For a first time Botox® patient at Citrus Aesthetics, the appointment starts with a consultation. Jessica Cvetic, PA-C, BS, MPAS, talks through your goals, evaluates your anatomy, and goes over the risks and benefits of treatment before anything is injected.
Nerves are part of a first visit, and so are questions about needles, about looking overdone, and about what to say when the provider asks what you want. The order below shows where each of those fits, so nothing in the room is a surprise.
First Time Botox: The Order of a Visit
A consultation-first visit moves through five stops. Your provider may reorder them to suit you, but the sequence is a good map to carry in.
Your Goals
The visit opens with what you want to change, in your own words, and what you want to leave alone. Bring your nerves and your questions to this part too.
Your Health and Your Face
Your provider asks about your health, your medications and any past treatments, then looks at how your face moves in the areas you named. Tell your provider about all medications and supplements, and follow their instructions.
Risks, Benefits and the Plan
Before treatment, you hear the risks and benefits, which areas make sense, and which product is recommended and why. If the risks outweigh the benefits for you, Jessica will say so and decline treatment.
The Injections
If you decide to go ahead, the chosen product is injected into the chosen muscles. The plan from the last stop sets which muscles and how much.
Before You Leave
Ask what to watch for and who to contact. Trouble swallowing, speaking or breathing needs medical care right away.
Which Areas a First Appointment Can Cover
The Botox Cosmetic prescribing information names four areas in adults: the lines between the brows, the lines at the outer corners of the eyes, the forehead, and platysma bands in the neck. Each one is a temporary improvement in the appearance of moderate to severe lines, and the label does not recommend use in anyone under 18.
The goals conversation narrows the list of areas, and our neuromodulator treatment page covers neuromodulator treatment at Citrus.
If Needles Make You Nervous
Say so at the start. Ask your provider to tell you what is coming before each step, so the injections are never a surprise. You can also ask to be shown which muscles are being treated and why, before the first injection.
How the injections feel varies from person to person, and a pain-free visit is not something we can promise. Ask what comfort options the practice offers before you decide.
You can also ask to pause at any point. A provider who explains each step before it happens leaves room for a breath, a question or a change of plan, and that matters more at a first visit than at a tenth.
If Looking Overdone Is Your Worry
Jessica's own overtreatment post lists two signs worth knowing: facial features that look frozen or stiff, and trouble expressing emotion. You can read the rest in our post on overtreatment.
Say at the consultation how much movement you want to keep. The amount and the placement are your provider's choices, so ask how they will make them, and remember that results vary from person to person.
What to Bring and What to Ask
A short list makes the consultation easier, and it helps a first-timer who is not sure what to say.
- A list of your medications and supplements, and any allergies
- Any record of past neuromodulator or filler treatments, with the product and the date
- Which areas do you recommend, and which would you leave alone?
- How do you decide how much to use?
- What are the risks for the areas we are discussing?
- What if I want an adjustment later, and how is that handled?
Before you leave, ask for the product name and the amount used in each area, or take a photo of the record. Your next provider can then start from facts and not from memory.
Risks and Side Effects for a First Treatment
The label for Botox Cosmetic puts its most serious warning first, and a first-timer should read it before booking.
Distant Spread of Toxin Effect
The boxed warning says the effects of the toxin can spread beyond the injection area. The label states that swallowing and breathing difficulties can be life threatening and that there have been reports of death.
Get medical care right away for trouble swallowing, speaking or breathing after treatment, and call 911 in an emergency.
The label also lists hypersensitivity to any botulinum toxin product or its ingredients, and infection at the injection site, as contraindications. In its frown line studies it reports eyelid ptosis, a drooping upper eyelid.
What Your Provider Needs to Know Before Treatment
The label points to a short list of things your provider needs to hear about, and a first-timer can prepare every one of them.
- Any past reaction to a botulinum toxin product or to anything in its formulation. The label lists this as a contraindication.
- Any infection or inflamed skin near the areas being treated. The label lists infection at the injection site as a contraindication and urges caution in the presence of inflammation.
- Any neuromuscular disorder. The label says patients with these conditions may be at increased risk of clinically significant effects.
- Every medicine you take. The label says the effect of the toxin may be potentiated by aminoglycoside antibiotics.
Your provider decides what each item means for your plan. The first visit exists to put all of it on the table before a decision is made.
Choosing a Product at a First Visit
More than one neuromodulator is on the market, and each has its own label, its own units and its own list of areas. Ask which product your provider plans to use, why, and what the label for that product says about the areas you want treated.
If the Consultation Ends Without Treatment
A consultation can end with a plan, a list of questions or a decision to wait, and each of those counts as a complete visit. Jessica will decline treatment when the risks outweigh the benefits for you, and she discusses her reasons with you.
You can also go home and think. Bring what you learned to your next visit, and book when you are ready.
Thinking About Filler Too?
Dermal filler is a separate product with its own risk list, including vascular occlusion, and the label for each filler is different. Bring it up in the goals conversation, and read about it on our dermal filler page first if you like.
Book Your First Time Botox Consultation
A first time Botox visit goes more smoothly when you arrive with your goals, your medication list and your questions.
You can read more about Jessica Cvetic, PA-C, BS, MPAS, who takes the time to learn your goals and answer your questions at our Mission Valley, San Diego practice.
Frequently Asked Questions
Can I get Botox if I am under 18?
The Botox Cosmetic label does not recommend use in children younger than 18, and its listed uses are for adults. A provider evaluates every adult patient before treatment.
How soon can I get Botox again after my first appointment?
The Botox Cosmetic label says that dosing more frequently than every 3 months has not been clinically evaluated. Your provider can tell you what that means for your plan.
How do I choose a provider for a first treatment?
Ask who will treat you, what their credentials are and how the consultation works. Our post on choosing an aesthetic provider goes through what to look for.
Do I need to know which product I want before I come in?
No. Your provider recommends a product after the goals conversation and the exam, and you can ask why. Reading about the options first helps you ask better questions.
This article is for educational purposes only and does not constitute medical advice. Whether a treatment is right for you depends on your health history, medications, goals, and anatomy, and results vary from person to person. A licensed provider must evaluate you before any treatment. Consult with a qualified provider for guidance specific to your situation.
Book a First Botox Consultation
A first visit starts with an exam and a conversation about your goals. Book your first consultation at Citrus Aesthetics and bring the questions above.