When done correctly, fillers and Botox can take years off your face, but on the flip side, a bad injection can make you appear older, or worse—downright scary. Luckily, it’s pretty easy to spot the red flags that indicate a bad injection is heading your way. Here, New York plastic surgeon, Stephen Greenberg, MD, reveals the signs that usually accompany a bad injection appointment.

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Red Flag #1: The room is dirty.
This may seem like a no-brainer, but your dermatologist or plastic surgeon’s office should be very clean. “The biggest red flag you should look out for when heading into your injection appointment is a dirty injection room and injection surface,” explains Dr. Greenberg. “Sterility of the needle, injection room cleanliness and a clean injection surface is so important to ensure the safety and general health of the patient.”

Red Flag #2: The injector isn’t licensed.
“Injectables shouldn’t be offered or performed by non-licensed practitioners or practitioners of specialties other than plastic surgery or dermatology,” says Dr. Greenberg. This is vital information to double check before your appointment, mainly because a non-licensed practitioner might not be experienced enough to give you the outcome you’re looking for.

Red Flag #3: The office has limited product options.
Similar to personalizing the placement of your fillers or Botox, the product brand offerings should be personalized as well (some people react better to certain injectables over others). According to Dr. Greenberg, “there are a great variety of injectable products on the market FDA-approved to treat a variety of facial concerns,” so you should be able to choose the product brand that you prefer.  

Red Flag #4: The injector doesn’t specialize in facial injections.
Similar to a non-licensed injector, doctors who don’t specialize in facial injections might not have the experience to inject according to your unique features, risking an unnatural-looking finish.

Red Flag #5: Your injections are steeply discounted.
If a deal sounds to good to be true, it probably is. “Many practitioners, often non-board certified or of non-cosmetic specialties, will offer steep discounts to attract patients looking for a great deal,” says Dr. Greenberg. “But in practice, I have seen countless patients who price shopped their injectables and have encountered issues that ultimately ended up costing them a lot more than their injectable treatment would have been if they came to see me in the first place.”

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Red Flag #6: The doctor isn't looking at more than just injections.
“A good injector will spend his or her time with you discussing your concerns and cosmetic goals, but a great injector will take it one step further by really planning out not only today’s injection, but a treatment plan moving forward,” says Dr. Greenberg. A treatment plan that includes future or sequential injections, spa services or topical skin care product recommendations can treat your face and skin in totality, making your outcome much better.

Red Flag #7: Your doctor appears nervous.
When you’re sitting in the doctor’s office being prepped for your treatment, your doctor shouldn’t be more nervous than you are. If your injector doesn’t seem confident, appears shaky, or inexperienced, ask for another doctor.