to come in on a schedule, our membership explainer shows how to tell whether a plan pays off.

What questions should you ask the injector?

Ask who will treat you and what license and training they have, which product they plan to use and whether it is FDA-approved for that area or used off-label, where the product is purchased, what the risks are at each injection site, and what the plan is if a complication happens. A confident provider welcomes these questions.

Each question maps to published guidance. The FDA's counterfeit Botox alert tells consumers to confirm the product comes from an authorized source and to ask whether the person injecting is licensed and trained to give it. The FDA's filler guidance says the chance of an injection into a blood vessel is low, but it can cause tissue death, blindness or stroke. It tells providers to keep an updated plan for treating it, on site or by immediate referral, and tells patients to seek care right away for unusual pain, vision changes, skin near the injection site that turns white, gray or blue, or signs of a stroke.

For neurotoxins, ask about side effects in each area: the Botox Cosmetic label lists drooping eyelids among them and carries a boxed warning that the toxin's effect can spread beyond the injection area, causing swallowing or breathing problems that can be life threatening. Who may inject, and how closely a physician must supervise, is set by state rules, so ask the person's license type directly. When you are ready to talk through a concern, you can book a consultation at the Buckhead or Cumming office and bring this list with you.

• Who will treat me, and what is your license and training for this treatment?
• Which product will you use, and is it FDA-approved for this area or off-label here?
• Where do you buy the product?
• What are the risks for each area you plan to treat?
• What is your plan if a blood vessel is affected or another complication occurs?
• How do I reach you once I am home, and when is my follow-up?

This article is general education and is not medical advice. It does not replace an in-person consultation. Whether a treatment suits you, and what result is realistic, depends on your health history and an examination.

Derm Clinic MD · Last updated October 2026.