ProductsI'm Dr. Debra Jaliman, a board-certified dermatologist in New York City. A consultation that goes wrong usually follows the same pattern. You walk in with a vague sense of what bothers you, someone confident tells you what you need, and you agree because disagreeing feels rude.
Ten questions, written down and asked out loud, change that conversation. With these questions to ask before Botox, the answers matter most, so each one below includes a reassuring answer and a vague one. The reassuring answers are the ones I give my own patients. A consultation you leave without booking is a consultation that worked.
If you'd like to know what happens at a Botox consultation, step by step, read that first.
1. Who is going to do this, you or someone else?
A good answer names one person for three jobs: examining you, deciding the dose and injecting you. That matters because a member of the doctor's medical staff sometimes gives the injections.
A reassuring answer: "I'll examine you, I'll decide the dose, and I'll do every injection myself, today and at your follow-up." Here, that person is me. I've injected Botox in New York City since 1992.
A vague answer sounds like "a doctor oversees all our treatments." Oversight isn't the same as holding the needle. For who's allowed to inject in New York, see dermatologist vs. med spa in NYC.
2. Is this an FDA-approved use, or off-label?
A good answer tells you whether the area you're treating is on the label, the FDA's list of approved uses. The current Botox Cosmetic label covers frown lines, crow's feet, forehead lines and moderate to severe neck bands. Other areas, such as the corners of the mouth or the jaw muscle, are off-label. A doctor may prescribe the drug for an unapproved use when they judge it medically appropriate, but the FDA hasn't determined it's safe and effective for that use.
A reassuring answer: "Your frown lines are an approved area. The jaw is off-label, so here's what we know about it and what we don't."
A vague answer sounds like "it's all the same Botox." It's the same drug, but some areas have more research behind them.
3. What are you seeing when you look at my face?
A good answer explains what's causing each line before it names a product. Ask the doctor to show you in a mirror which lines are there at rest and which appear only when you move.
A reassuring answer: "Your frown lines deepen when you concentrate, but the hollow under your eyes is there even when your face is still, which is a different conversation."
A vague answer sounds like "you'd be perfect for Botox," said before anyone's watched you frown or smile. Before I choose a dose or injection pattern (where each injection goes), I look at your facial anatomy, muscle strength, expressions and goals.
4. Is this the right treatment for what's bothering me, or is there something better?
A good answer tells you what Botox won't change, even when you came in asking for it. Botox temporarily relaxes muscles that crease the skin. Filler can restore lost fullness, a gel injected under the skin, and texture or dullness usually needs a different treatment.
A reassuring answer: "Botox would soften that line, but it won't fill the hollow, and the dullness usually responds better to a peel or a laser."
A vague answer sounds like "sure, we can do that," with no question back about what bothers you.
5. What are you not treating, and why?
A good answer names the areas the doctor plans to leave alone and gives a reason tied to how your face moves. Few people ask this question, and the answer shows whether anyone is thinking about restraint.
It works because dermatologists inject only enough to relax the targeted muscles so patients keep their natural expressions.
A reassuring answer: "I'm leaving the lines around your eyes alone, because they're part of how you smile."
A vague answer sounds like "we could do it all today," with no sense of what matters most to you.
6. What will I look like at two weeks, and at four months?
A good answer gives you both time points. The effect usually settles by about two weeks, and movement often starts to return at three to four months. Results vary, and not all people have visible results. With repeat treatment, the muscle may thin, and results may last longer.
A reassuring answer: "By about four months you'll probably see some movement coming back. That's normal, and we'll plan your next visit around it."
A vague answer sounds like "you'll look amazing," with no timeline and no range.
7. What happens if I don't like the result?
A good answer separates what can be adjusted from what has to wear off. If an area still moves more than you'd like, a little more Botox can often be added. If it's too strong, the answer is time, because the effect wears off on its own as muscles regain movement.
A reassuring answer: "I'd rather add a little at two weeks than overdo it today."
I include a complimentary two-week follow-up with Botox, plus additional Botox at no charge if you need it. The follow-up is for Botox only.
A vague answer sounds like "don't worry, everyone loves it."
8. What's normal in the first week, and what means I should call right away?
A good answer gives you two lists. Mild redness, swelling or bruising is common, and bruising lasts about one week. Some signs can't wait. If you have muscle weakness, vision or breathing problems, or trouble talking or swallowing, call your provider right away.
A reassuring answer: "A small bruise can wait for your two-week visit. Changes in your vision, swallowing or breathing mean you call right away."
A vague answer sounds like "everyone's fine, don't worry about it," with no list and no one to call.
9. What should I tell you, or stop taking, before treatment?
A good answer starts with questions about your health history. By reviewing your medical history, a dermatologist can tell you whether you have a higher risk. Tell your dermatologist about all pain relievers, blood thinners and other medicines, including ones you buy without a prescription, such as aspirin. Include herbs, vitamins and minerals, even ones you haven't taken for a while. Mention past surgeries and cosmetic treatments, and whether you're pregnant or planning to be.
A reassuring answer: "Give me the whole list, even the vitamin you stopped last month, and I'll tell you if anything needs to change first."
A vague answer sounds like "you look healthy, let's get started," said before anyone asks what you take.
10. How is this priced, and what does the whole plan involve over a year?
A useful answer covers the whole plan for the year. Ask which areas would be treated and how often you'd come back.
Here, Botox is priced by treatment area, and I go through exact pricing at the consultation.
A reassuring answer: "I'd treat these two areas, you'd likely come back every three to four months, and I'll map out the year with you."
A vague answer sounds like "let's just start and see," with no plan beyond today.
The ten questions to ask before Botox, or any cosmetic treatment
- Who is going to do this, you or someone else?
- Is this an FDA-approved use, or off-label?
- What are you seeing when you look at my face?
- Is this the right treatment for what's bothering me, or is there something better?
- What are you not treating, and why?
- What will I look like at two weeks, and at four months?
- What happens if I don't like the result?
- What's normal in the first week, and what means I should call right away?
- What should I tell you, or stop taking, before treatment?
- How is this priced, and what does the whole plan involve over a year?
You don't need to arrive knowing product names or having picked a treatment. You don't need to justify why something bothers you, either.
FAQ
Is it rude to ask a dermatologist this many questions?
No. A careful doctor expects them. If ten feels like a lot, start with 1, 3, and 5.
Should I write down the answers?
Yes. At two weeks, you can check the result against what you were told.
What if a good answer and a vague answer both sound reasonable?
Ask one follow-up: "What does that mean for my face?" A good answer gets more specific. If it stays general, you can leave without booking. If you're deciding between offices, the six checks worth comparing between NYC cosmetic dermatology practices cover more than the conversation.
Bring the list to your consultation
Bring these questions and ask every one. I'm glad when patients do. At your 15-minute consultation, I examine your whole face first, explain what's causing the change that bothers you, and recommend only what fits. That includes telling you when Botox isn't the answer. If you choose Botox, I'll see you again at two weeks to check how it's settled. Read about my background and academic appointment and how I approach Botox, including who should avoid it. When you're ready, request an appointment at 931 5th Avenue on the Upper East Side.
