ProductsWhat Happens at a Botox Consultation: A Step-by-Step Guide
"I'd like to come in, but I don't know what I want yet, and I don't want to be talked into anything." Patients tell me that more than anything else. I'm Dr. Debra Jaliman, a board-certified dermatologist who has injected Botox in New York City since 1992. A first Botox consultation is a 30-minute conversation and examination with me, and nothing is decided for you.
In the American Society for Dermatologic Surgery's 2025 consumer survey, concerns about side effects, pain and results were among the reasons people hesitated to book a cosmetic procedure.
Step 1: The paperwork that matters
The parts of the form that matter most are your medical conditions, pregnancy status, medications and past treatments, because each can change the plan. People with neuromuscular conditions such as myasthenia gravis may be at increased risk of serious side effects from Botox. Our Botox treatment page lists them among the reasons not to treat. Botox is also generally avoided during pregnancy and while breastfeeding, so the form asks about both.
The FDA's Botox Cosmetic medication guide asks patients to tell their doctor about all the medicines they take, including vitamins and herbal supplements, so bring a list. Note previous cosmetic treatments and roughly when you had them. Mention any reactions you have had to injectable ingredients. I read your form before I come in, so we don't spend the appointment going back over it.
Step 2: What is bothering you
What is bothering you, described in your own words rather than as a treatment name, is the most useful thing you can tell me. "I look tired in photos" gives me more to work with than "I want Botox."
Looking tired might come from frown lines, hollowing under the eyes or looser skin, and some of those causes need something other than a wrinkle relaxer.
Bring a photo of yourself from a few years ago that you liked. It shows me your proportions at rest, which helps more than a celebrity reference. If you know what bothers you but not what would help, you can book an appointment and we can work it out together.
Step 3: The skin examination
The skin examination happens under good light and sometimes magnification. I am assessing texture, pigment, and laxity, meaning skin that has become looser. I also look at vessel patterns, meaning the small visible blood vessels that show up as redness or broken capillaries.
Then I watch your face move. I will ask you to raise your eyebrows, frown, squint, and smile. A line that looks identical on two people can be driven by different muscles. I look at which lines disappear when your face relaxes and which stay, because a line that is still there at rest usually needs more than a wrinkle relaxer.
Natural asymmetry, such as one brow sitting higher, is noted before anything is done so we both know it was there from the start.
Because my practice covers medical as well as cosmetic dermatology, I also check your skin for medical problems at the same visit. I sometimes find a changing mole or a rough patch during an appointment booked for frown lines. If I do, I point it out and document it, and if it needs a biopsy, we discuss that as its own step. If you want every mole checked, that is a first dermatology appointment in NYC, booked as a medical visit.
Step 4: Building the plan
At this point in a cosmetic dermatology consultation, we build a plan that ranks your priorities and sets what to treat first. I also teach as an Assistant Clinical Professor of Dermatology at the Icahn School of Medicine at Mount Sinai. I explain why each step comes where it does.
A neuromodulator is a wrinkle relaxer, such as Botox, that temporarily relaxes the muscle creating a line. A dermal filler is a gel placed under the skin to restore volume. Many fillers are made of hyaluronic acid, a naturally occurring sugar-based molecule that holds water and keeps skin hydrated.
Botox Cosmetic is a prescription medicine injected into muscles to temporarily improve the look of certain lines. Dermal fillers are medical device implants approved by the FDA, which advises seeking a licensed provider with experience in dermatology or plastic surgery. That is why you are evaluated before anything is injected.
A plan often runs across several visits over a few months. Lines caused by movement, such as frown lines or crow's feet, are often where a neuromodulator comes first. Volume or texture may be better addressed later, once the first step settles.
The plan also covers what treatment is unlikely to deliver and what I would deliberately leave alone. Sometimes the honest answer is that nothing is needed yet. When you want a plan like this for your own face, book an appointment with me.
If you go ahead, I do every injection myself; I do not delegate treatment to a nurse or assistant. Where each injection goes and how much product goes in are judgment calls, and they explain why dermal filler results vary by injector.
Step 5: Photographs, records and next steps
Standardized photographs are taken with the same lighting and angles, your face at rest and in motion, for comparison at later visits.
A written record of the areas discussed and any products used lets each visit build on the last. Every treatment comes with a complimentary two-week follow-up, including a touch-up if needed. At that visit we compare the result with your photographs and adjust if something has settled unevenly.
Before any treatment you give informed consent. That means agreeing only after you have heard what the treatment involves, its risks, how likely it is to work, and your alternatives. If you plan to come back for treatment, preparing for Botox injections usually starts one to two weeks before the appointment.
Can you be treated the same day?
Sometimes yes, and sometimes it makes more sense to wait. Botox results are typically visible in 3 to 5 days, with full results at about two weeks, so an event in the next two weeks can change the timing. For a wedding, it helps to see a cosmetic dermatologist well before your wedding rather than the week of it.
Blood thinners, which raise the risk of bruising, may also mean waiting, and so may an infection where the injections would go, such as a cold sore.
You may simply want time to think. Leaving without booking anything is a normal, expected outcome. You can book a 30-minute consultation on its own and decide about treatment later.
What a Botox consultation covers
The consultation fee covers my time with you: your history, a medical and cosmetic examination, and a plan for what, if anything, is worth treating. The consultation fee is applied toward treatment. Exact pricing depends on your treatment plan and is discussed at your consultation.
FAQ
How long does a Botox consultation take?
A Botox consultation with me takes 30 minutes. That time covers your medical history, a skin examination of your whole face, watching how your face moves, and building a plan together. If you decide to be treated at the same visit, the injections come after the consultation, so allow a little extra time when you book.
Do I need to know what treatment I want?
No, you do not need to know which treatment you want before a Botox consultation. A photo of yourself from a few years ago and a sentence about what bothers you are enough to start. The recommendation comes out of the examination, where the dermatologist checks which muscles drive each line and whether volume or texture is part of the concern. The plan can also cover what to leave alone for now.
Does the consultation fee go toward treatment?
Yes. The consultation fee is applied toward treatment. The fee pays for a board-certified dermatologist's time on your medical history, a medical and cosmetic skin examination, and a treatment plan. Exact pricing depends on your treatment plan and is discussed at your consultation.
Book a 30-minute consultation
At a Botox consultation here, you see me, Dr. Jaliman, from start to finish, and the dermatologist who examines you is the one who treats you. I take your history, check your skin medically as well as cosmetically, and explain a plan you can follow. If you choose treatment, I do every injection myself, and it includes a complimentary two-week follow-up, including a touch-up if needed.
A certificate from the American Board of Dermatology is what to look for in a board-certified dermatologist in NYC. I'm a Diplomate of the American Board of Dermatology and a Fellow of the American Society for Dermatologic Surgery. You can read about my training and credentials.
To book an appointment, visit our Upper East Side office at 931 5th Avenue in Manhattan, or call .
