Why Don't Patients Ask What's Being Injected Into Their Face?
After more than 25 years in aesthetic medicine, there is one question I have almost never been asked in at our Surrey clinic “Exactly what product are you going to use?”
Patients ask about results, about discomfort, about downtime, about cost. But the specific product going into their face, they very rarely ask. I find this genuinely surprising, and I think it is worth exploring why it matters.
I assume it reflects trust — but trust has limits
With established patients, I suspect the answer is straightforward: they know me, I've treated them over a long period of time, they trust my judgement and assume I will use the very best available product for their needs. That trust is something I take seriously and strive to earn over time.
At the Cosmetic Doctors Company in Surrey, a patient’s trust is something we take very seriously and aim to earn over time.
But new patients, people who have never met me before, also rarely ask. That tells me something different; most patients simply assume that all products are broadly equivalent, that anything used in a legitimate clinic will be safe and effective, and that the choice of product is a technical detail they do not need to concern themselves with.
For prescription medications, that assumption is largely reasonable. For dermal fillers, it is most definitely not.
Botulinum toxin: the prescription medicine (POM) safeguard
Botox is a prescription-only medication. In the UK, it can only be prescribed by a qualified prescriber following a face-to-face consultation. All Botulinum products available through legitimate medical supply chains are licensed, regulated, and subject to rigorous quality control.
The major brands used in aesthetic medicine, and there are several, all with strong safety profiles and extensive clinical evidence behind them, are not meaningfully different in terms of safety.
A patient treated in a properly run clinic by a qualified prescriber will be receiving a product that has been through the full regulatory process.
Read our explanation about Botox Safety.
That said, there are increasing reports of unlicensed, imported Botox products entering the market — particularly in less regulated settings. These products have not been through UK or EU regulatory approval, their provenance cannot be verified, and their safety and efficacy cannot be assumed.
Read worrying reports about fake Botox.
This is another reason why the setting and the practitioner matter as much as the product itself. A prescription-only medication should only ever reach a patient through a legitimate supply and prescribing pathway.
Dermal fillers: a different matter entirely
Dermal fillers are where I have more significant concerns, and where the question of which product is being used becomes genuinely important.
Unlike botulinum toxin, dermal fillers are not prescription medications in the UK. They are classified as medical devices, and until recently that classification carried very little regulatory weight in practice.
The result is a market where products of vastly different quality, origin, and safety profile sit alongside one another, and where patients have almost no way of distinguishing between them.
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The hyaluronic acid fillers I use are established, well-evidenced products from manufacturers with long track records in medical aesthetics. They behave predictably, they integrate well with tissue, and, critically they can be dissolved with hyaluronidase in the event of a complication.
I use Belotero across my filler treatments. A decision I have written about separately, and one that comes down to consistency, predictability, and a long track record for safety in medical aesthetics. For more detail read why I use the Belotero brand as my hyaluronic acid filler.
Cheap, imported fillers of uncertain origin cannot offer those assurances. Some are poorly crosslinked, meaning they degrade unpredictably.
Some have not been tested for biocompatibility to any meaningful standard. Some have a higher tendency to cause inflammatory reactions. And some, if complications arise, may not respond to hyaluronidase in the way a patient and clinician would need them to.
Patients often assume that all hyaluronic acid fillers are essentially the same product at different price points — the way one might think about own-brand versus branded paracetamol.
They are not. The differences in manufacturing process, crosslinking technology, particle size, and purity between a premium medical-grade filler and a cheap imported alternative are substantial, and those differences have real clinical consequences.
So should you ask?
I think you should feel entirely comfortable asking any aesthetic practitioner what product they intend to use and why. A confident, experienced clinician will welcome the question and answer it without hesitation.
The answer itself matters less than the conversation it opens. Because a practitioner who has thought carefully about product selection, who can explain their reasoning, and who uses products with established safety records is almost certainly a practitioner who approaches everything else in the same way.
At The Cosmetic Doctors Company, we use prescription Botox through a fully compliant supply and prescribing pathway, and dermal fillers from manufacturers whose products I have used, trusted, and studied the scientific research literature for many years.
If you want to know exactly which products we use and why, ask me in consultation. I am very happy to tell you.
Also, while we are on the subject of questions you might ask, consider Before Your Dermal Filler Treatment Ask This One Vital Question
Consider Your Next Step
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About the author
Dr Peter Forrester is Medical Director of The Cosmetic Doctors Company in Esher, Surrey. He has practised aesthetic medicine for over 25 years and has extensive experience in non-surgical facial rejuvenation. He believes that all good aesthetic treatment begins with a thorough consultation, honest advice and a commitment to providing safe, natural-looking results for every patient.