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Your first aesthetic consultation, explained

Published Updated 10 min read Drafted with AI assistance and reviewed by the named author. How we work
Short answer

A first visit with a nurse injector is a medical appointment, not a purchase. You describe what you have noticed, the injector takes a history and looks at how your face moves, and a licensed practitioner examines you in a Good Faith Exam before any order is written. The Arizona State Board of Nursing expects that exam before a first treatment, along with written consent. Whether treatment follows the same day depends on the exam and on the clinic's own process.

The short version

A first visit with a nurse injector has a fixed order. You describe what you have noticed. The injector takes a history and looks at how your face moves. A licensed practitioner examines you and decides whether treatment is appropriate, and if so writes the order the nurse works from. You read and sign a consent. Only then does treatment happen, at that visit or a later one. This guide walks through each step as a patient’s reference, with the sources behind it. The short customer-facing version is on the What to expect page. This is general information, not legal or medical advice for your situation.

Why the visit is structured this way

Neuromodulators and dermal fillers are medical procedures. The FDA puts it directly for fillers: the FDA says that having filler injected should be considered a medical procedure, not a cosmetic treatment, and advises patients to ask about the provider's training and experience injecting dermal fillers. In Arizona the structure comes from the Arizona State Board of Nursing’s advisory opinion on medical aesthetic procedures, first approved in July 2011 and revised most recently in November 2025. The Board says an advisory opinion adopted by the Board is its interpretation of what the law requires; it is not law, but it is more than a recommendation. The opinion sorts aesthetic procedures by risk, and neuromodulators and dermal fillers are Level III, advanced procedures, which the opinion's table assigns to registered nurses and advanced practice registered nurses.

Three expectations in that opinion shape a first visit:

  • An examination of the patient by a qualified practitioner before the first treatment. The industry calls it the Good Faith Exam; the section below gives the opinion’s wording.
  • an order by a licensed practitioner is required to initiate a Level II or Level III medical aesthetic procedure.
  • Level III procedures require written informed consent.

The Arizona rules guide explains the opinion in full, including who the supervising practitioner is and what a standing order can and cannot authorize. This page stays with what the rules mean for your appointment.

Before you book

Write down what you have noticed and when it started. A photograph of yourself from a few years ago is useful, because it shows what changed rather than what you dislike today. Then make a list of everything you take: prescription medicines, over-the-counter medicines, vitamins and supplements. The list matters more than most people expect. For neuromodulators, the Botox Cosmetic Medication Guide tells patients to tell their doctor about all their medical conditions, including bleeding problems, planned surgery and previous surgery on the face, about all medicines including vitamins and herbal supplements, and whether they have received any botulinum toxin product in the last four months. For fillers, the FDA says filler injection should be delayed while skin at the site is inflamed or infected, that bleeding disorders and severe allergies or a history of anaphylaxis need to be discussed, and that the safety of fillers is unknown in pregnancy, while breastfeeding, and in people under 22.

If you take a prescribed blood thinner, say so when you book rather than at the visit, so the practitioner can plan around it. Do not stop it on your own; the section on medications below explains why.

Booking and intake

Booking a first visit is booking a consultation and an examination, not a treatment. A clinic that follows the Board’s opinion cannot promise a new patient a specific treatment before a practitioner has examined them, and a careful one will not promise a result at any point, because results vary from person to person.

Intake is the paperwork: identity, contact details, medical history, medications, allergies, previous aesthetic treatments and what was used, pregnancy or breastfeeding status, and the clinic’s policies. Fill it in completely. The history you give is what the practitioner’s examination is built on, and a gap in it is a gap in your safety screen. The clinic will explain its own intake process, including whether forms are completed online beforehand.

The consultation conversation

The consultation is a conversation between you and the injector. You explain what bothers you and what you hope to change. The injector looks at the whole face at rest and in movement, because a line or a hollow is rarely isolated from the structures around it, and asks about your history and your expectations.

A good consultation tells you three things: what is realistic, what the injector would not do, and what the alternatives are, including doing nothing. That is not a courtesy. The Board’s opinion sets it as part of a nurse’s training: a nurse's training for these procedures must cover proper client selection, history taking, physical assessment, indications and contraindications, management of complications, and the ability to articulate realistic and expected outcomes and to describe potential complications and side effects. If something you ask for is not a good idea for your face or your health, the right answer is no, and you should hear it at this stage rather than after the fact.

Tanya’s consultations follow this pattern. She looks at the whole face, says what she would and would not do, and does not treat a new patient before the practitioner’s examination. Pricing and products are discussed at the consultation, not on this page.

A medical consultation and a sales consultation

Most people can feel the difference, but it helps to name it. A medical consultation starts with your history and your face and ends with a plan that may include no treatment. A sales consultation starts with a product or a package and works backwards to a reason you need it.

Signs of a sales consultation:

  • A treatment is recommended before anyone has asked about your medications, allergies or medical history.
  • A result is promised, or shown as if it were typical.
  • You are pressed to decide, pay or book before you leave, or offered a price that expires that day.
  • Risks are waved away, or the consent form is handed over to sign without a conversation.
  • No practitioner examines you, and the explanation is that the injector is experienced.

None of these is illegal on its own. Together they describe a visit organized around a transaction rather than around you. The Board’s opinion does not use the word “sales”, but its structure, an examination by a practitioner, an order, written consent, is the opposite of that pattern. A practice that follows it may still sell packages, and that is not wrong; the question is whether the medical steps come first.

The Good Faith Exam, briefly

Before a first neuromodulator or filler treatment, a licensed practitioner examines you. The Board’s opinion says before any Level II or Level III medical aesthetic treatment, an initial face-to-face examination of the patient should be performed by a qualified licensed practitioner, and telemedicine may be used for that initial exam. The practitioner is not just any licensed person: medical aesthetic procedures are performed under the supervision of a licensed independent practitioner who has medical or surgical training and specific knowledge, skills and abilities in medical aesthetic procedures. In this practice that person is the delegating prescriber Tanya works under.

The examination covers your medical history, medications and supplements, allergies, previous treatments and how you responded, pregnancy or breastfeeding, and anything that would make treatment unwise for you. It ends in a decision: a candidate for a specific plan, a candidate with conditions, or not a candidate for now.

Two things this page does not restate, because they have their own articles: what the exam covers step by step is in What is a Good Faith Exam, and what happens during it?, and the licenses involved are in Who may inject in Arizona. Whether your exam is in person or by live video, and who performs it, is the clinic’s own process; the clinic will explain it when you book.

The patient-specific plan

What comes out of the exam is an order written for you: which treatment, where, and how much, within limits the practitioner sets. The site calls this a patient-specific order. The nurse carries it out and cannot change it on her own; the Arizona rules guide explains what a standing order may and may not authorize.

The plan should be explained to you in plain language before you consent to it. If it includes an area the FDA has not approved for the product, that should be said. the FDA recommends against injecting dermal fillers into the glabella, nose, periorbital area, forehead or neck. Treating such an area is a prescriber’s decision, and the consent should name it as off-label so you know what you are agreeing to.

Written consent is a conversation, then a signature. The Board has a separate advisory opinion on informed consent, and it sets the elements: for a patient to give informed consent, the patient must be advised of the diagnosis if known, the general nature and purpose of the procedure, the alternatives, and the associated risks and benefits, must have all questions answered, and must provide written authorization. It also says who is responsible for that conversation: the responsibility for advising the patient and answering the patient's questions rests with the licensed practitioner or the person who will perform the procedure and may not be delegated; a registered nurse may advise a patient about a procedure the nurse will perform. For a treatment the nurse herself will give, the nurse can be the one who explains it.

The signature is not a formality. The opinion says a nurse who witnesses the consent signature has the right and the ethical obligation to make certain the patient understood the advice given and had their questions answered, and should not obtain the signature if there is any concern that the patient does not understand or still has questions. If you have a question, ask it before you sign. A clinic that hurries this step is telling you something.

Clinical photographs are usually taken before treatment, from standard angles, and again at follow-up. They are part of your medical record and are how the result is assessed against the starting point. Any use beyond the record, on a website or in social media, needs your separate written permission, which you can decline without affecting your care. Ask what the photographs are for and where they are stored.

What can and cannot happen the same day

What cannot happen: a new patient being treated before a practitioner has examined them and written an order, or before written consent. The Board’s opinion sets the order of events, not the clinic’s convenience.

What can happen: once the examination is done, the order is written and consent is signed, treatment can follow at the same visit if the clinic arranges it that way and the plan is straightforward. Many practices build the first visit around the examination for that reason. Whether this clinic offers same-day treatment after the exam, and for which treatments, is its own policy; ask when you book.

There is also a good reason to leave without treatment on a first visit. If the plan involves a decision you want time with, a product you are unsure about, or a medication you need to discuss with another clinician, going home with the plan and returning is the better choice. Nothing about the consultation expires.

Preparing for the visit: medications and supplements

Bruising is the most common nuisance after injections, and some of it is avoidable. bruising was reported in 19 to 24 percent of patients in one filler study and in as many as 68 percent in others. The things that raise the risk are mostly things that thin the blood or weaken small vessels. This section is a summary; a cluster article in this guide, Which medications and supplements raise bruising risk before injections?, goes through them one by one.

The rule that matters most: do not stop a medicine a clinician prescribed because of an aesthetic appointment. prescribed anticoagulants such as warfarin, the newer oral anticoagulants and heparins raise bleeding and bruising risk and should not be stopped without specialist advice. a 2013 review does not recommend discontinuing prescribed anticoagulants before injectable treatment, because they are usually medically necessary. The practitioner decides what to do with that information at the exam.

For things you take by choice, the published advice is more specific, and the figures are in the callout below. One caveat: the supplement window in that consensus comes from surgical practice, and the authors do not set a separate one for injections. Treat it as the cautious end, and ask at the exam.

Numbers

Aspirin and NSAIDs: a 2017 expert consensus advises that aspirin taken for another reason, such as pain relief, be avoided for one week before treatment, and non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen for a similar period. Supplements: fish oil and omega-3 supplements, garlic, high-dose vitamin E, ginkgo biloba and St John's wort may increase bruising, and the general consensus is to avoid them for two weeks before surgical procedures. Alcohol: patients should avoid alcohol for 24 hours before treatment.

Also mention an active cold sore, a dental appointment near the visit, recent illness, or a planned trip or event, since each can change the timing of a treatment. These are discussed at the exam, not decided by you in advance.

Aftercare basics

You leave with written aftercare for your specific treatment and a number to call. The basics are the same across injectables. cold packs within the first 48 hours followed by heat can help a bruise resolve, local compression after injection reduces bruising risk, and exercise should be avoided for the first 24 hours after an aesthetic procedure. Keep your hands off the treated area unless the aftercare says otherwise, and skip the gym that day.

Expect some swelling, redness and tenderness, and possibly a bruise. For neuromodulators, adverse reactions to Botox Cosmetic generally occur within the first week after injection, and localized pain, infection, inflammation, tenderness, swelling, redness and bleeding or bruising may be associated with the injection itself. For fillers, common risks of dermal fillers include bruising, redness, swelling, pain, tenderness, itching and rash, and many resolve in a few days to weeks. Swelling after lip filler has its own timeline, covered in How long does lip filler swelling last?.

Scottsdale adds one variable the literature mostly ignores: heat. A cluster article in this guide, “Does Arizona heat change aftercare for injectables?”, covers it. Until then, follow the written aftercare and ask the clinic about sun, heat and exercise for your treatment.

How follow-up works

Follow-up has two purposes: to check the result once swelling has settled, and to catch anything that is not going as expected. For filler, the result is assessed when swelling is down, with the clinical photographs as the comparison. For neuromodulators, the effect develops over days and is judged once it has settled; the Botox Cosmetic label states that the safety and effectiveness of dosing more frequently than every three months have not been clinically evaluated, so a follow-up is for assessment rather than for more product within that window.

Who you see at follow-up, how it is scheduled, and whether it carries a charge are the clinic’s own process. Returning patients are not re-examined on a schedule the Board sets: the opinion calls for an initial examination before treatment and does not set a schedule for repeating it. Practices set their own policy, and a careful one asks for a new evaluation when your health or medications change. Ask the clinic how it handles this.

Red flags that mean call the clinic

Most reactions after injections are mild and local. A few are not, and the written aftercare should tell you which. The clinic is expected to be ready for them: the practice maintains written policies, procedures or protocols, approved by a qualified practitioner, that give detailed procedures for administering treatments and guidance on responding to adverse effects. And the practitioner remains reachable: for Level III procedures the practitioner is available by telecommunication for consultation or referral and must be able to assess a patient, when the nurse or the patient asks, within a medically reasonable timeframe.

After a neuromodulator: the Botox Cosmetic Medication Guide says to call your doctor or get medical help right away for problems swallowing, speaking or breathing, which can happen hours, days or weeks after an injection, and for signs of an allergic reaction such as wheezing, asthma symptoms, dizziness or feeling faint. These are emergencies, not clinic-hours questions.

After filler: unintentional injection of filler into a blood vessel has been reported to cause tissue death, vision abnormalities including blindness, and stroke, and the FDA says to seek immediate medical attention for unusual pain or vision changes. Skin that turns white, mottled or dusky, pain out of proportion to the injection, or any change in vision is a call to the clinic immediately, and to emergency services if you cannot reach the clinic. What vascular occlusion looks like and why minutes matter.

After either: spreading redness or warmth, fever, a bruise that keeps growing, or anything that worries you. The number you were given at the visit is there to be used; a practice that follows the Board’s structure expects the call.

Checking an injector’s license

Registered nurses, practical nurses and advanced practice nurses in Arizona are licensed by the Arizona State Board of Nursing, and the Board publishes where to verify a license. the Arizona State Board of Nursing's website points its "License Verification (RN/LPN/APRN)" link to Nursys. Nursys describes itself as the only national nurse licensure and disciplinary database, with data supplied directly by boards of nursing, and its QuickConfirm tool lets anyone look up and verify a license from a participating board. A lookup shows whether the license is active and whether there is public discipline. Ask the clinic for the injector’s full name and license type before the visit if you want to check; a licensed injector will not mind.

Beyond the license, the FDA’s advice for fillers applies to any injectable: ask about training and experience with the specific treatment. The article How do I check an injector’s license in Arizona? walks through the lookup step by step.

The clusters in this guide

This pillar is the overview. Each cluster goes deeper on one question, and new ones are added as they are written:

Related guides on this site: Arizona’s rules for nurse injectors, Neuromodulators, explained for patients, and Filler safety.

Sources

  1. Advisory Opinion: Medical Aesthetic Procedures Performed by Licensed Nurses, Licensed Cosmetologist, Licensed Aestheticians and Certified Laser Technologists (approved 7/26/11, revised through 11/25) , Arizona State Board of Nursing Regulator Accessed
  2. Advisory Opinion: Informed Consent (approved 07/12, revised through 01/24) , Arizona State Board of Nursing Regulator Accessed
  3. Advisory Opinions & Position Statements , Arizona State Board of Nursing Regulator Accessed
  4. BOTOX Cosmetic (onabotulinumtoxinA) for injection, Prescribing Information and Medication Guide (revised 10/2024) , AbbVie Manufacturer Accessed
  5. Dermal Fillers (Soft Tissue Fillers) , U.S. Food and Drug Administration Regulator Accessed
  6. The Management of Bruising following Nonsurgical Cosmetic Treatment , Journal of Clinical and Aesthetic Dermatology (PubMed Central) Peer-reviewed Accessed
  7. Minimizing Bruising Following Fillers and Other Cosmetic Injectables , Journal of Clinical and Aesthetic Dermatology (PubMed Central) Peer-reviewed Accessed
  8. Nursys, National Nurse Licensure and Disciplinary Database , National Council of State Boards of Nursing Accessed

Questions readers ask

How long should I allow for a first visit?

Longer than a return visit, because the history, the consultation, the practitioner's examination and the consent discussion all happen before anything else can. The clinic will tell you its usual length when you book; this guide does not set one because it varies with the treatment and with how the examination is arranged.

Do I have to decide on treatment at the first visit?

No. A consultation can end with a plan and no treatment, and a careful practice will be comfortable with that. Going home to think about a plan is a reasonable choice and does not change what you are offered later.

What if I am taking a blood thinner?

Tell the injector and the practitioner before the visit. Prescribed anticoagulants are not stopped for an aesthetic treatment without the advice of the clinician who prescribed them. The practitioner may decide to proceed with extra care, to adjust the plan, or to defer treatment.

Can I have the Good Faith Exam by video?

The Board of Nursing's opinion says telemedicine may be used for the initial examination, so a live video visit with the practitioner can satisfy it. A questionnaire you complete on your own is not an examination by a practitioner. Ask the clinic how it arranges the exam.

Will photographs of me be used in advertising?

Not without your separate written permission. Clinical photographs are part of your medical record and are taken to document your treatment and compare results at follow-up. Any use beyond the record needs a signed release that you can decline.

What should I bring?

A list of every prescription and over-the-counter medicine, vitamin and supplement you take, any diagnoses that matter, the dates and products of previous aesthetic treatments if you know them, and a note of what you have noticed and would like to discuss.

Revision history (1)
  1. update First version, written from the Arizona Board of Nursing opinion and peer-reviewed literature Editorial team

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