How Can I Be Sure My Doctor is Using a New Needle when Injecting?

I was just reading a story about a dentist who was using the uncleaned instruments and the same needles on multiple patients, giving them HIV. In the comments, I read several nurses and assistants saying they have seen needles used on multiple people before to save money. Now I am concerned about Botox and filler injections ! I know some docs "save" left over filler and who is to say the medispas are moral enough to use separate needles on people? How can I be sure I am getting a new needle?

Doctor Answers 14

Sharing needles? Medi-spas and the practice of medicine

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This question may not be as far-fetched as it seems.

There is tremendous price pressure on 'injectors' to inject filler or Botox for the lowest cost per unit.  Ads at medi-spas tout ultra low prices, some that approach the cost of the product itself.

How can clinics do things for such a low price, and what are the warning signs?

A patient must trust their injector.  They must trust the product they are receiving.  They must trust the integrity of the finances.

Unfortunately practices are rampant that endanger patient safety, and nothing is being done about them.  Here are the warning signs:

1.  Unclean appearing staff.  

Why can't my injector afford a clean uniform?  What else are they cutting costs on?

2.  Reusing syringes

Did your injector offer to save the unused portion of the syringe for you for next time?  If so, this is an unclean practice that can allow contamination of the product, spoilage, and mixing of patient samples.  It should never be done.  Oops, you just got hepatitis C, well at least you saved $50 on your treatment!  Good luck recovering money to pay for a lifetime of medical costs from a marginally qualified practitioner with no assets and marginal insurance.

3.  Semi-medical setting.  

Nail cutting.  Brow waxing.  Botox.  These unfortunately don't mix well.  Medical treatments should be performed in a medical setting.

4.  Price too good to be true.

How do you know what you are paying per unit?  The patient doesn't know.  It comes down to trust.

So if you are feeling uneasy in your 'injector's' office, move on.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

How can I be sure my doctor is using a new needle when injecting Botox and fillers?

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It is good that you are looking out for your safety when having a Botox treatment. For starters, you should be conscious of the following:

1) Be sure you are receiving the treatment by a board certified physician at a reputable clinic.     They are likely to use a safe and sterile process to administer your injections.

2) If you are concerned, ask them to set up the treatment where you can see.

To address what you mentioned about leftover filler, any leftover filler will be stored and labeled precisely for the patient the next time they arrive. Furthermore, a new needle should be used for the vial the leftover filler is in. As mentioned, ask to see the setup to ensure you are receiving the best possible care for your treatment. I hope this helps, and I wish you the best of luck.

Ensuring your doctor uses clean equipment

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You should not need to ask such questions if you go to a reputable professional such as a dermatologist or plastic surgeon. That said, if you have any funny vibes or are just very concerned, observe as the doctor prepares the botox and fillers, and ask questions about the hygience practiced in the office. Avoid salons and spas to avoid mishaps as they don't have the reputation to maintain as a specialist physician would. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

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Injections and new needles

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If you're visiting a reputable practice, you should be confident that they're using new product with all treatments. If you're concerned, discuss this with your injector, prior to receiving injections.

Sam Naficy, MD, FACS
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How Can I Be Sure My Doctor is Using a New Needle when Injecting?

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 None of the things that you bring up, in your question, should ever occur with fillers, Botox or any medical procedure...ever.  This is why patients should never use the price of a treatment or procedure as the dictating factor on the plastic & cosmetic surgeon they choose.  Choose quality Surgeons that will NOT compromise ever!

Francis R. Palmer, III, MD
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Thanks for raising this issue.

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Hygiene standards need to be absolute to avoid cross contamination which risks transmission of life threatening viruses such as HIV and hepatitis.  Packaging for filler materials are all disposable.  Once a package is opened it must be used.  As a practical reality, the is never a reason for wasting or not using a complete syringe.  Once opened a syringe should not be stored for later use.  There is no way to ensure the sterility of an open package and this increases the risk of cross contamination.  Packages should be opened in front of you.  And yes, if you are not sure if your doctor washed their hands, speak up.

Kenneth D. Steinsapir, MD
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Using new needle when injecting fillers

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It's actually very simple. Ask to see the intact package which the filler came out of. Ask to see needles being opened from the package in front of you. It's not rude or disrespectful to your physician. We present all the fillers intact inside the package on a tray and place on the counter in front of our patients. Patients should be able to trust their physicians and we should do everything we can to allow our patients to have trust in us.

Best Wishes,

Stewart Wang, MD, FACS
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Injection Treatment Safety

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Hi Lidia.  If you are concerned about your injector using new needles, you can watch him or her open the product and/or attach the needle.  If you have to question whether or not the facility you are going to would do this then you are at the wrong facility.  This gets to the heart of the question of discounting in the elective healthcare market.  If you have to worry about your injector buying illegal Botox from Mexico or Canada and re-using needles, then maybe it's better to go to someone that has a reputation for doing things the right way.  Costs a bit more, but will give you piece of mind.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
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Clean Needles and Safety for Injections

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There are several ways to protect yourself from the possibility of problems and contamination from an injection. The first step is to determine who is doing the injections. The place where it is done should be the office of a physician who is trained in the injections. These are generally plastic surgeons, ENT surgeons and specifically trained dermatologists. Most of these will have Expert Injector Credentials ( Secondly, look at the price. If it is the cheapest around, there is usually a reason. Physicians who do a lot of injections can get a small discount on the product, but that will not lower the cost much. The other supplies to make the injection safe are also expensive. Therefore, low prices mean some other area, frequently knowledge or safety, has been compromised. After you get to the office, use your eyes and watch as well as ask questions. The syringes and needles used should be taken out of protective wrappers. If you require a significant amount injection (i.e., more than one syringe), the second syringe and needle should be new. Whatever is used should be thrown away in a red container. The product should be what you are told it is. If you do all this and choose a reputable injector, you should be OK.


Robert T. Buchanan, MD
Highlands Plastic Surgeon

Clean needles for injecting

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The story about the dentist is very similar to something that happened in NV a few years back with a doctor reusing dirty instruments, needles, and single use patient vials on multiple people. He's being prosecuted, but his practices gave several people Hep C. It's terrible. The bottom line is that there will always be unscrupulous people, and it's awful. But you should be able to watch your doctor, or his support staff, set up your aesthetics procedure. When I do treatments I allow patients to be in the rooms for set-ups if they want so they can see that we get clean, sterile items out, and when we are done that we deposit all used items into biohazard containers and such. The practice of "saving" leftovers isn't the best but it should only be done with fillers, and the doctor should have a very specific way of labeling and keeping these fillers separated, dated, and known. Even then when the patient comes back, a new sterile needle should be attached and used. Needles are fractions of a cent, seriously. And as a side note, you can tend to feel a new needle. I don't even use the same needle to draw out of a vial that I use to inject because I want the needle as sharp as possible, and as painless for a patient as can be.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.