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How To Choose an Aesthetic Provider 

Cosmetic surgery and many non-surgical aesthetic treatments involve important health-care decisions. Whether you are considering surgery, injectable treatments, lasers, plasma, microneedling, chemical peels, ultrasound or radiofrequency; the most important choice is not the product or device. It is the person responsible for your care. 

Credentials and experience matter 

For cosmetic surgery, begin with a physician who has recognized specialty training in Plastic and Reconstructive Surgery and whose practice focuses on the type of procedure you are considering. For cosmetic surgery of the face and body, Plastic and Reconstructive Surgery provides the broadest formal specialty training encompassing reconstructive and aesthetic surgery across multiple anatomical regions. This foundation includes knowledge of both surgical and non-surgical strategies. However, formal education must be supported by substantial experience, sound judgment and critical appraisal skills that take time to develop. For facial and neck cosmetic surgery, I would favour a Plastic Surgeon whose practice includes substantial and ongoing experience in facial aesthetic surgery. Select Otolaryngology–Head and Neck Surgeons with appropriate facial plastic surgery training may also be considered. For cosmetic eyelid surgery, an Ophthalmologist with additional oculoplastic training may also be an appropriate choice. 

Understand that the physician “title” used in advertising may not tell the whole story. Ask what residency training the physician completed, how much of their practice is devoted to aesthetic surgery/treatments, and how often they perform the treatment or procedure you are considering. Doctors should not describe themselves as an “expert” or “specialist” unless they connect this with the actual specialty that they have completed. Look for physicians willing to share their personal experience with similar situations and what their confidence is in achieving the results you are looking for. 

Courses and certificates have limits 

Continuing education is essential for health-care professionals. Courses, workshops and conferences can provide valuable education, but attendance or completion of a course is not equivalent to clinical expertise. Expertise develops through formal education, supervised clinical experience, mentorship, repeated practice, critical evaluation of outcomes and experience recognizing and managing complications. 

Watching someone perform a treatment is not the same as being competent to perform it. 

Social media is marketing — not credentialing 

Social-media platforms do not independently verify a provider’s expertise, the accuracy of a biography, the representativeness of before-and-after photographs, or the scientific validity of treatment claims. A large following, a curated social profile or even the title “expert injector” or “industry trainer” does not establish competence. AI searches produce results from searching unfiltered and potentially inaccurate information available online. 

Use social media and a friend’s opinion to learn about a provider, but verify credentials and experience independently. 

For injectable treatments in British Columbia 

My preference is for assessment and medical oversight by an appropriately trained and experienced physician who regularly practises aesthetic medicine. Be cautious of clinics with limited business hours, medical directors who do not perform injections, or medical oversight that changes from day to day. If your injector is an RN or LPN, ask who has assessed you and who provided the required client-specific order. Current BCCNM standards require the ordering health professional — or another health professional who has assumed responsibility for your care — to be present in the facility during the injectable procedure and immediately available for consultation. 

In other words, ask who is medically responsible for you, the credentials of that professional, whether that person will be physically present during your treatment, and what the plan is if a complication develops after you leave. A clinic should not rely on 811 or an emergency department as its routine plan for managing treatment-related concerns. There should be a clear pathway to contact and, when appropriate, be assessed by a qualified professional familiar with your treatment. 

Injectable treatments done well are highly effective and safe. However, they may not be the best or only option. Alternatives and a flexible treatment timeline should be customized for you. 

Do not shop for a device 

Lasers, ultrasound, radiofrequency, microneedling systems and other technologies can be remarkable tools. But a device does not assess you, select the settings, recognize excessive tissue injury or manage a complication. The provider does. 

Do not let a brand name, promotion or low price substitute for credentials, experience and clinical judgment. The same device can produce very different results in different hands. 

Who is doing your treatment is more important than what the device is.

Five questions worth asking 

1. What is your regulated health-care profession and formal specialty training? 

2. How much experience do you have with this treatment and with patients like me? 

3. What alternatives should I consider — including doing nothing? 

4. Who is responsible if a complication occurs? 

5. Am I being educated about my options so that I can make an informed decision—or am I simply being sold a treatment? 

Don’t just choose an injector. Choose a credentialed adviser

A final thought 

After more than three decades of caring for aesthetic patients, I have become convinced that the technical performance of a procedure is not the most important part of excellent care. Good aesthetic medicine requires knowledge, anatomy, experience, judgment, restraint, empathy, continuity of care and personal accountability.

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Regulatory references — British Columbia 

BC College of Nurses and Midwives (BCCNM). Medical aesthetics guidance and applicable practice standards for Registered Nurses and Licensed Practical Nurses. Key requirements include additional education, a client-specific order for injectable drugs/substances or implantable devices, and presence of the ordering or responsible health professional within the facility and immediate availability during the procedure. 

College of Physicians and Surgeons of British Columbia (CPSBC). Practice Standard: Injection of Botulinum Toxin, Dermal Fillers and Venous Sclerotherapy. Key requirements include relevant physician education and training; when ordering a nurse to perform injections, the physician must first assess the patient and ensure that the ordering physician, or another physician who has assumed responsibility, is present within the facility and immediately available at the time of the procedure. 

This guide is intended as general patient education. Professional standards and scopes of practice can change; patients and providers should consult the current standards of the applicable regulatory college. 

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